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首页> 外文会议>Conference on Photonic Therapeutics and Diagnostics >Osteoporosis: Are we measuring what we intend to measure? In search of the ideal bone strength study
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Osteoporosis: Are we measuring what we intend to measure? In search of the ideal bone strength study

机译：骨质疏松症：我们是否衡量了我们打算衡量的内容？寻找理想的骨骼强度研究

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In 1991 the World Health Organization (WHO) defined osteoporosis as a "loss of bone mass and micro architectural deterioration of the skeleton leading to increased risk of fracture."1,2 Since microarchitecture can not be measured directly, a panel of the WHO recommended that the diagnosis be made according to a quantifiable surrogate marker, calcium mineral, in bone. Subsequently in 1994, the definition focused on the actual bone "density," giving densitometric technology a central place in establishing the diagnosis of osteoporosis.3,4 But soon it became obvious that there was only limited correlation between bone mineral density (BMD) and actual occurrence of fractures and that decreases in bone mass account for only about 50% of the deterioration of bone strength with aging. In other words only about 60% of bone strength is related to BMD.5 Recent developments in bone research have shown that bone mineral density in itself is not sufficient to accurately predict fracture risk. Bone is composed of inorganic calcium apatite crystals that mineralize an organic type I collagen matrix. The degree of mineralization, the properties of the collagen matrix, crystal size, trabecular orientation, special distribution of the different components and many more factors are all impacting bone strength.6-14 Human cadaver studies have confirmed the correlation between bone density and bone.26 strength.5,15-20 Changes in cancellous bone morphology appear to lead to a disproportionate decrease in bone strength.21-26 When postmenopausal women are stratified by age, obvious differences between BMD and actual fracture risk are observed.24 Felsenberg eloquently summarizes what he calls the "Bone Quality Framework." In great detail he talks about the geometry and micro- architecture of bone and how the different components are related to functional stability.27 Are our current testing modalities appropriately addressing these structural factors? Are we keeping in mind that in screening for osteoporosis the key variable is fragility, not bone density itself? All currently FDA approved and commercially available equipments for the evaluation of bone status claim that they - at least indirectly - assess the biological fracture risk. This review summarizes an extensive current literature research covering FDA approved as well as experimental devices for the evaluation of bone. The pros and cons of the different techniques are discussed in the context of diagnostic accuracies and practical implications.
机译：1991年，世界卫生组织（世卫组织）定义了骨质疏松症，作为“骨骼骨质损失和微观架构恶化，导致骨折的风险增加。”由于微体系结构无法直接测量，这是谁推荐的谁诊断根据量化的替代标记，钙矿物质，骨中的诊断。随后于1994年，定义专注于实际骨骼“密度”，给出密度计量技术，是建立骨质疏松症诊断的中央的核心区。但很快，骨矿物密度（BMD）之间只有有限的相关性有限的相关性骨折的实际发生，骨质占骨骼的降低仅约50％的骨骼强度与老化的劣化。换句话说，只有大约60％的骨骼强度与BMD.5骨骼研究的最新发育表明，骨矿物密度本身本身不足以准确地预测骨折风险。骨由无机钙磷灰石晶体组成，可使有机型I胶原基质矿化。矿化程度，胶原蛋白基质的性质，晶体尺寸，短边锋取向，不同组分的特殊分布以及许多因素都受到影响骨骼强度.6-14人类尸体研究证实了骨密度与骨之间的相关性。 26强度.5,15-20松质骨形态的变化似乎导致骨骼强度的减少.21-26当预混妇女按年龄分层分层时，BMD与实际骨折风险之间的明显差异.24 Felsenberg雄辩地总结他称之为“骨头质量框架”。详细信息，他讨论了骨骼的几何和微观结构以及不同的组件如何与功能稳定性相关.27是我们当前的测试模式适当地解决这些结构因素？我们是否记住，在筛查骨质疏松症时，关键变量是脆弱的，而不是骨密度本身？目前所有目前的FDA批准和商业上可获得的设备，用于评估骨骼状态，它们至少间接 - 评估生物骨折风险。本综述总结了涵盖FDA批准的广泛文献研究以及评估骨骼的实验装置。在诊断准确性和实际意义的背景下讨论了不同技术的优缺点。

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