正常中国妇女前臂骨量及骨代谢生化指标及与丹麦妇女的比较

Forearm bone mass and biochemical markers of bone remodelling in normal Chinese women and comparison with Danish women

观察正常中国妇女前臂骨量和骨代谢生化指标及其与丹麦妇女的比较。对２０～８０岁，每岁５名，共３０５名正常妇女以单能Ｘ线吸收法测量非常用侧前壁１／４远端、８ｍｍ远端及超远端的骨量和骨密度。骨形成指标为血清骨钙素（ＯＣ）及碱性磷酸酶（ＡＬＰ），骨吸收指标为空腹晨两小时尿Ｉ型胶原降解物／肌酐（Ｔｙｐｅ１／Ｃｒ）和钙／肌酐（Ｃａ／Ｃｒ）。结果：绝经后比绝经前骨量明显减少，１／４远端减少１５％，８ｍｍ远端为２５％，超远端为３５％。５０岁时我国妇女骨量与丹麦相似，但５０岁后，我国妇女骨加速丢失的速度似较快。骨的加速丢失出现在绝经后１０～１５年内，此后稳定约５～１０年。在绝经的最初５年内，含松质骨较多的部位（超远端）骨丢失最多，为１６．２％。绝经后骨转换指标明显高于绝经前，与骨量呈负相关。本研究取得了正常中国妇女前臂三个部位的骨量。与丹麦妇女比较表明，东西方妇女骨量与骨代谢规律相似，但有一定差异。

Objective: Bone mineral content and density(BMC/BMD) and markers of bone turnover were studied in normal Chinese women and compared with normal Denmark women. Methods: BMC and BMD at three sites of the nondominant forearm were mearsured with single X ray absorptiometry (SXA) in 305 subjects from the age of 20 to 80 years (5 at each age).Serum osteocalcin (OC) and alkaline phosphatase (ALP) were measured as markers of bone formation and fasting urinary calcium/creatinine (Ca/Cr) and a degradation product of type 1 collagen/Cr (Crosslaps TM ) (Type 1/Cr) as markers of bone resorption. Results: The postmenopausal women lost much more bone mass than the premenopausal women,15% at the 1/4 D site,25% at the 8mm D site,and 35% at the ultra D site.At age 50 the Chinese women had very similar bone mass when compared to Danish women.After age 50 the bone loss accelerated and the loss seemed more rapid in the Chinese than in the Danish women. Accelerated bone loss was noticed during the first 10￣15 postmenopausal years,and remained stationary at the 3 sites the following 5￣10 years.Within the first 5 years after menopause bone loss is mainly at trabecular site and highest (16.2%) at ultra Dsite.The postmenopausal women had significantly higher levels of bone turnover markers than premenopausal women and they correlate negatively to bone mass. Conclusion: The present study presents the normal values of bone mass in Chinese women at three sites of the forearm.The comparison to a group of normal Danish women showed that women from east and west are relatively similar but with some differences in terms of bone mass and calcium metabolism.