Nilas L, Christiansen C
Department of Clinical Chemistry, Glostrup Hospital, Denmark.
Eur J Clin Invest. 1988 Oct;18(5):529-34. doi: 10.1111/j.1365-2362.1988.tb01052.x.
We have followed the changes in bone mass over 2 years in 42 premenopausal, seven perimenopausal and 76 postmenopausal women. The latter had passed a natural menopause between 6 months and 7 years previously. Bone mass was measured every 3 months at the proximal and distal forearm sites by single photon absorptiometry, and every 6 and 12 months in the lumbar spine and whole body by dual photon absorptiometry. The relative content of trabecular bone is approximately 15, 50, 60 and 20% at these four sites. Before the menopause there was a significantly low rate of bone loss from the two forearm sites and the whole body, whereas the spinal loss was insignificant. The rate of loss was five- to ten-fold higher at all sites after the menopause (P less than 0.001). With increasing menopausal duration the rate of loss declined at the two forearm sites and whole body (P less than 0.01). The distal forearm loss was larger than the proximal, both before and after the menopause (P less than 0.01). From the forearm results we thus conclude that a slightly larger loss of trabecular than cortical bone takes place both before and immediately after the menopause. The loss of both types of bone is, however, much larger after the menopause and this rapid bone loss seems to take place throughout the skeleton.
我们对42名绝经前、7名围绝经期和76名绝经后女性的骨量变化进行了为期两年的跟踪研究。后者在6个月至7年之前经历了自然绝经。通过单光子吸收法每3个月测量一次前臂近端和远端部位的骨量，通过双光子吸收法每6个月和12个月测量一次腰椎和全身的骨量。这四个部位小梁骨的相对含量分别约为15%、50%、60%和20%。绝经前，两个前臂部位和全身的骨量流失率显著较低，而脊柱的骨量流失不显著。绝经后，所有部位的骨量流失率高出五至十倍（P<0.001）。随着绝经时间的延长，两个前臂部位和全身的骨量流失率下降（P<0.01）。绝经前后，前臂远端的骨量流失均大于近端（P<0.01）。因此，从前臂的研究结果我们得出结论，绝经前和绝经后即刻，小梁骨的流失略大于皮质骨。然而，绝经后两种类型骨的流失都要大得多，而且这种快速的骨量流失似乎发生在整个骨骼中。
