[Bone histomorphometry study in post-menopausal women with osteopenia]

To investigate the histological features of bone, the turnover status of bone remodeling in postmenopausal women with osteopenia. To observe the influence of age on the changes of bone turnover.

Two hundred ninety three bone biopsies were obtained from posterior iliac crests of postmenopausal white women with osteopenia after taking fluorescence-labelled tetracyclin. All these specimens were embedded in methacrylate, the nondecalcified sections were stained routinely and measured by computerized histomorphometry.

The mean trabecular bone volume was 10.6% +/- 5.47%, which is 29.3% less than the low limit of normal range (15%) established in our laboratory. There were 186 cases (63.5%) in normal turnover status, 75 cases (25.6%) in high turnover, and 32 cases (10.9%) in low turnover. In comparison with the normal turnover group, the osteoclast number, corrected bone mineralization rate and bone formation rate were elevated and mineralization lag time was reduced in the high turnover group (P < 0.01). In contrary, all the above parameters in the low turnover group were on the opposite (P < 0.05-0.01). Comparison of three age groups (51-60, 61-70, > 70 years) showed that the bone volume and osteoid volume decreased as the age increased. The proportion of high and low turnover types began to increase in the 51-60 age group, peaked in the 61-70 age group and dropped to nadir in the > 70 age group.

Bone histomorphometry examination is not only valuable in distinguishing osteoporosis from osteomalacia, but also beneficial for determination of the bone turnover status and, therefore, is useful for the direction of clinical treatment in patients with postmenopausal osteopenia.