Crockett K, Arnold C M, Farthing J P, Chilibeck P D, Johnston J D, Bath B, Baxter-Jones A D G, Kontulainen S A
School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada.
Osteoporos Int. 2015 Oct;26(10):2461-9. doi: 10.1007/s00198-015-3160-8. Epub 2015 May 23.
Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk.
The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF.
One hundred sixty-six postmenopausal women (50-78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6-24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA).
There was a significant group difference (p < 0.05) for the forearm and lower leg, with the Fx group demonstrating 16 and 19% lower BSIc, 3 and 6% lower muscle density, and 20 and 21% lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures.
Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.
50岁以上女性桡骨远端（手腕）骨折（DRF）是骨脆性的早期迹象。与未发生DRF的女性相比，近期发生DRF的女性骨强度、肌肉密度和力量较低，但在双能X线吸收法（DXA）测量中无差异，这表明仅DXA可能不足以预测DRF风险。
本研究的目的是调查近期发生DRF和未发生DRF的女性在骨骼和肌肉特性方面的差异。
招募了166名绝经后女性（50 - 78岁）。如果参与者在过去6个月内服用过改变骨骼的药物，或患有严重影响日常生活或上肢的疾病，则将其排除。对77名年龄匹配的女性进行了骨骼和肌肉特性测量，其中32名在过去6 - 24个月内发生骨折（Fx组），45名未发生骨折（NFx组），使用非优势侧（NFx组）或未骨折肢体（Fx组）进行测量。采用外周定量计算机断层扫描（pQCT）评估桡骨远端和胫骨的压缩骨强度（BSIc）、骨干部位的扭转骨强度（SSIp）、肌肉密度以及前臂和小腿的面积。通过DXA测量超远端前臂、脊柱和股骨颈的骨面积密度。使用握力和30秒椅子站立测试评估上肢和下肢肌肉力量。使用多变量方差分析（MANOVA）比较组间肢体特异性差异。
在前臂和小腿方面存在显著的组间差异（p < 0.05），Fx组的桡骨远端和胫骨BSIc分别低16%和19%，肌肉密度分别低3%和6%，上肢和下肢肌肉力量分别低20%和21%。DXA测量的组间无差异。
近期发生DRF的女性桡骨远端和胫骨的pQCT衍生估计骨强度较低，且四肢的肌肉密度和力量也较低。
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