【摘要】 目的 评价健康女性随增龄，不同骨胳部位的骨丢失。方法 用DXAQDR 4500A型扇形束骨密度仪测量1 664例15～96岁健康女性不同骨胳部位(腰椎正位和侧位、髋部和前臂)的骨密度(BMD)。结果 横断面分析显示，绝经时所有部位骨丢失显著(P<0.01～0.001)，其中松质骨占优势的部位(腰椎侧位和Ward's三角)丢失最多(-13%～-19%，P<0.001)。所有部位绝经15年内(<65岁)及25年后(≥75岁)呈快速丢失。预期寿命(≥72岁)与峰值年龄比较，各部位BMD减少31%～59%(平均38.7%±7.7%)，Ward's区减少最多(-59%)。骨质疏松(OP)检出率腰椎侧位(41%～58%)、桡骨(43%～58%)和Ward's区(46%)较高，腰椎正位(29%)和股骨颈(19%)较低。结论 绝经早期腰椎侧位是诊断OP的最敏感部位。不同骨胳部位峰值骨量的变异度较高，致绝经后OP检出率随测量部位不同而显示较大差异。
Age-related bone loss atvarious skeletal sites in healthy women
Wu Xianping,Liao Eryuan,Deng Xiaoge,et al.Institute of Metabolism and Endocrinology,Hunan Medical University,Changsha,410011
【Abstract】 Objective Toevaluate the age-related bone loss at various skeletal sites in healthy women. Methods Bonemineral density (BMD) at various skeletal sites 〔spine anteroposterior (AP) and lateral(LAT)〕, hip, and forearm was measured by DXA with a QDR 4500A fan beam bone densitometerin 1 664 healthy women, 15 to 96 years of age. Results Cross-sectionalanalysis indicated that a significant apparent bone loss was found at the time ofmenopause at all skeletal sites (P<0.01 to P<0.001), the amount being highest incancellous bone rich sites, i.e., LAT spine and Ward's triangle (-13% to -19%, P<0.001).Apparent bone loss was accelerated within the 15 years following menopause (age<65years), continued thereafter at all sites with a relatively slow speed, and was then againaccelerated in those elderly women more than 25 years post menopause (age≥75 years).Comparison of BMD between peak age and expected average life of women in China (age≥72years), BMD decreased by 31% to 59% (mean±SD, 31.7%±7.7%) depending on the siteexamined, and the decrease was highest at the Ward's triangle (-59%). The percentages ofpostmenopausal women classified as osteoporotic according to the World Heath Organizationcriteria were higher at the lateral spine (41% to 58%), radius (43% to 58%) and Ward'striangle (46%), and lower at the AP spine (29%) and femoral neck (19%). Conclusion Thelateral spine is most sensitive for diagnosis of osteoporosis among all the skeletal sitesin the early postmenopausal women. Owing to the high variability of the peak bone mass atdifferent skeletal sites, the percentage of postmenopausal women identified as beingosteoporotic varies widely with the sites of measurement.
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