Cheng X G, Lowet G, Boonen S, Nicholson P H, Van der Perre G, Dequeker J
Arthritis & Metabolic Bone Disease Research Unit, University Hospitals, Catholic University of Leuven, Belgium.
J Bone Miner Res. 1998 Sep;13(9):1439-43. doi: 10.1359/jbmr.1998.13.9.1439.
The aim of the present study was to investigate the prediction of vertebral and femoral strength in vitro by bone mineral density (BMD) measured at different skeletal sites. The third lumbar vertebral body, the right proximal femur, and the right calcaneus were removed from 38 male and 32 female cadavers (mean age 69 years, range 23-92 years). Areal BMD of all bone specimens was determined by dual-energy X-ray absorptiometry (DXA). The failure load of the vertebral body and the femur was determined by mechanical testing. Vertebral and femoral strength were both greater in males than females (p < 0.01), as was BMD at all sites (p < 0.01). Vertebral strength correlated well with vertebral BMD (r2 = 0.64) but was only moderately correlated with BMD measured at the femur (r2 = 0.36) or the calcaneus (r2 = 0.18). Femoral strength showed the highest correlations with femoral BMD (r2 = 0.88) and somewhat weaker relationships with BMD at the vertebra (r2 = 0.50) and the calcaneus (r2 = 0.54). BMD values at the vertebra, femur, and calcaneus were only moderately interrelated (r2 = 0.31-0.65), and vertebral strength correlated only modestly with the strength of the femur (r2 = 0.36). These in vitro results support the concept that optimal prediction of vertebral or femoral strength by DXA requires site-specific assessments.
本研究的目的是通过测量不同骨骼部位的骨密度（BMD）来体外研究椎骨和股骨强度的预测情况。从38具男性和32具女性尸体（平均年龄69岁，范围23 - 92岁）上取下第三腰椎椎体、右股骨近端和右跟骨。所有骨标本的面积骨密度通过双能X线吸收法（DXA）测定。椎体和股骨的破坏载荷通过力学测试确定。男性的椎体和股骨强度均高于女性（p < 0.01），所有部位的骨密度也是如此（p < 0.01）。椎体强度与椎体骨密度相关性良好（r2 = 0.64），但与股骨（r2 = 0.36）或跟骨（r2 = 0.18）处测量的骨密度仅呈中度相关。股骨强度与股骨骨密度的相关性最高（r2 = 0.88），与椎体（r2 = 0.50）和跟骨（r2 = 0.54）处的骨密度关系稍弱。椎体、股骨和跟骨处的骨密度值仅呈中度相关（r2 = 0.31 - 0.65），椎体强度与股骨强度的相关性也仅为中度（r2 = 0.36）。这些体外研究结果支持了这样一种观点，即通过DXA对椎体或股骨强度进行最佳预测需要进行特定部位的评估。
