Arlot M E, Bradbeer J N, Edouard C, Green J R, Hesp R, Roux J P, Meunier P J, Reeve J
INSERM U 234, Faculte Alexis Carrel, Universite Claude Bernard, Lyon, France.
Calcif Tissue Int. 1993 Jan;52(1):10-5. doi: 10.1007/BF00675620.
The histologic heterogeneity of osteoporosis relative to normal controls has attracted great interest. There has been controversy as to whether patients with high turnover osteoporosis may convert to a normal or low turnover form, and vice versa. We have studied 44 patients over 12 years by dynamic histomorphometry and 85Sr kinetics+calcium balance performed within 60 days in 20 patients (Group 1) and 75-808 days apart in the remainder (Group 2). In the first group, the histologic tissue level bone formation rate (BFR/BV or BFR/BS) was predictive of the 85Sr measurements of bone formation (r = 0.66 P < 0.01). There was no statistically significant correlation in Group 2 and the regression coefficients were significantly different (P = 0.01). Periodic regression was used to determine if seasonal changes were responsible for this loss of correlation; none was found that was of statistical significance. No systematic changes with time in bone formation were found in Group 2 during the period of observation; nor were consistent secular changes detected when the data for both groups were examined according to procedure date. In conclusion, bone formation may change with time in postmenopausal osteoporosis. Evidence that these changes are systematic was not found and this has implications for the design of treatment studies.
与正常对照组相比，骨质疏松症的组织学异质性引起了极大关注。关于高转换型骨质疏松症患者是否会转变为正常或低转换型，反之亦然，一直存在争议。我们对44例患者进行了12年的研究，通过动态组织形态计量学以及对20例患者（第1组）在60天内进行的85Sr动力学+钙平衡研究，其余患者（第2组）在75 - 808天内进行相关研究。在第1组中，组织学组织水平的骨形成率（BFR/BV或BFR/BS）可预测85Sr骨形成测量值（r = 0.66，P < 0.01）。第2组中无统计学显著相关性，且回归系数差异显著（P = 0.01）。采用周期性回归来确定季节性变化是否是这种相关性丧失的原因；未发现具有统计学意义的结果。在观察期内，第2组未发现骨形成随时间的系统性变化；根据检查日期对两组数据进行检查时，也未检测到一致的长期变化。总之，绝经后骨质疏松症的骨形成可能随时间变化。未发现这些变化具有系统性的证据，这对治疗研究的设计具有启示意义。
