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维生素 D 是否会影响保守治疗的绝经后桡骨远端骨折后容积骨密度和骨结构的变化?

Does Vitamin D affects changes in volumetric bone mineral density and architecture in postmenopausal women after conservatively treated distal radius fractures?

机构信息

Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece.

Department of Orthopaedics and Traumatology, 251 HAF - VA Hospital, Athens, Greece.

出版信息

J Musculoskelet Neuronal Interact. 2021 Mar 1;21(1):93-103.


DOI:
PMID:33657759
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8020027/
Abstract

OBJECTIVE: We examined the role of vitamin D on volumetric bone mineral density (vBMD) and architecture during the first week's post-fracture in postmenopausal women (PMW) with distal radial fractures (DRF) treated conservatively using peripheral Quantitative Computed Tomography (pQCT). METHODS: Patients were classified into 2 groups according to initial median 25(OH)D level; Group A (25(OH)D ≥15 ng/ml) and group B (25(OH)D <15 ng/ml). All patients were followed for 12 weeks at three visits: baseline, 6 weeks and 12 weeks post fracture. pQCT was performed at baseline in fractured and contralateral non-fractured radius and at 6 and 12 week on the fractured side. RESULTS: 39 patients completed the protocol. Mean 25(OH)D levels were 15.60±7.35 ng/ml (3.5-41.7). Trabecular (trab) bone mineral content (BMC) and trabvBMD increased at 6 wk. vs. baseline (p<0.001). Cortical BMC, cortvBMD and cross- sectional area (CSA) progressively decreased (p<0.001) during the 12 weeks. There was no interaction between baseline 25(OH)D levels and changes in trabecular and cortical BMC, vBMD and CSA. Advanced age and higher CTX and P1NP were associated with higher cortical bone loss. CONCLUSION: Vitamin D deficiency does not affect the early architectural changes after a DRF. Advanced age and higher bone remodeling were associated with higher cortical bone loss, probably related to immobilization and independent of vitamin D levels.

摘要

目的:我们研究了维生素 D 对保守治疗的绝经后女性(PMW)桡骨远端骨折(DRF)患者骨折后第 1 周体积骨矿物质密度(vBMD)和骨结构的作用,采用外周定量计算机断层扫描(pQCT)。 方法:根据初始 25(OH)D 中位数水平,将患者分为 2 组;组 A(25(OH)D≥15ng/ml)和组 B(25(OH)D<15ng/ml)。所有患者在骨折后 3 次就诊中进行 12 周随访:基线、6 周和 12 周。在基线时对骨折和对侧非骨折桡骨进行 pQCT 检查,并在 6 和 12 周时对骨折侧进行检查。 结果:39 例患者完成了方案。平均 25(OH)D 水平为 15.60±7.35ng/ml(3.5-41.7)。与基线相比,6 周时骨小梁(trab)骨矿物质含量(BMC)和 trabvBMD 增加(p<0.001)。在 12 周期间,皮质 BMC、cortvBMD 和横截面积(CSA)逐渐减少(p<0.001)。基线 25(OH)D 水平与骨小梁和皮质 BMC、vBMD 和 CSA 的变化之间无相互作用。年龄较大、CTX 和 P1NP 较高与皮质骨丢失较多有关。 结论:维生素 D 缺乏并不影响 DRF 后早期的结构变化。年龄较大和较高的骨重塑与较高的皮质骨丢失有关,这可能与固定有关,与维生素 D 水平无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/4acb348308f3/JMNI-21-093-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/494696243cfa/JMNI-21-093-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/23052ad6162c/JMNI-21-093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/91fee536d17f/JMNI-21-093-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/939ceee66af8/JMNI-21-093-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/4acb348308f3/JMNI-21-093-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/494696243cfa/JMNI-21-093-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/23052ad6162c/JMNI-21-093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/91fee536d17f/JMNI-21-093-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/939ceee66af8/JMNI-21-093-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6418/8020027/4acb348308f3/JMNI-21-093-g005.jpg

相似文献

[1]
Does Vitamin D affects changes in volumetric bone mineral density and architecture in postmenopausal women after conservatively treated distal radius fractures?

J Musculoskelet Neuronal Interact. 2021-3-1

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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Osteoporos Int. 2016-8

[8]
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[9]
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[10]
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Calcif Tissue Int. 2019-2-8

本文引用的文献

[1]
Serum 25-hydroxyvitamin D status, quantitative ultrasound parameters, and their determinants in Greek population.

Arch Osteoporos. 2018-10-15

[2]
Physiological and pathological osteocytic osteolysis.

J Musculoskelet Neuronal Interact. 2018-9-1

[3]
The effect of a single early high-dose vitamin D supplement on fracture union in patients with hypovitaminosis D: a prospective randomised trial.

Bone Joint J. 2017-11

[4]
Calcium and vitamin-D deficiency marginally impairs fracture healing but aggravates posttraumatic bone loss in osteoporotic mice.

Sci Rep. 2017-8-3

[5]
Effect of Polyester and Plaster of Paris Casts on Determination of Volumetric Bone Mineral Density Assessed by Peripheral Quantitative Computed Tomography (pQCT).

Calcif Tissue Int. 2016-11

[6]
Osteocyte Apoptosis Caused by Hindlimb Unloading is Required to Trigger Osteocyte RANKL Production and Subsequent Resorption of Cortical and Trabecular Bone in Mice Femurs.

J Bone Miner Res. 2016-7

[7]
Healing of cancellous fracture in a novel mouse model.

Am J Transl Res. 2015-11-15

[8]
Clinical Practice. Postmenopausal Osteoporosis.

N Engl J Med. 2016-1-21

[9]
Fracture Repair in the Distal Radius in Postmenopausal Women: A Follow-Up 2 Years Postfracture Using HRpQCT.

J Bone Miner Res. 2016-5

[10]
What Is the Role of Vitamin D Supplementation in Acute Fracture Patients? A Systematic Review and Meta-Analysis of the Prevalence of Hypovitaminosis D and Supplementation Efficacy.

J Orthop Trauma. 2016-2

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