Luisetto G, Zangari M, Tizian L, Nardi A, Ramazzina E, Adami S, Galuppo P
Department of Endocrinology, University of Padova, Italy.
Bone Miner. 1993 Jul;22(1):9-25. doi: 10.1016/s0169-6009(08)80077-3.
In order to assess the relative influence of aging and menopause in determining the decrease of bone mass in adult women, two groups of normal subjects were examined in this retrospective, cross-sectional study. In group A, bone mineral density (BMD) was evaluated at spine (L2-L4) by dual X-ray absorptiometry (DXA) (Hologic QDR-1000); in group B, BMD was measured at the distal forearm by single photon absorptiometry (SPA) (Osteometer DT 100). Both groups were further divided into two subgroups: A1 and B1 included women with the same postmenopausal, but different chronological age; A2 and B2 included women with the same chronological, but different postmenopausal age. BMD and BMI-corrected BMD (cBMD) were plotted versus age and years since menopause, respectively. Mathematical analysis of the correlation curves between BMD and chronological age showed that the decrease of BMD is very similar at spine and forearm, and is better fitted by a quadratic function. Age-related fractional bone diminution shows a progressive increase with aging (at spine: -0.38%/year at 45 years, -0.81%/year at 50, -1.3%/year at 55 and -1.9%/year at 60. At forearm: -0.5%/year at 50 years, -1.1%/year at 55 and -1.68%/year at 60). On the other hand, menopause-related BMD decrement is very evident during the first year since menopause (at spine: -8.1%/year; at forearm: -3.4%/year), and progressively decreases, according to a logarithmic function. Ten years later, yearly diminution of BMD is below 1%/year and 0.4%/year at spine and forearm, respectively. At this time, age contributes to determine bone loss for 2/3 and menopause for 1/3.
为了评估衰老和绝经在成年女性骨量减少过程中的相对影响，在这项回顾性横断面研究中对两组正常受试者进行了检查。A组通过双能X线吸收法（DXA）（Hologic QDR - 1000）测量脊柱（L2 - L4）的骨密度（BMD）；B组通过单光子吸收法（SPA）（Osteometer DT 100）测量前臂远端的骨密度。两组又进一步分为两个亚组：A1和B1包括绝经状态相同但实际年龄不同的女性；A2和B2包括实际年龄相同但绝经年限不同的女性。分别将BMD和体重指数校正的BMD（cBMD）与年龄和绝经后的年限作图。对BMD与实际年龄之间的相关曲线进行数学分析表明，脊柱和前臂的BMD下降非常相似，并且用二次函数拟合效果更好。与年龄相关的骨量减少分数随衰老而逐渐增加（在脊柱：45岁时为-0.38%/年，50岁时为-0.81%/年，55岁时为-1.3%/年，60岁时为-1.9%/年。在前臂：50岁时为-0.5%/年，55岁时为-1.1%/年，60岁时为-1.68%/年）。另一方面，绝经相关的BMD下降在绝经后的第一年非常明显（在脊柱：-8.1%/年；在前臂：-3.4%/年），并根据对数函数逐渐下降。十年后，脊柱和前臂的BMD每年减少分别低于1%/年和0.4%/年。此时，骨量流失中年龄因素占三分之二，绝经因素占三分之一。
