Dent C E, Engelbrecht H E, Godfrey R C
Br Med J. 1968 Oct 12;4(5623):76-9. doi: 10.1136/bmj.4.5623.76.
To try to establish whether mechanical stress and muscular activity in earlier life influence the incidence and severity of spinal osteoporosis in old age lateral x-ray films of the lumbar vertebrae were obtained from three matched groups, each of 100 women 50 to 90 years old. Group A was of rural Bantu accustomed to carrying heavy loads on their heads. Group B was of urban Bantu, mainly in domestic service. Group C was of women of European origin.Severe osteoporosis occurred in three cases from group A, two from group B, and 14 from group C. Lesser degrees of osteoporosis could not be assessed precisely enough for inclusion in these figures. Evenly biconcave vertebral bodies, strongly suggestive of osteomalacia, were seen in 10 from group A, five from group B, and one from group C. In many Bantu subjects the fifth lumbar vertebra appeared flattened though of good radiodensity and with no marked changes in the other vertebrae. Twenty-eight of these were from group A, 16 from group B, and none from group C.About a third of each group showed severe degenerative changes in the spine; another third showed milder changes. More cases of spondylolisthesis occurred in the Bantu groups than in the white group. Severe calcification in the abdominal aorta was noted in 24 women in group C. Mild signs occurred in 35 further women from group C, in six from group B, and in only one from group A.
为了确定早年的机械应力和肌肉活动是否会影响老年时脊柱骨质疏松症的发病率和严重程度,从三个匹配组中获取了100名年龄在50至90岁之间的女性的腰椎侧位X线片。A组是习惯头顶重物的农村班图人。B组是主要从事家政服务的城市班图人。C组是欧洲裔女性。A组有3例发生严重骨质疏松症,B组有2例,C组有14例。程度较轻的骨质疏松症由于评估不够精确,未纳入这些数字。在A组中有10人、B组中有5人、C组中有1人可见椎体呈均匀双凹形,强烈提示骨软化症。在许多班图受试者中,第五腰椎虽放射密度良好且其他椎体无明显变化,但看起来变扁了。其中28例来自A组,16例来自B组,C组无。每组约三分之一的人脊柱出现严重退行性改变;另外三分之一的人有较轻的改变。班图组发生腰椎滑脱的病例比白人组多。C组有24名女性腹主动脉严重钙化。C组另有35名女性、B组有6名女性、A组仅有1名女性出现轻微症状。