Karaaslan Fatih, Mutlu Mahmut, Mermerkaya Musa Uğur, Karaoğlu Sinan, Saçmaci Şerife, Kartal Şenol
Department of Orthopaedics and Traumatology, Faculty of Medicine, Bozok University, Yozgat, Turkey.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Clin Interv Aging. 2014 Aug 18;9:1375-82. doi: 10.2147/CIA.S66354. eCollection 2014.
This study examined the role of trace elements in osteoporosis by comparing the trace-element concentrations in bone and the radiographic bone density and bone mineral density (BMD) of patients with osteoporotic femur fractures and osteoarthritis.
The study enrolled 30 patients operated on for proximal femoral fractures after falls, and another 30 patients undergoing hip arthroplasty at the same center for hip osteoarthritis. Bone samples were obtained during the surgical procedures. The density of the bone samples was assessed using computed tomography and the Hounsfield scale. The levels of Ca(II), Mg(II), and other trace elements in the bone samples were determined using flame atomic absorption spectrometry and inductively coupled plasma mass spectrometry. In addition, BMD, Z-scores, and T-scores were measured in the unaffected hips of all patients using dual-energy X-ray absorptiometry.
Magnesium (1,908 ± 507 versus 2,540 ± 435, P<0.05), calcium (10.4 ± 3.5 versus 13.9 ± 3.7, P<0.05), and zinc (2,342 ± 1,252 versus 3,145 ± 1,604, P<0.05) μg g(-1), levels were significantly lower in the bone samples in the fracture group. The groups did not differ in the other biochemical parameters. All dual-energy X-ray absorptiometry findings were significantly worse in the fracture group than in the osteoarthritis group. However, the groups did not differ in femoral neck density assessed radiologically using the Hounsfield scale. The following parameters were negatively correlated with age: magnesium, r=-0.436, P<0.001; calcium, r=-0.331, P=0.01; T-score, r=-0.381, P=0.003; Z-score, r=-0.267, P=0.043; and BMD, r=-0.365, P=0.004.
Ca(II), Mg(II), and Zn(II) appear to play important roles in bone breakdown/synthesis. Further studies of the roles of trace elements in the etiology and treatment of osteoporosis are warranted. We found decreased bone levels of Ca, Mg, and Zn in patients with osteoporotic fractures compared to subjects with osteoarthritis.
本研究通过比较骨质疏松性股骨骨折患者和骨关节炎患者骨骼中的微量元素浓度、X线骨密度及骨矿物质密度（BMD），来探讨微量元素在骨质疏松症中的作用。
本研究纳入了30例因跌倒导致股骨近端骨折而接受手术的患者，以及另外30例在同一中心因髋骨关节炎接受髋关节置换术的患者。在手术过程中获取骨样本。使用计算机断层扫描和亨氏单位对骨样本的密度进行评估。使用火焰原子吸收光谱法和电感耦合等离子体质谱法测定骨样本中Ca(II)、Mg(II)及其他微量元素的水平。此外，使用双能X线吸收法测量所有患者未受影响髋部的BMD、Z值和T值。
骨折组骨样本中的镁（1908±507对2540±435，P<0.05）、钙（10.4±3.5对13.9±3.7，P<0.05）和锌（2342±1252对3145±1604，P<0.05）μg g(-1)水平显著较低。两组在其他生化参数方面无差异。骨折组所有双能X线吸收法检查结果均显著差于骨关节炎组。然而，使用亨氏单位进行放射学评估时，两组在股骨颈密度方面无差异。以下参数与年龄呈负相关：镁，r=-0.436，P<0.001；钙，r=-0.33,1，P=0.01；T值，r=-0.381，P=0.003；Z值，r=-0.267，P=0.043；以及BMD，r=-0.365，P=0.004。
Ca(II)、Mg(II)和Zn(II)似乎在骨分解/合成中起重要作用。有必要进一步研究微量元素在骨质疏松症病因学和治疗中的作用。我们发现，与骨关节炎患者相比，骨质疏松性骨折患者骨骼中的钙、镁和锌水平降低。
