Leni and Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, New York, New York 10029, USA.
J Bone Miner Res. 2009 Dec;24(12):1969-80. doi: 10.1359/jbmr.090525.
Adults acquire unique sets of morphological and tissue-quality bone traits that are predictable based on robustness and deterministic of strength and fragility. How and when individual trait sets arise during growth has not been established. Longitudinal structural changes of the metacarpal diaphysis were measured for boys and girls from 3 mo to 8 yr of age using hand radiographs obtained from the Bolton-Brush collection. Robustness varied approximately 2-fold among boys and girls, and individual values were established by 2 yr of age, indicating that genetic and environmental factors controlling the relationship between growth in width and growth in length were established early during postnatal growth. Significant negative correlations between robustness and relative cortical area and a significant positive correlation between robustness and a novel measure capturing the efficiency of growth indicated that coordination of the subperiosteal and endocortical surfaces was responsible for this population acquiring a narrow range of trait sets that was predictable based on robustness. Boys and girls with robust diaphyses had proportionally thinner cortices to minimize mass, whereas children with slender diaphyses had proportionally thicker cortices to maximize stiffness. Girls had more slender metacarpals with proportionally thicker cortices compared with boys at all prepubertal ages. Although postnatal growth patterns varied in fundamentally different ways with sex and robustness, the dependence of trait sets on robustness indicated that children sustained variants affecting subperiosteal growth because they shared a common biological factor regulating functional adaptation. Considering the natural variation in acquired trait sets may help identify determinants of fracture risk, because age-related bone loss and gain will affect slender and robust structures differently.
成年人获得独特的形态和组织质量骨特征集，这些特征集可根据坚固性和强度及脆性的确定性进行预测。个体特征集在生长过程中是如何以及何时出现的尚未确定。使用从 Bolton-Brush 收藏中获得的手部射线照片，对 3 个月至 8 岁的男孩和女孩的掌骨干骺进行了纵向结构变化测量。男孩和女孩的坚固性差异约为 2 倍，个体值在 2 岁时确立，表明控制宽度和长度生长之间关系的遗传和环境因素在出生后生长的早期就已经建立。坚固性与相对皮质面积之间存在显著负相关，坚固性与捕捉生长效率的新指标之间存在显著正相关，这表明骨膜下和内皮质表面的协调性使该人群获得了一组狭窄的特征集，这些特征集可以根据坚固性进行预测。坚固骨干骺的男孩和女孩的皮质相对较薄，以最小化质量，而细长骨干骺的儿童皮质相对较厚，以最大化刚度。与男孩相比，所有青春期前的女孩的掌骨都更细长，皮质相对较厚。尽管性别的性别和坚固性以根本不同的方式影响了出生后的生长模式，但特征集对坚固性的依赖表明，儿童承受了影响骨膜下生长的变体，因为它们共享调节功能适应的共同生物因素。考虑到获得的特征集的自然变化可能有助于确定骨折风险的决定因素，因为与年龄相关的骨质流失和增加将以不同的方式影响细长和坚固的结构。
