一名老年人的肢端肥大症与股骨近端骨折：骨组织形态计量学、维生素D代谢产物及甲状旁腺激素

Acromegaly and proximal femoral fracture in an aged person: bone histomorphometry, vitamin D metabolites and parathormone.

作者信息

Lowenthal M N, Galinsky D, Fried V, Castel H, Shany S, Gazit D

机构信息

Department of Geriatric Medicine, Soroka Medical Center, Beer Sheva, Israel.

出版信息

Isr J Med Sci. 1990 May;26(5):280-3.

PMID:2380027

Abstract

Osteoporosis and fractures are rare in acromegaly. An 84-year-old acromegalic woman sustained a fractured neck of femur in a fall. Histomorphometric analysis of an iliac crest biopsy showed marked osteoporosis and augmented resorption parameters. Cortical plates were very thin and bone volume was 8.5%; 12.5% is the reference value for women at this age. The total resorption surfaces were 23.7% compared with the reference value of 8%. We conjecture that postmenopausal and involutional osteoporosis were far advanced before the development of acromegaly, explaining the coexistence of the two conditions. Parathormone (65 pmol/l) and 24,25-dihydroxyvitamin D (1.34 ng/ml) levels were within normal limits, but those of 25-hydroxyvitamin D (5.6 ng/ml) and 1,25-dihydroxyvitamin D (15 pg/ml) were markedly decreased.

摘要

骨质疏松症和骨折在肢端肥大症中较为罕见。一名84岁的肢端肥大症女性在一次跌倒中发生了股骨颈骨折。对髂嵴活检进行组织形态计量学分析显示存在明显的骨质疏松症且吸收参数增加。皮质骨板非常薄，骨体积为8.5%；该年龄女性的参考值为12.5%。总吸收表面积为23.7%，而参考值为8%。我们推测绝经后和衰老性骨质疏松症在肢端肥大症发生之前就已非常严重，这解释了这两种情况的并存。甲状旁腺激素（65 pmol/l）和24,25 - 二羟维生素D（1.34 ng/ml）水平在正常范围内，但25 - 羟维生素D（5.6 ng/ml）和1,25 - 二羟维生素D（15 pg/ml）水平明显降低。