Johnston C C, Norton J, Khairi M R, Kernek C, Edouard C, Arlot M, Meunier P J
J Clin Endocrinol Metab. 1985 Sep;61(3):551-6. doi: 10.1210/jcem-61-3-551.
Studies were performed on 32 women with vertebral crush fractures (mean age, 65.1 yr) and 27 patients with recent hip fractures (mean age, 83.6 yr). Histomorphometric analysis of undecalcified transiliac crest biopsies revealed significant differences between the two fracture groups. Trabecular bone volume (TBV) was significantly lower in vertebral fracture than in hip fracture patients (12.0 +/- 4.4% (+/- SD) vs. 14.8 +/- 3.6%; P = 0.014), while thickness of cortices was significantly lower for hip fracture than for vertebral fracture patients (436 +/- 231 vs. 823 +/- 465 microns; P less than 0.001). The TBV and radial bone mass (measured by absorptiometry on the shaft) for the vertebral fracture group were significantly lower than age-expected values. For the patients with hip fractures, the TBV was significantly above the expected value, and radial bone mass was not significantly different from the expected value. Other quantitative histological measurements did not generally differ between the two fracture groups and were compatible with normal or increased bone remodeling. The serum PTH in the hip fracture group was significantly increased above that expected in normal women of similar age. These data demonstrate the anatomical heterogeneity of osteoporotic fracture syndromes. Patients with vertebral fractures have an early deficit of trabecular bone for their age, while those with hip fractures have a deficit of both cortical and trabecular bone compared to women of age 50 yr, but the deficit is not excessive compared to others of similar age without fractures.
对32名患有椎体压缩性骨折的女性（平均年龄65.1岁）和27名近期发生髋部骨折的患者（平均年龄83.6岁）进行了研究。对未脱钙的髂嵴活检组织进行组织形态计量学分析，结果显示两组骨折患者之间存在显著差异。椎体骨折患者的小梁骨体积（TBV）显著低于髋部骨折患者（分别为12.0±4.4%（±标准差）和14.8±3.6%；P = 0.014），而髋部骨折患者的皮质厚度显著低于椎体骨折患者（分别为436±231微米和823±465微米；P＜0.001）。椎体骨折组的TBV和骨干吸收法测量的桡骨骨量显著低于年龄预期值。对于髋部骨折患者，TBV显著高于预期值，桡骨骨量与预期值无显著差异。两组骨折患者的其他定量组织学测量结果一般无差异，且与正常或增加的骨重塑情况相符。髋部骨折组的血清甲状旁腺激素（PTH）显著高于年龄相仿的正常女性预期值。这些数据表明骨质疏松性骨折综合征存在解剖学异质性。椎体骨折患者在其年龄阶段存在小梁骨早期缺失，而髋部骨折患者与50岁女性相比，皮质骨和小梁骨均有缺失，但与其他无骨折的同龄患者相比，这种缺失并不严重。
