I don't see why, but apparently the difference lies in the linear definition of a vector based font format like .shx, which specifies basic line segments, whereas apparently (according to deegs link and the TRUE TYPE entry in wikipedia) a TTF uses quadratic formulas to specify curvature of fonts with extra "hinting language" to express further control over actual pixels at varying font sizes.
TTF also seems to be intended to be used at certain font sizes which I believe is point size, 9pt, 10pt, 36pt, etc... whereas in Autocad we force TTFs to conform to 3/32" or 1/8" or whatever we fancy. This bastardization of size may contribute to some of the work the application must perform in order to properly render the TTF.
I still dunno, heh. I think I am gonna go hit up Google a littler harder, though, because now I'm curious.