Eastell R, Wahner H W, O'Fallon W M, Amadio P C, Melton L J, Riggs B L
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905.
J Clin Invest. 1989 Jan;83(1):168-74. doi: 10.1172/JCI113854.
We measured bone mineral density (BMD) at the lumbar spine (LS-BMD) and ultradistal radius (UDR-BMD) in 42 postmenopausal normal women and in 108 postmenopausal osteoporotic women (55 with vertebral fracture, 34 with Colles' fracture, and 19 with both fractures). By receiver operating characteristic analysis, LS-BMD was better than UDR-BMD (P less than 0.01) as an indicator of vertebral fracture; the converse was true for Colles' fracture (P less than 0.01). Although UDR-BMD and LS-BMD were lower in each of the three fracture groups than in controls (P less than 0.01), the pattern of bone loss differed (P less than 0.001, analysis of variance): with vertebral fracture, LS-BMD decreased relatively more than UDR-BMD; with Colles' fracture, UDR-BMD decreased relatively more than LS-BMD; and with both fractures, decreases in LS-BMD and UDR-BMD were similar. We conclude that both types of fracture are caused by excessive bone loss but the difference in bone loss at the two sites is a major factor in determining which will fracture.
我们测量了42名绝经后正常女性以及108名绝经后骨质疏松女性（55名患有椎体骨折，34名患有Colles骨折，19名两种骨折均有）的腰椎骨密度（LS - BMD）和桡骨远端骨密度（UDR - BMD）。通过受试者工作特征分析，作为椎体骨折的指标，LS - BMD优于UDR - BMD（P < 0.01）；对于Colles骨折则相反（P < 0.01）。尽管三个骨折组中UDR - BMD和LS - BMD均低于对照组（P < 0.01），但骨丢失模式有所不同（方差分析，P < 0.001）：对于椎体骨折，LS - BMD的下降相对大于UDR - BMD；对于Colles骨折，UDR - BMD的下降相对大于LS - BMD；对于两种骨折均有的情况，LS - BMD和UDR - BMD的下降相似。我们得出结论，两种类型的骨折均由过度骨丢失引起，但两个部位骨丢失的差异是决定哪个部位会发生骨折的主要因素。
