Han Z H, Palnitkar S, Rao D S, Nelson D, Parfitt A M
Bone and Mineral Division, Henry Ford Hospital, Detroit, Michigan, USA.
J Bone Miner Res. 1996 Dec;11(12):1967-75. doi: 10.1002/jbmr.5650111219.
We measured indices of bone volume (cancellous, cortical) and bone surface (cancellous, endocortical, and intracortical) in intact full-thickness transiliac bone biopsies obtained from 144 healthy women aged 20-74 (35 black and 109 white, 62 premenopausal and 82 postmenopausal). The data were analyzed by two-way analysis of variance of the four groups defined by age/menopause and ethnicity and by linear regression of major variables on age. None of the interaction terms was significant, and none of the regression slopes on age differed between blacks and whites, indicating that the effects of ethnicity and of age/menopause were independent. Accordingly, the data were also analyzed separately for the effects of ethnicity (pre- and postmenopausal combined) and age/menopause (blacks and whites combined). The analyses led to the following conclusions. (1) Blacks have more cancellous and cortical bone than whites in the ilium; the difference was due to thicker trabeculae and thicker cortices with no difference in trabecular number or cortical porosity. (2) The magnitude of the black/white differences was the same throughout the age range covered by the study, indicating differences in peak adult values, not in rates of loss with age. (3) As the result of age/menopause, there were significant reductions in all indices of the amount and structure of bone except for trabecular thickness; the magnitude of the reductions was the same in blacks and whites. (4) Cancellous bone loss was mainly the result of the complete removal of some trabecular elements with increased separation between remaining elements. Cortical bone loss was due to thinning from the endocortical surface with a small but significant contribution from increased cortical porosity, due to an increased number of intracortical canals. These patterns of bone loss were the same in blacks and whites. (5) Although the percentage losses of bone with age/menopause were higher for cancellous than for cortical bone, the absolute amounts of bone lost were about the same for cortical as for cancellous bone. (6) The ratio of surface to tissue volume decreased with age/menopause in cancellous bone but increased in cortical bone; rates of bone loss would change in the same manner if the loss per unit of surface remained constant. (7) The total extent of bone surface in the ilium did not change with age/menopause, so that the surface/volume ratio for the entire bone increased; volumetric bone turnover would increase and bone age decrease if remodeling activity per unit of surface remained constant.
我们测量了从144名年龄在20 - 74岁的健康女性（35名黑人、109名白人，62名绝经前女性和82名绝经后女性）获取的完整全层髂骨活检样本中的骨体积指标（松质骨、皮质骨）和骨表面指标（松质骨、内皮质骨和皮质内骨）。数据通过年龄/绝经状态和种族定义的四组的双向方差分析以及主要变量对年龄的线性回归进行分析。交互项均无显著意义，且黑人与白人在年龄的回归斜率上没有差异，这表明种族和年龄/绝经状态的影响是独立的。因此，数据还分别针对种族（绝经前和绝经后合并）和年龄/绝经状态（黑人和白人合并）的影响进行了分析。分析得出以下结论：（1）黑人髂骨的松质骨和皮质骨比白人多；差异在于小梁更厚、皮质更厚，而小梁数量或皮质孔隙率无差异。（2）在本研究涵盖的整个年龄范围内，黑/白差异的幅度相同，表明是成人峰值的差异，而非随年龄的丢失率差异。（3）由于年龄/绝经状态，除小梁厚度外，骨量和结构的所有指标均显著降低；黑人和白人的降低幅度相同。（4）松质骨丢失主要是一些小梁单元完全消失且剩余单元间距增加的结果。皮质骨丢失是由于内皮质表面变薄，同时皮质孔隙率增加（由于皮质内管道数量增加）有小但显著的贡献。黑人和白人的这些骨丢失模式相同。（5）尽管随年龄/绝经状态松质骨的骨丢失百分比高于皮质骨，但皮质骨和松质骨的绝对骨丢失量大致相同。（6）松质骨中表面与组织体积的比率随年龄/绝经状态降低，但皮质骨中增加；如果单位表面的丢失保持恒定，骨丢失率将以相同方式变化。（7）髂骨的骨表面总面积不随年龄/绝经状态变化，因此整个骨骼的表面/体积比率增加；如果单位表面的重塑活动保持恒定，体积骨转换将增加且骨龄降低。
