Ryan P J, Blake G M, Herd R, Parker J, Fogelman I
Department of Nuclear Medicine, Guy's Hospital, London.
Calcif Tissue Int. 1993 Apr;52(4):263-8. doi: 10.1007/BF00296649.
Bone mineral density (BMD) at the lumbar spine, femoral neck, trochanteric region, and Ward's triangle was measured using dual-energy X-ray absorptiometry (DXA) in 118 women with osteoporotic vertebral collapse (average age 65 years), divided into four groups according to numbers and SD of vertebral deformation below norms: group 1: -3SD deformations only; group 2: one -4SD deformation; group 3: two-four -4SD deformations; and group 4: 5 or more -4SD deformations. There were no significant differences between the groups. Results were compared with those from 80 premenopausal (average age 32 years, range 20-40 years) and 109 postmenopausal normal women (average age 64, range 60-70 years). Mean BMD in osteoporotic group 1 was lower than premenopausal normal women by 32% at the lumbar spine, 31% femoral neck, 30% trochanteric region, and 44% at Ward's triangle, and postmenopausal controls by 17% lumbar spine, 16% femoral neck, 17% trochanter, and 14% Ward's triangle. There was a clear trend to reduction in mean BMD between osteoporotic groups 1 and 4 at all four measured sites with significant differences at the spine of 0.102 g/cm2 (P < 0.01) and Ward's triangle 0.059 g/cm2 (P < 0.01). When compared with premenopausal controls, there was a reduction in mean BMD between osteoporotic groups 1 and 4 of 10% at the lumbar spine, 7% femoral neck, 8% trochanteric region, and 13% Ward's triangle. Receiver operating characteristic analysis showed no significant differences in diagnostic sensitivities among the four measured sites for vertebral fractures. We conclude from this cross-sectional data that the majority of bone loss in spinal osteoporosis occurs before the onset of fractures.
采用双能X线吸收法（DXA）测量了118例有骨质疏松性椎体塌陷的女性（平均年龄65岁）腰椎、股骨颈、大转子区和沃德三角区的骨密度（BMD）。这些女性根据椎体变形低于正常标准的数量和标准差分为四组：第1组：仅-3SD变形；第2组：一个-4SD变形；第3组：两个至四个-4SD变形；第4组：5个或更多-4SD变形。各组之间无显著差异。将结果与80例绝经前女性（平均年龄32岁，范围20 - 40岁）和109例绝经后正常女性（平均年龄64岁，范围60 - 70岁）的结果进行比较。骨质疏松第1组的平均BMD在腰椎比绝经前正常女性低32%，股骨颈低31%，大转子区低30%，沃德三角区低44%；在腰椎比绝经后对照组低17%，股骨颈低16%，大转子低17%，沃德三角区低14%。在所有四个测量部位，骨质疏松第1组和第4组之间的平均BMD有明显下降趋势，在脊柱处差异显著，为0.102 g/cm²（P < 0.01），在沃德三角区为0.059 g/cm²（P < 0.01）。与绝经前对照组相比，骨质疏松第1组和第4组之间在腰椎的平均BMD下降了¹⁰%，股骨颈下降了7%，大转子区下降了8%，沃德三角区下降了13%。受试者工作特征分析表明，在四个测量部位对椎体骨折的诊断敏感性无显著差异。从这些横断面数据我们得出结论，脊柱骨质疏松症中大部分骨质流失发生在骨折之前。
