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手术诱导绝经后女性的骨质流失及骨重塑生化指标

Bone loss and biochemical indices of bone remodeling in surgically induced postmenopausal women.

作者信息

Stĕpán J J, Pospíchal J, Presl J, Pacovský V

机构信息

Department of Internal Medicine 3, Charles University Faculty of Medicine, Prague, Czechoslovakia.

出版信息

Bone. 1987;8(5):279-84. doi: 10.1016/8756-3282(87)90002-0.

Abstract

In a cross-sectional study in 214 women who had undergone bilateral oophorectomy up to 12 years previously, the maximal rate of bone loss, as judged by radiogrammetry of the metacarpals and by dual-photon absorptiometry of the lumbar spine, coincided with the peak of the dissociation between urinary hydroxyproline excretion and/or plasma tartrate resistant acid phosphatase activity and the activity of bone isoenzyme of serum alkaline phosphatase. A significant negative correlation was found between the prevalence of the biochemical indices of bone resorption relative to bone formation and/or biochemical indices of bone resorption and the change in the metacarpal cortical area per year. The prevalence of bone resorption relative to bone formation was evident even 12 years after oophorectomy, indicating continuous imbalance of bone remodeling in the patients. Accordingly, the rates of 2.8% cortical and 8% trabecular bone loss per year on the first year after oophorectomy decreased exponentially but did not become asymptotic with the slow phase of bone loss in healthy women up to 12 years after oophorectomy.

摘要

在一项针对214名女性的横断面研究中,这些女性在之前12年内接受了双侧卵巢切除术,通过掌骨X线骨密度测量和腰椎双能光子吸收测定法判断,骨量丢失的最大速率与尿羟脯氨酸排泄和/或血浆抗酒石酸酸性磷酸酶活性与血清碱性磷酸酶骨同工酶活性之间的解离峰值相吻合。相对于骨形成的骨吸收生化指标患病率和/或骨吸收生化指标与每年掌骨皮质面积变化之间存在显著负相关。相对于骨形成的骨吸收患病率在卵巢切除术后12年仍然明显,表明患者骨重塑持续失衡。因此,卵巢切除术后第一年皮质骨每年2.8%和小梁骨每年8%的骨丢失率呈指数下降,但在卵巢切除术后长达12年的时间里,并未随着健康女性骨丢失的缓慢阶段而趋于平稳。

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