In 94 men with crush fracture, 40 were found to have primary osteoporosis. Cross-sectional measurements of a number of variables related to bone in these 40 patients were compared to the values in various groups of healthy men aged 20-96. In healthy men, metacarpal and femoral cortical area/tolal area, bone volume, osteoid surfaces, seam and trabecular width, plasma dihydroepiandrosterone and estrone, and radiocalcium absorption fell with age, whereas eroded surfaces, trabecular number, urine hydroxyproline and calcium/creatinine ratios, plasma alkaline phosphatase, estradiol, androstenedione, cortisol and testosterone remained constant with age. As compared with healthy men, men with primary osteoporosis had reduced femoral cortical area/total area (P < 0.05), and Singh grade (P < 0.001) and in seven there was a history of forearm or femoral fracture. On iliac crest biopsy, bone volume (P < 0.001) and trabecular number (P < 0.01) were decreased. Plasma alkaline phosphatase (P < 0.02) was increased but urine hydroxyproline and calcium excretion were not significantly raised. Calcium balance was negative due to failure of absorption to match urinary calcium loss and radiocalcium absorption (P < 0.01) and plasma 1,25-dihydroxyvitamin D (P < 0.05) were reduced.
- Bone histology
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