绝经前小梁骨丢失与脆性骨折家族史相关。

Premenopausal Trabecular Bone Loss is Associated with a Family History of Fragility Fracture.

作者信息

Prior J C, Hitchcock C L, Vigna Y M, Seifert-Klauss V

机构信息

Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada; Dept. of Medicine, University of British Columbia, Vancouver, BC, Canada; Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.

Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada.

出版信息

Geburtshilfe Frauenheilkd. 2016 Aug;76(8):895-901. doi: 10.1055/s-0042-103751.

DOI:10.1055/s-0042-103751

PMID:27582584

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5000784/

Abstract

INTRODUCTION

Although a fragility fracture family history (FFFH+) has repeatedly been shown to be associated with lower bone mineral density (BMD), its relationship to human BMD is unclear. Animal research, however, documented that different purebred strains within rodent species have wide ranges in rates of bone acquisition during growth as well as in change post-ovariectomy. Our objective was to compare the rate of premenopausal spinal trabecular BMD change between women with and without a general family history of fragility fracture.

PARTICIPANTS AND METHODS

Healthy premenopausal community women participated in prospective observational studies at two academic medical research centres: Vancouver, Canada (n = 66) and Munich, Germany (n = 20). The primary outcome was annual spinal BMD change, measured by quantitative computed tomography (QCT). The two studies employed similar methodologies for assessing QCT and FFFH.

RESULTS

Volunteer community participants had a mean age of 36.0 (SD, 6.9) years, body mass index 22.5 (2.4) and baseline QCT of 150.2 (22.5) mg/cm trabecular bone. The rates of BMD change were similar in both cities: - 3.5 (5.1)/year Vancouver, - 2.0 (3.4)/year Munich (95 % CI of difference: - 3.9, 0.9). Over a third of the women (31 of the 86, 36 %) reported FFFH+. Those with and without a FFFH were similar in demographics, nutrition, exercise, menstrual cycle and luteal phase lengths and physiological measures (serum calcium, osteocalcin and estradiol). However, women with FFFH+ lost trabecular BMD more rapidly: FFFH+, - 4.9 (5.0), FFFH-, - 2.2 (4.4) mg/cm/year (95 % CI diff - 0.7 to - 4.8, F = 7.88, p = 0.006). FFFH+ explained 7.7 % of the variance in QCT volumetric trabecular spinal bone change/year in these healthy premenopausal women.

CONCLUSION

This study shows for the first time that having a history of a fragility fracture in a family member is associated with a greater rate of premenopausal spinal trabecular bone loss.

摘要

引言

尽管脆性骨折家族史（FFFH+）已多次被证明与较低的骨矿物质密度（BMD）相关，但其与人类骨密度的关系尚不清楚。然而，动物研究表明，啮齿动物物种内不同的纯种品系在生长期间的骨获取率以及卵巢切除术后的变化方面存在很大差异。我们的目的是比较有和没有脆性骨折家族史的绝经前女性脊柱小梁骨密度的变化率。

参与者和方法

健康的绝经前社区女性在两个学术医学研究中心参与了前瞻性观察研究：加拿大温哥华（n = 66）和德国慕尼黑（n = 20）。主要结局是通过定量计算机断层扫描（QCT）测量的年度脊柱骨密度变化。两项研究采用了相似的方法来评估QCT和FFFH。

结果

志愿者社区参与者的平均年龄为36.0（标准差，6.9）岁，体重指数为22.5（2.4），基线QCT小梁骨为150.2（22.5）mg/cm。两个城市的骨密度变化率相似：温哥华每年为 -3.5（5.1），慕尼黑每年为 -2.0（3.4）（差异的95%置信区间：-3.9，0.9）。超过三分之一的女性（86名中的31名，36%）报告有FFFH+。有和没有FFFH的女性在人口统计学、营养、运动、月经周期和黄体期长度以及生理指标（血清钙、骨钙素和雌二醇）方面相似。然而，有FFFH+的女性小梁骨密度丢失更快：FFFH+组为每年 -4.9（5.0）mg/cm，FFFH-组为每年 -2.2（4.4）mg/cm（差异的95%置信区间为 -0.7至 -4.8，F = 7.88，p = 0.006）。在这些健康的绝经前女性中，FFFH+解释了每年QCT体积小梁脊柱骨变化方差的7.7%。