整形外科通院患者での橈骨DEXAによる骨密度測定に関する研究

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骨粗鬆症の診断の一手段として, 最近DEXA (Dual Energy X-ray Absoptiometry) 法が注目されている。この方法が開発されるまでは, 腰椎,股関節や手などの骨の単純X線写真を用いてその海綿骨の骨梁の変化を読み取り判断してきた［1］。しかしながら, この部位のX線写真を見慣れていないと読影が難しく, ましてや患者本人が自分の骨密度について把握することは不可能に近かった。ところが, DEXA法による骨密度測定により骨塩量が定量化され, 誰にでも自分の骨密度の状態やその経過的な変化を知ることが可能になってきた。今回我々は整形外科外来に通院する患者500名に対し, 橈骨DEXAを用いて骨塩量を計測した結果以下のような結果が得られた。すなわち, 女性群では男性群に比し骨塩量は明らかに低く, 男女とも高齢化に従い骨塩量は減少傾向にあり, 体重増加と平行して骨塩量は増加傾向が認められた。また, 厚生省骨粗鬆症検診の区分分類での要精検者は男性群 131名中13名（9.9%）に対し, 女性群では 369名中262名（71.0%）, さらには, 骨折危険ライン (0.51g/c㎡以下) を超えたものは男性群 131名中8名（6.1%）に対し女性群では369名中205名（55.5%）であり, 女性群の要精検に分類された人の78.2%が骨折危険ラインを超えているという成績が得られた。以上の結果, 将来 DEXA法は骨粗鬆症検診および臨床診断の中心になるであろうことが示唆された。Concerning a total of 500 cases（consisting of 131 males and 369 females） of outpatients who were examined at Nishi Orthopedics Clinic, the bone mineral density at their anterior arm was measured by an osterosaline analyzer（Model DCS-600） and consequently the following results were obtained. 1) The average value of bone mineral density measured is 0.674±0.890g/c㎡ in male vs 0.495±0.107g/c㎡. It becomes clear that the bone mineral density is apparently lowered in female. 2) For the average value of bone mineral density by age group, this confirms a fact that it is on the decrease with aging in both male ane female. This inclination is clearer especially in female, and a significant difference is observed statistically. 3) In the average of bone mineral density by height and weight, the measurement shows that gradually higher values are obtained as each of the height and weight increases in both male and female. For the increase in weight in particular, there is seen a close relation with the increase in bone mineral density. 4) From the weight/height ratio, the body type of subjects was classified into three groups of the slim, the normal and the corpulent. The classification shows that there is a significant difference between the slim group and the corpulent group in male, while an even more significant difference between each body type in female and therewith the bone mineral density is lowered in the slim group. 5) The ratio of “close examination requirants” who require a more close examination, due to their bone mineral density under 0.548g/c㎡ according to the Ministry of Health and Welfare（MHW)‘s classification of the osteoporosis medical examination, amounts to 71.0％ in female as against 9.9％ in male. This shows that the frequency of bone mineral density declining is overwhelmingly higher in the female group. 6) Among the subjects in this time study, those who broke the bone fracture danger line (0.51g/c㎡) below 75％ of the maximum bone mineral density numbers in 213 persons in female as against 8 persons in male, and they account for 78.2％ of all those classified into the “close examination requirements”. From the facts described above, we may conclude that the bone mineral density is apparently lower in female than in male; its decrease gets clearer with aging both in male and female; and such an inclination is more remarkable in the case of slim body type (that is, of low weight).
大阪教育大学の論文

整形外科通院患者での橈骨DEXAによる骨密度測定に関する研究

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