Rheumatology Division, Faculdade Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3o andar, sala 3193, Sao Paulo, 01246-903, Brazil.
Osteoporos Int. 2017 Apr;28(4):1335-1346. doi: 10.1007/s00198-016-3876-0. Epub 2016 Dec 15.
In a cross-sectional cohort of 450 healthy women aged 20 to 85 years, data on the density, structure, and strength of the distal radius and tibia were obtained using high-resolution peripheral quantitative computed tomography (HR-pQCT) and were adjusted for age, weight, and height. Age-dependent patterns of change differed between the sites and between the trabecular and cortical compartments. In postmenopausal women, the trabecular bone remained relatively stable at the distal tibia, but the cortical compartment changed significantly. Cortical porosity exhibited a very weak correlation with stiffness.
The aim of this study is to provide information on age-related, weight-related, and height-related changes in the volumetric bone mineral density (vBMD), structure, and biomechanical parameters of the cortical and trabecular compartments in a healthy female population using HR-pQCT.
For a cross-sectional Brazilian cohort of 450 women aged 20 to 85 years, age-related reference curves of the vBMD, structure, and biomechanical parameters of the distal radius (DR) and distal tibia (DT) were constructed and adjusted for weight and height, and comparisons between premenopausal and postmenopausal women were performed.
Reference curves were obtained for all parameters. At the DR, age-related changes varied from -8.68% (cortical thickness [Ct.Th]) to 26.7% (trabecular separation [Tb.Sp]). At the DT, the changes varied from -12.4% (Ct.Th) to 26.3% (Tb.Sp). Cortical porosity (Ct.Po) exhibited the largest percent changes: 342.2% at the DR and 381.5% at the DT. In premenopausal women, Ct.Th remained constant; in postmenopausal women, structural trabecular parameters (trabecular number (Tb.N), trabecular thickness (Tb.Th), Tb.Sp) did not change, whereas cortical parameters and stiffness were significantly altered. Cortical vBMD showed the greatest absolute decrease at both sites, and the slopes were highly negative after menopause. Pearson correlations between stiffness (S) and HR-pCT parameters revealed a significant correlation between the densities and structures of the trabecular and cortical compartments. A weak correlation was observed between S and Ct.Po (DR r = -0.162, DT r = -0.273; p < 0.05).
These data provide reference curves from healthy women and demonstrate that density and structural and biomechanical parameters differ between the radius and tibia and between the trabecular and cortical compartments. In postmenopausal women, the trabecular bone remained relatively stable at the tibia site, whereas the cortical compartment changed significantly.
本研究旨在使用高分辨率外周定量计算机断层扫描(HR-pQCT)提供关于健康女性人群桡骨和胫骨皮质和小梁骨的体积骨密度(vBMD)、结构和生物力学参数的与年龄、体重和身高相关的变化信息。
对于一个 450 名年龄在 20 至 85 岁的巴西女性的横断面队列,构建了桡骨远端(DR)和胫骨远端(DT)的 vBMD、结构和生物力学参数的年龄参考曲线,并根据体重和身高进行了调整,还比较了绝经前和绝经后女性之间的差异。
获得了所有参数的参考曲线。在 DR 处,年龄相关的变化范围从 -8.68%(皮质厚度[Ct.Th])到 26.7%(小梁间隔[Tb.Sp])。在 DT 处,变化范围从 -12.4%(Ct.Th)到 26.3%(Tb.Sp)。皮质孔隙率(Ct.Po)表现出最大的百分比变化:DR 处为 342.2%,DT 处为 381.5%。在绝经前妇女中,Ct.Th 保持不变;在绝经后妇女中,结构小梁参数(小梁数量(Tb.N)、小梁厚度(Tb.Th)、Tb.Sp)没有变化,而皮质参数和刚度则显著改变。皮质 vBMD 在两个部位的绝对下降最大,绝经后斜率为负。刚度(S)与 HR-pCT 参数之间的 Pearson 相关性显示,小梁和皮质骨的密度和结构之间存在显著相关性。S 与 Ct.Po 之间观察到弱相关性(DR r = -0.162,DT r = -0.273;p < 0.05)。
这些数据提供了健康女性的参考曲线,并表明桡骨和胫骨以及小梁和皮质骨之间的密度和结构以及生物力学参数存在差异。在绝经后妇女中,胫骨部位的小梁骨相对稳定,而皮质骨明显变化。