Lees B, Molleson T, Arnett T R, Stevenson J C
Wynn Institute for Metabolic Research, London, UK.
Lancet. 1993 Mar 13;341(8846):673-5. doi: 10.1016/0140-6736(93)90433-h.
The incidence of osteoporotic hip fractures in northern Europe has been increasing over the past few decades faster than the rate adjusted for increased life expectancy. One important factor that determines osteoporotic fracture risk is bone density. The restoration of a London church, during which skeletal material dating from 1729 to 1852 was recovered, gave us the opportunity to compare the rate of bone loss in the femora of these samples with that of present-day women. The rate of bone loss, as judged by dual energy X-ray absorptiometry, was significantly greater in modern-day women than in the women from two centuries ago, both pre-menopausally (p < 0.05) and post-menopausally (p < 0.01). The difference in bone loss in the Ward's triangle region between the Spitalfields samples and present-day women remained even when the assumed age at menopause was increased to 48 years or decreased to 42 years. The results suggest that differences in rates of bone loss over two centuries may partly account for the increasing incidence of hip fracture in modern-day women. Reasons for these differences are unclear, but one factor may be a lower degree of physical activity in present-day women.
在过去几十年里，北欧骨质疏松性髋部骨折的发病率增长速度超过了根据预期寿命延长所调整的速率。决定骨质疏松性骨折风险的一个重要因素是骨密度。一座伦敦教堂的修复工程让我们有机会将这些可追溯至1729年至1852年的骨骼样本的股骨骨质流失率与现代女性的骨质流失率进行比较，在修复过程中这些骨骼样本被发掘出来。通过双能X线吸收法判断，现代女性的骨质流失率在绝经前（p < 0.05）和绝经后（p < 0.01）均显著高于两个世纪前的女性。即使将假设的绝经年龄提高到48岁或降低到42岁，斯皮塔菲尔德样本与现代女性在沃德三角区的骨质流失差异依然存在。结果表明，两个世纪以来骨质流失率的差异可能部分解释了现代女性髋部骨折发病率的上升。造成这些差异的原因尚不清楚，但一个因素可能是现代女性的身体活动程度较低。
