Greenspan S L, Maitland L A, Myers E R, Krasnow M B, Kido T H
Department of Medicine, Beth Israel Hospital, Boston, Massachusetts.
J Bone Miner Res. 1994 Dec;9(12):1959-65. doi: 10.1002/jbmr.5650091216.
Although previous longitudinal studies suggest bone loss ceases at the spine and radius in women over age 65, few data are available to determine whether femoral bone loss continues in this age group. Because a low femoral bone mass is associated with an increased risk of hip fracture and current therapies for fracture prevention focus on halting bone loss, it is imperative to determine whether femoral bone loss occurs in those who sustain 90% of hip fractures: women over age 65. To determine the annual rate of femoral bone loss, the association of bone loss and age, and the relationship between femoral and spinal bone loss in this age group, we prospectively followed femoral and spinal bone mineral density (BMD) in 85 healthy, community-dwelling, ambulatory women over age 65 (mean 77 years, range 66-93 years). Measurements of femoral and spinal BMD were assessed twice over 1 year using dual-energy x-ray absorptiometry. Cross-sectional analysis of site-specific baseline BMD suggested a significant bone loss in the femoral neck (-0.76% per year, p < 0.01), total hip (-0.70% per year, p < 0.01), trochanter (-0.71% per year, p < 0.05), intertrochanter (-0.88% per year, p < 0.01), and Ward's triangle (-0.86% per year, p < 0.01) but no significant change at the spine.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管先前的纵向研究表明，65岁以上女性的脊柱和桡骨骨质流失会停止，但几乎没有数据可用于确定该年龄组的股骨骨质流失是否仍在继续。由于股骨骨量低与髋部骨折风险增加相关，且目前预防骨折的治疗重点是阻止骨质流失，因此必须确定在90%髋部骨折患者（65岁以上女性）中是否会发生股骨骨质流失。为了确定股骨骨质流失的年发生率、骨质流失与年龄的关系以及该年龄组股骨与脊柱骨质流失之间的关系，我们对85名年龄在65岁以上（平均77岁，范围66 - 93岁）、健康、居住在社区且能自主活动的女性的股骨和脊柱骨矿物质密度（BMD）进行了前瞻性跟踪。使用双能X线吸收法在1年内对股骨和脊柱BMD进行了两次测量。对特定部位基线BMD的横断面分析表明，股骨颈（每年-0.76%，p < 0.01）、全髋（每年-0.70%，p < 0.01）、大转子（每年-0.71%，p < 0.05）、转子间（每年-0.88%，p < 0.01）和沃德三角区（每年-0.86%，p < 0.01）有显著骨质流失，但脊柱无显著变化。（摘要截选至250字）
