OTSUKA Nobuaki Nuclear Medicine, Kawasaki Medical School, Assistant Professor, 医学部, 講師 (20140519)
SONE Teruki Nuclear Medicine, Kawasaki Medical School, Associate Professor, 医学部, 助教授 (90179383)
|Budget Amount *help
¥3,100,000 (Direct Cost : ¥3,100,000)
Fiscal Year 1999 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1998 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 1997 : ¥2,000,000 (Direct Cost : ¥2,000,000)
To clarify the etiology of spinal and hip fractures complicated with osteoporosis, the bone mineral density (BMD) and bone geometry or bone metabolic state were studied.
The BMDs were measured with dual-energy X-ray absorptiometry (DXA) equipment ; the DCS-600 for midradius, and the QDR-2000 for the second to fourth lumbar vertebrae, and proximal femur. As bone markers, The levels of pyridinoline (Pyr), deoxypyridinoline (D-Pyr), and NTx were measured. This study was conducted on women. Spinal fracture was judged by employing the diagnostic criteria for primary osteoporosis, after morphometry of anterior, central, and posterior vertebral height on lateral X-ray films of the thoracic and lumbar spines. For the geometry of the proximal femur, femur axis length (FAL) and neck width were measured.
With respect to spinal fracture ; (1) The radial, lumbar, and femoral BMDs in the fractured cases (N=41) were significantly lower (p<0.0001-0.0062) than those in the non-fractured cases (N=118-125)
. (2) Pyr levels in the fractured cases tended to be higher. (3) The fractured cases showed a significantly (p=0.0092-0.0188) higher incidence of not only increased levels of both Pyr and D-Pyr (more than 33.2 pmol/mmol/Cr and 6.4 pmol/mmol/Cr, respectively), but also decreased BMD levels, less than 70% of the young adult mean, in both the radius and lumbar vertebrae, compared with the non-fractured cases.
With respect to hip fracture ; (1) Femoral neck BMDs were significantly lower(p<0.0001) in the fractured cases (N=76). (2) The increased odds ratio of hip fracture, which is calculated from logistic regression analysis, ageadjusted, was 3.40 (p<0.0001) for a decrease in the ISD of femoral neck BMD, and 1.48 (p=0.0320) for a decrease of 10kg of body weight. (3) The threshold value of femoral neck BMD of hip fractures was 0.516 g/cmィイD12ィエD1, and (4) from a study of fractured cases (N37) and non-fractured cases (N=161) of more than 70 years old, a significantly longer neck width was noted in the fractured cases than in the non-fractured cases, while there were no differences in FAL between the two groups.
Thus, it was suspected that spinal fracture is related to both a low BMD and the increased bone turnover, but hip fracture is related to geometry, as well as a low BMD.