Endocrine Centre, Heidelberg Repatriation Hospital, Austin Health, Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia.
J Bone Miner Res. 2011 Jul;26(7):1577-83. doi: 10.1002/jbmr.360.
Skeletal fragility is common at metaphyseal regions of long bones. The cortices of this region are derived by coalescence of trabeculae around the periphery of the growth plate, not by periosteal apposition, as occurs in the diaphyses. We therefore hypothesized that trabecular bone in childhood predicted both cortical and trabecular morphology in adulthood. To test this hypothesis, we measured distal radial and tibial structure using high-resolution peripheral quantitative computed tomography in 61 daughter-mother pairs, mean age 12.5 years (range 7 to 19 years) and 44.1 years (range 32 to 50 years), respectively. The daughters' trabecular bone volume (BV/TV), thickness, number, and separation predicted the corresponding traits in their mothers. Their trabecular BV/TV also predicted their mothers' cortical thickness (r = 0.32, p = .02). By contrast, the daughters' cortical thickness did not predict their mothers' cortical thickness. The daughters had higher trabecular BV/TV than their mothers (mean ± SD, radius 0.134 ± 0.024 versus 0.124 ± 0.033, p = .03; tibia 0.145 ± 0.021 versus 0.135 ± 0.032, p < .01) owing to greater trabecular number, not thickness, and less trabecular separation. Abnormalities in the development of metaphyseal trabecular bone are likely to influence fragility in both trabecular and cortical bone of this region in adulthood.
骨骼脆弱在长骨的干骺端区域很常见。该区域的皮质由生长板周围的小梁融合而成,而不是像骨干那样通过骨膜外成骨形成。因此,我们假设儿童时期的小梁骨可以预测成年后皮质和小梁的形态。为了验证这一假设,我们使用高分辨率外周定量 CT 对 61 对母女(平均年龄 12.5 岁,范围为 7 至 19 岁和 44.1 岁,范围为 32 至 50 岁)的桡骨远端和胫骨进行了结构测量。女儿的小梁骨体积(BV/TV)、厚度、数量和分离度预测了其母亲的相应特征。她们的小梁骨 BV/TV 也预测了其母亲的皮质厚度(r = 0.32,p =.02)。相比之下,女儿的皮质厚度并不能预测其母亲的皮质厚度。女儿的小梁骨 BV/TV 高于母亲(平均值 ± SD,桡骨 0.134 ± 0.024 比 0.124 ± 0.033,p =.03;胫骨 0.145 ± 0.021 比 0.135 ± 0.032,p <.01),这是由于小梁数量增加,而不是厚度增加,以及小梁分离减少所致。干骺端小梁骨发育异常可能会影响该区域成年后小梁骨和皮质骨的脆弱性。