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1.
High Bone Turnover is Associated with Low Bone Mass and Spinal Fracture in Postmenopausal Women 总被引:4,自引:0,他引:4
P. Ravn M. Rix H. Andreassen B. Clemmesen M. Bidstrup M. Gunnes 《Calcified tissue international》1997,60(3):255-260
A group of 366 healthy, white postmenopausal women, aged 50–81 years, mean age 66 years, were selected from the screened
population of Scandinavians who were part of a multicenter study of the efficacy of tiludronate, a new bisphosphonate, in
established postmenopausal osteoporosis. Eighty-eight women had a lumbar spine bone mineral density (BMD) above 0.860 g/cm2, and 278 women had a BMD below 0.860 g/cm2. Spinal fracture was diagnosed from lateral spine X-ray studies and defined as at least 20% height reduction (wedge, compression,
or endplate fracture) in at least one vertebra (T4–L4). Bone resorption was assessed by measurement of the urinary excretion
of type I collagen degradation products by the CrossLaps™ enzyme-linked immunoassay (ELISA). Bone formation was assessed by
ELISA measurement of the N-terminal-mid-fragment as well as the intact serum osteocalcin (OCN-MID), thus omitting the influence of the instability of osteocalcin caused by the labile 6 amino acid C-terminal sequence. The
women were divided into groups with high or low bone turnover according to the concentrations of urinary CrossLaps™ or OCN-MID. Women in the quartiles with the highest concentrations of CrossLaps [519 ± 119 μg/mmol (SD)] or OCN-MID [44.6 ± 7.5 ng/ml (SD)] had 10–16% lower spinal BMD compared with women in the lowest quartiles (CrossLaps 170 ± 48 μg/mmol
(SD), and OCN-MID [22.1 ± 3.0 ng/ml (SD)] (P < 0.0004). The prevalences of spinal fracture were 25 to 29% in the lowest quartiles, whereas the prevalences in the highest
quartiles were almost double—53–54% (P < 0.006). If the women were subgrouped according to spinal BMD and prevalence of spinal fracture, corresponding results were
found. Women with a BMD less than 0.860 g/cm2, without or with spinal fracture (n = 136 and n = 142), had 36–43% higher concentration of CrossLaps (P= 0.0001) and 11–15% higher concentration of OCN-MID (P < 0.02), as compared with women with a BMD above 0.860 g/cm2 and no spinal fracture (n = 84). In conclusion, the results indicate a strong association among high bone turnover, low bone
mass, and prevalence of spinal fracture, which supports the theory that high bone turnover is a risk factor for spinal fracture
and osteoporosis.
Received: 29 February 1996 / Accepted: 9 August 1996 相似文献
2.
J.-F. Chiu S.-J. Lan C.-Y. Yang P.-W. Wang W.-J. Yao I.-H. Su C.-C. Hsieh 《Calcified tissue international》1997,60(3):245-249
This study examined bone density among postmenopausal Buddhist nuns and female religious followers of Buddhism in southern
Taiwan and related the measurements to subject characteristics including age, body mass, physical activity, nutrient intake,
and vegetarian practice. A total of 258 postmenopausal Taiwanese vegetarian women participated in the study. Lumbar spine
and femoral neck bone mineral density (BMD) were measured using dual-photon absorptimetry. BMD measurements were analyzed
first as quantitative outcomes in multiple regression analyses and next as indicators of osteopenia status in logistic regression
analyses. Among the independent variables examined, age inversely and body mass index positively correlated with both the
spine and femoral neck BMD measurements. They were also significant predictors of the osteopenia status. Energy intake from
protein was a significant correlate of lumbar spine BMD only. Other nutrients, including calcium and energy intake from nonprotein
sources, did not correlate significantly with the two bone density parameters. Long-term practitioners of vegan vegetarian
were found to be at a higher risk of exceeding lumbar spine fracture threshold (adjusted odds ratio = 2.48, 95% confidence
interval = 1.03–5.96) and of being classified as having osteopenia of the femoral neck (3.94, 1.21–12.82). Identification
of effective nutrition supplements may be necessary to improve BMD levels and to reduce the risk of osteoporosis among long-term
female vegetarians.
Received: 10 May 1996 / Accepted: 9 August 1996 相似文献
3.
Fujita T Satomura A Hidaka M Ohsawa I Endo M Ohi H 《Calcified tissue international》2000,66(3):195-199
It is widely known that glucocorticoids induce and accelerate osteoporosis. High-dose glucocorticoids are administrated daily
to patients in the acute phase of nephrotic syndrome. It could be inferred that high-dose glucocorticoids rapidly decrease
patients' basal bone mineral density (BMD) and this accelerates the natural progress of osteoporosis associated with aging
or menopause. Nine nephrotic patients (male/female: 5/4) without previous prednisolone administration were chosen to measure
BMD and the level of the markers for bone turnover before and after treatment for 3 months (total prednisolone administration:
4.5 ± 0.0 g). Twenty-three patients under remission with prednisolone administration (male/female: 14/9) were included in
the long-term treatment group. Patients in this group whose %YAM in the lateral lumbar spine was less than 89% were classified
into a low BMD group (n = 10, male/female: 3/7). They were administered etidronate disodium at 200 mg/day for 14 days. BMD
and % of young adult mean (YAM) in the lumbar spine (L2-L4 in lateral objection) and other regions were measured by dual-energy
X-ray absorptiometry. As markers of bone metabolism, the urinary level of deoxypyridinoline (Dpd) was determined to evaluate
osteogenesis, and serum osteocalcin was measured to evaluate bone resorption. BMD of the lumbar spine significantly decreased
in the 3-month treatment group (752 ± 96 mg/cm2, 7 ± 4% reduction) compared with the pretreatment group (810 ± 85 mg/cm2). BMD in the long-term treatment group decreased continuously (683 ± 135 mg/cm2). No significant differences were noted in other measurement sites. BMD in the etidronate treatment group increased significantly
(597 ± 55 mg/cm2) compared with the pretreatment group (549 ± 76 mg/cm2). Etidronate did not change BMD at the sites with a normal BMD. Among the biochemical markers (BM) examined, the urinary
level of Dpd (nMol/liter · Cr) significantly increased in the 3-month treatment group (8.6 ± 5.1 nMol/liter·Cr) compared with
the pretreatment group (5.8 ± 2.0 nMol/liter · Cr). No significant differences were seen in the BMs measured in the long-term
treatment group. The urinary Dpd level of the etidronate treatment group decreased (3.9 ± 1.4 nMol/liter · Cr) compared with
the pretreatment group. These data indicate that etidronate could improve the accelerated bone resorption. In conclusion,
high-dose glucocorticoid therapy causes rapid bone resorption and accelerates the natural progress of osteoporosis associated
with aging or menopause. Etidronate administration prevents the progress of osteoporosis in nephrotic patients. Preventive
treatment should be performed when the estimated BMD in 3 months falls below the baseline by more than 7 ± 4%, reaching the
therapeutic range.
Received: 31 March 1999 / Accepted: 29 September 1999 相似文献
4.
Risk Factors for the Development of Vertebral and Total Skeleton Osteoporosis in Patients with Primary Biliary Cirrhosis 总被引:4,自引:0,他引:4
A. Bagur C. Mautalen J. Findor J. Sorda J. Somoza 《Calcified tissue international》1998,63(5):385-390
The objectives of this work was to (1) study the bone mineral density (BMD) of the lumbar spine, total skeleton, and body
composition in patients with primary biliary cirrhosis (PBC) and (2) evaluate the risk factors (premature menopause, stages
of the disease, hyperbilirubinemia) and bone and liver biochemical parameters for the development of osteoporosis. We studied
23 women with a compatible diagnosis of PBC. The BMD and body composition were evaluated by X-ray absorptiometry (Lunar DPX-L).
The average age of the population was 56.7 ± 10.2 years. The BMD of the lumbar spine and of the total skeleton was 1.3 SDs
below the normal population matched for sex and age. In the total skeleton, the legs were the most severely affected area
(Z score −1.5). The body composition showed no significant difference compared with the normal population. The BMD of 56%
of the patients was less than −2.5 SDs from the average normal young values. Patients with a history of vertebral fractures
had diminished mineral density of the lumbar spine, as did those who had had no fractures. Of the risk factors studied, patients
with premature menopause had a lower bone mass compared with patients with normal menopausal age (Z score of the total skeleton
was −2.1 ± 1.8 versus −1.1 ± 1.0) but the difference did not reach statistical significance. The bone mass was not affected
in patients with regular menstrual cycles. There were no statistically significant differences in high levels of bilirubin,
advanced stages of the disease, or the biochemical variables studied. It is concluded that patients with primary biliary cirrhosis
present diminished cortical and trabecular bone mass, whereas body composition was unaffected. Premature hormone deficit,
possibly triggered by the chronic hepatic pathology, is a contributing factor to the osteoporosis in this population.
Received: 21 October 1997 / Accepted: 5 March 1998 相似文献
5.
Association of Methylenetetrahydrofolate Reductase (MTHFR) Polymorphism with Bone Mineral Density in Postmenopausal Japanese Women 总被引:4,自引:4,他引:0
Miyao M Morita H Hosoi T Kurihara H Inoue S Hoshino S Shiraki M Yazaki Y Ouchi Y 《Calcified tissue international》2000,66(3):190-194
The pathogenesis of osteoporosis is controlled by genetic and environmental factors. Considering the high prevalence of osteoporosis
in homocystinuria, abnormal homocysteine metabolism would contribute to the pathogenesis of osteoporosis. It is known that
the polymorphism of methylenetetrahydrofolate reductase (MTHFR), the enzyme catalyzing the reduction of 5,10-methylenetetrahydrofolate
to 5-methyltetrahydrofolate, correlates with hyperhomocysteinemia. In this study, we examined the association of this polymorphism
with bone mineral density (BMD). BMD was measured by dual-energy X-ray absorptiometry (DXA) in 307 postmenopausal women. MTHFR
A/V polymorphism was analyzed using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). We compared
BMD, clinical characteristics, and bone metabolic markers among MTHFR groups (AA, AV, VV). The groups did not differ in terms of baseline data. The values of lumbar spine BMD and total body BMD were as follows:
lumbar spine: AA, 0.91 ± 0.18, AV, 0.88 ± 0.16, VV, 0.84 ± 0.14 g/cm2; total body: AA, 0.97 ± 0.11, AV, 0.96 ± 0.11, VV, 0.93 ± 0.09 g/cm2. In the VV genotype, lumbar spine BMD values were significantly lower than those of the women with the AA genotype (P= 0.016) and total body BMD was significantly lower than those of the women with AA genotype (P= 0.03) and AV genotype (P= 0.04). This is the first report that suggests that the VV genotype of MTHFR is one of the genetic risk factors for low BMD.
Received: 29 March 1999 / Accepted: 20 September 1999 相似文献
6.
A. Tenenhouse L. Joseph N. Kreiger S. Poliquin T. M. Murray L. Blondeau C. Berger D. A. Hanley J. C. Prior 《Osteoporosis international》2000,11(10):897-904
The Canadian Multicentre Osteoporosis Study (CaMos) is a prospective cohort study which will measure the incidence and prevalence
of osteoporosis and fractures, and the effect of putative risk factors, in a random sample of 10 061 women and men aged ≥25
years recruited in approximately equal numbers in nine centers across Canada. In this paper we report the results of studies
to establish peak bone mass (PBM) which would be appropriate reference data for use in Canada. These reference data are used
to estimate the prevalence of osteoporosis and osteopenia in Canadian women and men aged ≥50 years. Participants were recruited
via randomly selected household telephone listings. Bone mineral density (BMD) of the lumbar spine and femoral neck were measured
by dual-energy X-ray absorptiometry using Hologic QDR 1000 or 2000 or Lunar DPX densitometers. BMD results for lumbar spine
and femoral neck were converted to a Hologic base. BMD of the lumbar spine in 578 women and 467 men was constant to age 39
years giving a PBM of 1.042 ± 0.121 g/cm2 for women and 1.058 ± 0.127 g/cm2 for men. BMD at the femoral neck declined from age 29 years. The mean femoral neck BMD between 25 and 29 years was taken
as PBM and was found to be 0.857 ± 0.125 g/cm2 for women and 0.910 ± 0.125 g/cm2 for men. Prevalence of osteoporosis, as defined by WHO criteria, in Canadian women aged ≥50 years was 12.1% at the lumbar
spine and 7.9% at the femoral neck with a combined prevalence of 15.8%. In men it was 2.9% at the lumbar spine and 4.8% at
the femoral neck with a combined prevalence of 6.6%.
Received: 23 April 1999 / Accepted: 14 April 2000 相似文献
7.
D. Borderie B. Cherruau M. Dougados O. G. Ekindjian C. Roux 《Calcified tissue international》1998,62(1):21-25
To evaluate bone biochemical markers as predictors of the efficacy of a hormone replacement therapy (HRT), we studied the
bone changes induced by the cessation and return of ovarian function in 28 patients treated for 6 months with a GnRH agonist.
This model reproduced the effects observed in postmenopausal women with high bone turnover treated with HRT. At the end of
the treatment, Z scores were 1.8 ± 0.3 for Crosslaps (CTx) and deoxypyridinoline (D-Pyr), and 1.1 ± 0.2 for bone alkaline
phosphatase (B-ALP) and osteocalcin (OC). This indicated an imbalance in bone remodeling with a high bone resorption. Bone
mineral density (BMD) fell by 4.2 ± 2.5%. The changes in BMD between the 6th and 12th months were 0.34 ± 2.24 and −1.73 ±
3.25% at the lumbar spine and the femoral neck, respectively. Biochemical markers except urinary calcium and hydroxyproline
measured at 6 months were positively correlated with the BMD changes at the lumbar spine. After the resumption of menstruation,
13 of 28 women displayed positive spine BMD changes between the 6th and 12th months; in this group, bone biochemical markers
measured at 6 months were significantly higher (P= 0.02). Stepwise regression analysis showed that the association of B-ALP and D-Pyr measured at 6 months explained 40% of
BMD variance and the association of B-ALP, PTH, and estradiol 56%. We conclude that measuring individual biochemical bone
markers can help to predict the bone effect of an increase in the circulating estradiol in women with ovarian deficiency.
Received: 16 January 1997 / Accepted: 17 June 1997 相似文献
8.
Lateral Spine Densitometry in Obese Women 总被引:3,自引:0,他引:3
E. R. Brooks D. Heltz P. Wozniak C. Partington J. C. Lovejoy 《Calcified tissue international》1998,63(2):173-176
The lateral (LAT) spine scan has been suggested as a more sensitive measure than posterior-anterior (PA) scanning for assessing
age-related bone loss in normal-weight postmenopausal women. The measurement error of PA and LAT bone mineral density (BMD)
using dual energy X-ray absorptiometry (DXA) has also been shown to rise with incremental increases in fat and from large
variance in fat thickness, respectively. The purpose of this cross-sectional study was to determine specific affects of obesity
on paired PA and LAT lumbar (L2–L4) BMD and Z score (BMD of patient versus age-matched reference database) correlation in 30 obese postmenopausal women (mean
BMI ± SD = 33.3 ± 4.06). The mean PA and LAT BMD ± SD were 0.946 ± 0.123 and 0.749 ± 0.134, respectively. The mean PA and
LAT Z scores were −0.17 ± 1.15 and 0.80 ± 1.7. The correlation between PA and LAT BMD was significantly lower (r = 0.55; P < 0.05) than previously reported, and PA and LAT Z score correlation was (r = 0.57; P= 0.0016). After adjusting for body mass index (BMI), percent body fat, fat mass, and truncal fat by DXA, waist:hip ratio
(WHR) and visceral and subcutaneous abdominal fat by computerized axial tomography (CT), PA and LAT Z score correlation increased
to r = 0.62; P= 0.0065. In our subjects, the mean LAT Z score was 4.6 times higher than the mean AP Z, contrary to previous observations
in normal-weight postmenopausal women. Our findings may be due to increased soft tissue composition and fat inhomogeneity
in the LAT scanning field resulting in increased X-ray attenuation in obesity.
Received: 22 July 1997 / Accepted: 26 January 1998 相似文献
9.
Resch H Newrkla S Grampp S Resch A Zapf S Piringer S Hockl A Weiss P 《Calcified tissue international》2000,66(5):338-341
In 20 patients (mean age 23 ± 5 years) with anorexia nervosa (AN), bone mass was evaluated by broadband ultrasound attenuation
(BUA) of the calcaneus, peripheral quantitative computed tomography (pQCT) of the distal radius, and dual X-ray absorptiometry
(DXA) of the lumbar spine and the hip. Compared with 20 age- and sex- matched healthy controls, patients with AN showed marked
osteopenia at all measuring sites. Values of BUA (33.0 ± 9dB/MHz vs. 51.0 ± 5.7 dB/MHz; P < 0.0001) and of BMD of all regions of the hip (e.g., femoral neck: 0.71 ± 0.13 g/cm2 versus 0.89 ± 0.07 g/cm2; P < 0.001), lumbar spine (0.82 ± 0.15 g/cm2 versus 1.24 ± 0.06 g/cm2; P < 0.003) and total BMD of the peripheral radius (303.2 ± 75 g/cm3 versus 369.4 ± 53.2 g/cm3, P < 0.001) were significantly reduced. Calculating a Z-score we found the most prominent differences between AN and controls
by BUA of the calcaneus (−3.2 ± 1.6), followed by DXA at the lumbar spine (−2.9 ± 2.2) and the hip (femoral neck −2.1 ± 1.7)
and by pQCT at the distal radius (total BMD −1.2 ± 2.0). There were highly significant correlations between BUA of the calcaneus
and BMD of the femoral neck (r = 0.78, P < 0.0001) and lumbar spine (r = 0.75, P < 0.0001) as well as between BMD values of the femoral neck and lumbar spine (r = 0.95; P < 0.0001). In addition, there were significant correlations (P < 0.001) between body mass index (BMI) and the three different measuring sites and between the duration of the disease and
BUA (r = 0.5, P < 0.05). Our data suggest that BUA of the calcaneus is a valuable tool in the management of osteoporosis. Being a fast, radiation-free
investigation method of good acceptance, it may be well suited for an assessment of the skeletal status in patients with AN.
Received: 14 October 1998 / Accepted: 10 December 1999 相似文献
10.
S. L. Bonnick D. L. Nichols C. F. Sanborn K. Lloyd S. G. Payne L. Lewis C. A. Reed 《Calcified tissue international》1997,61(4):263-265
The purpose of this study was to determine if differences exist in premenopausal women between z-scores for lumbar spine
and proximal femoral bone mineral densities (BMD). Participants were 237 women ranging in age from 20 to 45 years. BMDs of
the lumbar spine and proximal femur (femoral neck, Ward's area, and trochanter) were assessed using dual-energy X-ray absorptiometry
(Lunar DPX). Mean (±SD) age, height, and weight of the participants were 29.4 ± 6.9 years, 164.4 ± 6.1 cm, and 64.9 ± 12.1
kg, respectively. Lumbar spine BMD and BMD at the femoral neck, Ward's area, and trochanter were significantly correlated
with large SEEs (r = 0.59–0.65; SEE = 0.09–0.11). No positive correlation with age and BMD at any site was seen in this population
but a significant negative correlation with age was seen in the proximal femur beginning at age 30. Twenty to 24% of the 20–29-year-olds
exhibited a difference in z-scores of greater than 1 between the spine and sites in the proximal femur. This percentage increased
to 32–46% in the 30–45-year-olds but the nature of the observed differences changed. The differences in spine and proximal
femoral z-scores that are seen in the older age group appear to be the result of the earlier onset of bone loss in the proximal
femur rather than an initial difference in peak bone mass which has been maintained.
Received: 28 August 1996 / Accepted: 25 April 1997 相似文献
11.
Treatment of Postmenopausal Women with Osteoporosis or Low Bone Density with Raloxifene 总被引:3,自引:0,他引:3
P. J. Meunier E. Vignot P. Garnero E. Confavreux E. Paris S. Liu-Leage S. Sarkar T. Liu M. Wong M. W. Draper 《Osteoporosis international》1999,10(4):330-336
Raloxifene, a selective estrogen receptor modulator (SERM), has been shown to improved bone mineral density (BMD) and serum
lipid profiles in healthy postmenopausal women. The objective of this study was to examine the effects of raloxifene on BMD,
biochemical markers of bone metabolism and serum lipids in postmenopausal women with low bone density or osteoporosis. This
Phase II, multicenter, 24-month, double-masked study assessed the efficacy and safety of raloxifene in 129 postmenopausal
women (mean age ± SD: 60.2 ± 6.7 years) with osteoporosis or low bone density (baseline mean lumbar spine BMD T-score: −2.8). Women were randomly assigned to one of three treatment groups: placebo, 60 mg/day raloxifene-HCl (RLX 60) or
150 mg/day raloxifene-HCl (RLX 150) and concomitantly received 1000 mg/day calcium and 300 U/day vitamin D3. At 24 months, BMD was significantly increased in the lumbar spine (+3.2%), femoral neck (+2.1%), trochanter (+2.7%) and
total hip (+1.6%) in the RLX 60 group compared with the placebo group (p<0.05). The RLX 150 group had increases in BMD similar to those observed with RLX 60. A greater percentage of raloxifene-treated
patients, compared with those receiving placebo, had increased BMD (p<0.05). Serum bone-specific alkaline phosphatase activity, serum osteocalcin, and urinary type I collagen:creatinine ratio
were significantly decreased in the RLX-treated groups, compared with the placebo group (p<0.01). RLX 60 treatment significantly decreased serum levels of triglycerides, and total- and LDL-cholesterol levels (p<0.01). The rates of patient discontinuation and adverse events were not significantly different among groups. In this study,
raloxifene increased bone density, decreased bone turnover, and improved the serum lipid profile with minimal adverse events,
and may be a safe and effective treatment for postmenopausal women with osteoporosis or low bone density.
Received: 26 December 1998 / Accepted: 31 March 1999 相似文献
12.
J. M. Thompson G. W. Modin C. D. Arnaud N. E. Lane 《Calcified tissue international》1997,61(5):377-381
Chronic steroid use results in osteoporosis, and postmenopausal women are believed to be at a high risk for steroid-induced
bone loss. The purpose of this study was to determine predictors of bone mineral density (BMD) in postmenopausal women on
both chronic steroid and hormone replacement therapy. Seventy-six postmenopausal women (≥3 years postmenopausal, ≥2 years
of steroid treatment of ≥5 mg/day of prednisone, and ≥1 year of hormone replacement therapy) were recruited into this study.
Measurements of BMD of the lumbar spine and femoral neck were obtained in all subjects. Risk factors for osteoporosis were
obtained by questionnaire. Discriminant analysis was performed to determine predictors of BMD. Osteoporosis, defined by a
T score of <−2.5, was present in the lumbar spine or femoral neck in 34 of the 76 subjects. Based on these criteria, women
with osteoporosis were significantly older, were more years postmenopausal, and had a lower body mass index (BMI) than women
who did not have osteoporosis. Predictors of osteoporosis for both the femoral neck and spine included a low BMI (P < 0.05),
more years postmenopausal (P < 0.01), and more years on steroids (P < 0.01). Low BMI was the only significant predictor of osteoporosis in the lumbar spine (P < 0.05), whereas for the femoral neck both years on steroids (P < 0.05) and BMI (P < 0.05) were significant predictors of low BMD. In summary, not all postmenopausal women on chronic steroid and hormone replacement
therapy are osteoporotic but a low BMI, more years on steroids, and more years postmenopausal were significant predictors
of osteoporosis in these subjects.
Received: 8 November 1997 / Accepted: 21 May 1997 相似文献
13.
Bone Mineral Content and Density in Professional Tennis Players 总被引:5,自引:0,他引:5
J. A. L. Calbet J. S. Moysi C. Dorado L. P. Rodríguez 《Calcified tissue international》1998,62(6):491-496
Total and regional bone mineral content (BMC) as well as lean and fat mass were measured in nine male professional tennis
players (TPs) and 17 nonactive subjects; dual-energy X-ray absorptiometry (DXA) was used for measuring. The mean (±SD) age,
body mass, and height were 26 ± 6 and 24 ± 3 years, 77 ± 10 and 74 ± 9 kg, and 180 ± 6 and 178 ± 6 cm for the TP and the control
group (CG), respectively. The whole body composition for BMC, lean mass, and fat of the TP was similar to that observed in
the CG. The tissue composition of the arms and legs was determined from the regional analysis of the whole-body DXA scan.
The arm region included the hand, forearm, and arm, and was separated from the trunk by an inclined line crossing the scapulo-humeral
joint. In the TP, the arm tissue mass (BMC + fat + lean mass) was about 20% greater in the dominant compared with the contralateral
arm because of a greater lean (3772 ± 500 versus 3148 ± 380 g, P < 0.001) and BMC (229.0 ± 43.5 versus 188.2 ± 31.9 g, P < 0.001). In contrast, no significant differences were observed either in BMC or BMD between arms in the CG. Total mass,
lean mass, and BMC were greater in the dominant arm of the TP than in the CG (all P < 0.05). In the TP, BMD was similar in both legs whereas in the CG, BMD was greater in the right leg. Lumbar spine (L2–L4)
BMD, adjusted for body mass and height, was 15% greater in the TP than in the CG (P < 0.05). Femoral neck BMDs (femoral neck, Ward's triangle, greater trochanter, and intertrochanteric regions) adjusted for
body mass and height were 10–15% greater in the TP (all P < 0.05). Ward's triangle BMD was correlated with the maximal leg extension isometric strength (r = 0.77, P < 0.05) even when adjusted for body mass (r = 0.76, P < 0.05) and height (r = 0.77, P < 0.05). In summary, the participation in tennis is associated with increased BMD in the lumbar spine and femoral neck. These
results may have implications for devising exercise strategies in young and middle-aged persons to prevent involutional osteoporosis
later in life.
Received: 29 April 1997 / Accepted: 14 November 1997 相似文献
14.
目的:探讨最大限度雄激素阻断(MAB)治疗对前列腺癌患者骨密度的影响。方法:对40例因前列腺癌行MAB治疗的患者进行调查,治疗时间7~12个月,分别于治疗前后检测血清前列腺特异性抗原(PSA)、睾酮及血钙、血磷、24 h尿钙、尿磷、碱性磷酸酶、甲状旁腺激素、血常规及肝肾功能,双能X线吸收法测定腰椎、股骨颈骨密度,并进行疼痛评分,比较MAB治疗前后各项指标差异。结果:前列腺癌患者治疗前5例(12.5%)腰椎骨量减少,8例(20.0%)腰椎骨质疏松;13例(32.5%)左股骨颈骨量减少,15例(37.5%)左股骨颈骨质疏松。MAB治疗前患者血清PSA为(52.9±69.9)μg/L,睾酮为(18.9±6.5)nmol/L,治疗后PSA为(1.5±1.6)μg/L,睾酮为(1.9±1.3)nmol/L,与治疗前比较均显著下降(P<0.05)。治疗前血钙为(2.5±0.2)mmol/L,血磷为(1.2±0.2)mmol/L,尿钙为(3.1±1.4)mmol/L,尿磷为(11.5±8.1)mmol/L,治疗后血钙为(2.5±0.1)mmol/L,血磷为(1.2±0.1)mmol/L,尿钙为(2.8±1.2)mmol/L,尿磷为(9.9±4.0)mmol/L,两者比较差异均无统计学意义(P>0.05)。治疗前后碱性磷酸酶、甲状旁腺激素、血常规、肝肾功能差异均无统计学意义(P>0.05)。治疗前腰椎和股骨颈骨密度分别为(1.1±0.1)g/cm2和(0.8±0.2)g/cm2,疼痛评分为(0.6±0.2)分,治疗后腰椎和股骨颈骨密度分别为(1.1±0.2)g/cm2和(0.8±0.1)g/cm2,疼痛评分为(0.7±0.1)分,与治疗前比较差异均无统计学意义(P>0.05)。结论:7~12个月MAB治疗对前列腺癌患者骨密度无明显影响,安全有效,但治疗前应注意监测患者骨密度。 相似文献
15.
E. Vega G. Ghiringhelli C. Mautalen G. Rey Valzacchi H. Scaglia C. Zylberstein 《Calcified tissue international》1998,62(5):465-469
The bone mineral density (BMD) at the lumbar spine, proximal femur, and total skeleton was evaluated in 38 men with primary
osteoporosis and vertebral fractures. BMD of the patients was significantly reduced over all skeletal areas compared with
controls. The Z-score of the lumbar spine (−2.8 ± 0.9) was less than that of the other areas (P < 0.001) except the legs (−2.5 ± 1.1) (p.n.s.) showing that bone loss had a tendency to be greater over the axial skeleton.
Vertebral dimensions compared with age-matched controls were as follows: projected L2–L4 area (cm 2): 45.7 ± 5.6 versus 53.7
± 3.6 (P < 0.001); vertebral width (cm): 4.37 ± 0.44 versus 4.90 ± 0.36 (P < 0.001). Serum biochemical parameters and testosterone levels were similar between osteoporotic and control men. We conclude
that men with vertebral osteoporotic fractures have reduced vertebral BMD and vertebral dimensions compared with age-matched
controls. Thus, these findings indicate that the achievement of a reduced bone size at the end of the growth period or a failure
of periosteal increase during adult life is likely to contribute to the pathogenesis of the vertebral fractures observed in
older men.
Received: 31 January 1997 / Accepted: 2 July 1997 相似文献
16.
J. Fiter J. M. Nolla C. Gómez-Vaquero D. Martínez-Aguilá J. Valverde D. Roig-Escofet 《Osteoporosis international》2001,12(7):565-569
The aim of the study was to evaluate whether computed digital absorptiometry (CDA) of the hand might be a useful screening
technique for identifying patients with postmenopausal osteoporosis and to compare the results of CDA with those of dual-energy
X-ray absorptiometry (DXA) of the lumbar spine and femoral neck. We studied 230 postmenopausal women (mean age 58.4 ± 7.9
years). For CDA, bone mineral density (BMD) was measured with an AccuDEXA Schick densitometer in the third middle phalanx
of the nondominant hand. For DXA, BMD of the lumbar spine and upper femur was assessed using a DXA Hologic QDR-1000 densitometer.
We did a comparative analysis (ANOVA) and linear correlation tests. Sensitivity and specificity of CDA and receiver operating
characteristic (ROC) curves for the diagnosis of osteoporosis were calculated. The mean BMD with CDA was 0.445 ± 0.084 (T-score: −1.27 ± 1.29). The mean BMD (g/cm2) with DXA at the lumbar spine was 0.877 ± 0.166 (T-score: −1.52 ± 1.59) and 0.708 ± 0.127 at the femoral neck (T-score: −1.12 ± 1.25). BMD at the lumbar spine and femoral neck correlated positively with CDA of the hand (r= 0.66 and r= 0.65 respectively, p<0.001). When using as cut-off a T-score of −2.5, according to WHO criteria, 76 women (33%) had osteoporosis of the lumbar spine and/or femoral neck with DXA
and 42 (18%) with CDA (p<0.001). The kappa score for osteoporosis was 0.33 for CDA versus spinal DXA and 0.35 for CDA versus femoral DXA. With the
cut-off level used, sensitivity and specificity of CDA in detecting osteoporosis at the lumbar spine were 0.39 and 0.90, respectively;
sensitivity and specificity of CDA in identifying osteoporosis at the femoral neck were 0.58 and 0.87, respectively. The positive
predictive value of CDA for osteoporosis was 69% and the negative predictive value was 75%. The area under the ROC curve for
osteoporosis was 0.822 ± 0.028. We conclude that: (a) CDA assessment has a moderate correlation with BMD measured by DXA at
the lumbar spine and femoral neck; (b) CDA has a low sensitivity for the diagnosis of osteoporosis compared with spinal and
femoral DXA; and (c) predictive values for osteoporosis at both the lumbar spine and femoral neck are acceptable.
Received: September 2000 / Accepted: January 2001 相似文献
17.
Calcaneus bone mineral density (BMD) of 738 Japanese women (605 healthy and 133 with osteoporosis) was measured using single
X-ray absorptiometry (SXA). A reference range of calcaneus BMD values for healthy Japanese women was established and the usefulness
of this method for screening and diagnosis of osteoporosis was evaluated. There was no significant age change of calcaneus
BMD prior to menopause, though values decreased significantly thereafter. BMD loss ratio was 1.7%/year in the 10 years after
menopause.
The reference range of calcaneus BMD was 410 ± 43 mg/cm2, calculated from the mean BMD value of subjects whose ages ranged from 25 to 50 years old. The fracture threshold for the
spine was established as 294 mg/cm2, which corresponded to −2.67 SD from the average BMD of the young healthy women, and the odds ratio for spine fracture in
the subjects with BMD lower than this threshold was 3.52 [95% CI (confidence interval) 1.34–9.26]. The spine fracture group
showed statistically lower calcaneus BMD than the nonfracture group when subjects with adjusted age and body size were analyzed.
There were no significant differences in the ROC analysis for spine fracture between calcaneus BMD and spine BMD. Therefore,
calcaneus BMD is not readily affected by degenerative change or soft tissue, and the annual decrement rate (1.7%/year) can
be detected easily and with low precision error (0.8%). These indices may prove useful for the screening and diagnosis of
osteoporosis.
Received: 16 September 1998 / Accepted: 28 January 1999 相似文献
18.
M. M. Boomsma C. A. Stegeman A. B. Kramer M. Karsijns D. A. Piers J. W. Cohen Tervaert 《Osteoporosis international》2002,13(1):74-82
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a relapsing-remitting disease, which is treated with
corticosteroids (CS) in combination with cyclophosphamide. One of the major side-effects of this treatment is osteoporosis,
which may result in the increased occurrence of fractures. In the present study we measured the prevalence of reduced bone
mineral density (BMD) in a cross-sectional cohort of patients and correlated BMD findings with cumulative doses of CS and/or
cyclophosphamide. BMD was measured by dual-energy X-ray absorptiometry (DXA) of the lumbar spine, radius and proximal femur
between January 1998 and December 1999. Cumulative doses of CS and cyclophosphamide were calculated by chart review. Ninety-nine
consecutive patients (48 men, 51 women) aged 55 ± 16 years (mean ± SD) were studied 50 months (median; range 0–400 months)
after a diagnosis of ANCA-associated vasculitis had been made. Sixty-nine patients were treated with 10.7 g (median cumulative
dose; range 0.4–67.2g) of CS, and 88 patients were treated with 34.1 g (median cumulative dose; range 0.8–324.3g) of cyclophosphamide.
Fifty-seven percent of the patients had osteopenia (T-score: –1 to –2.5 SD), and 21% had osteoporosis (T-score: <−2.5 SD) at least at one site. Thirty-four of 37 (92%) postmenopausal women, 9 of 14 (64%) premenopausal women, and
34 of 48 (71%) men had either osteopenia or osteoporosis. The mean age- and sex-adjusted BMD (Z-score) of the proximal femur in men was found to be significantly lower than zero. Cumulative dose of CS therapy showed an
inverse relation with Z-scores at the lumbar spine (p= 0.035) and proximal femur (p = 0.011). Cumulative dose of cyclophosphamide was not correlated with Z-scores. Osteopenia and osteoporosis are thus frequently observed in patients with ANCA-associated vasculities. However, only
in men is the mean Z-score significantly lower than zero. Cumulative dose of CS therapy is significantly associated with bone loss at the spine
and femur.
Received: 26 March 2001 / Accepted: 1 August 2001 相似文献
19.
Intravenous Pamidronate as Treatment for Osteoporosis after Heart Transplantation: A Prospective Study 总被引:4,自引:0,他引:4
M. A. Krieg C. Seydoux L. Sandini J. J. Goy D. Gillard Berguer D. Thie´baud P. Burckhardt 《Osteoporosis international》2001,12(2):112-116
Fractures due to osteoporosis are one of the major complications after heart transplantation, occurring mostly during the
first 6 months after the graft, with an incidence ranging from 18% to 50% for vertebral fractures. Bone mineral density (BMD)
decreases dramatically following the graft, at trabecular sites as well as cortical sites. This is explained by the relatively
high doses of glucocorticoids used during the months following the graft, and by a long-term increase of bone turnover which
is probably due to cyclosporine. There is some evidence for a beneficial effect on BMD of antiresorptive treatments after
heart transplantation. The aim of this study was to assess prospectively the effect on BMD of a 3-year treatment of quarterly
infusions of 60 mg of pamidronate, combined with 1 g calcium and 1000 U vitamin D per day, in osteoporotic heart transplant
recipients, and that of a treatment with calcium and vitamin D in heart transplant recipients with no osteoporosis. BMD of
the lumbar spine and the femoral neck was measured by dual-energy X-ray absorptiometry in all patients every 6 months for
2 years and after 3 years. Seventeen patients, (1 woman, 16 men) aged 46 ± 4 years (mean ± SEM) received only calcium and
vitamin D. A significant decrease in BMD was observed after 6 months following the graft, at the lumbar spine (−6.6%) as well
as at the femoral neck (−7.8%). After 2 years, BMD tended to recover at the lumbar spine, whereas the loss persisted after
3 years at the femoral neck. Eleven patients (1 woman and 10 men) aged 46 ± 4 years (mean ± SEM) started treatment with pamidronate
on average 6 months after the graft, because they had osteoporosis of the lumbar spine and/or femoral neck (BMD T-score below −2.5 SD). Over the whole treatment period, a continuous increase in BMD at the lumbar spine was noticed, reaching
18.3% after 3 years (14.3% compared with the BMD at the time of the graft). BMD at the femoral neck was lowered in the first
year by −3.4%, but recovered totally after 3 years of treatment. In conclusion, a 3-year study of treatment with pamidronate
given every 3 months to patients with existing osteoporosis led to a significant increase in lumbar spine BMD and prevented
loss at the femoral neck. However, since some of these patients were treated up to 14 months after the transplant, they may
already have passed through the phase of most rapid bone loss. In patients who were not osteoporotic at baseline, treatment
with calcium and vitamin D alone was not able to prevent the rapid bone loss that occurs immediately after transplantation.
Received: 31 June 2000 / Accepted: 23 August 2000 相似文献
20.
Effects of Risedronate Treatment on Bone Density and Vertebral Fracture in Patients on Corticosteroid Therapy 总被引:22,自引:0,他引:22
Wallach S Cohen S Reid DM Hughes RA Hosking DJ Laan RF Doherty SM Maricic M Rosen C Brown J Barton I Chines AA 《Calcified tissue international》2000,67(4):277-285
Men and women (n = 518) receiving moderate-to-high doses of corticosteroids were enrolled in two studies with similar protocols
and randomly assigned to receive either placebo or risedronate (2.5 or 5 mg) for 1 year. All patients received daily calcium
supplementation (500–1000 mg), and most also received supplemental vitamin D (400 IU). The primary endpoint was the difference
between the placebo and active groups in lumbar spine bone mineral density (BMD) at 1 year; changes in BMD at other sites,
biochemical markers of bone turnover, and the incidence of vertebral fractures were also assessed. In the overall population,
the mean (SE) lumbar spine BMD increased 1.9 ± 0.38% from baseline in the risedronate 5 mg group (P < 0.001) and decreased 1.0 ± 0.4% in the placebo group (P= 0.005). BMD at the femoral neck, trochanter, and distal radius increased or was maintained with risedronate 5 mg treatment,
but decreased in the placebo group. Midshaft radius BMD did not change significantly in either treatment group. The difference
in BMD between the risedronate 5 mg and placebo groups was significant at all skeletal sites (P < 0.05) except the midshaft radius at 1 year. The 2.5 mg dose also had a positive effect on BMD, although of a lesser magnitude
than that seen with risedronate 5 mg. A significant reduction of 70% in vertebral fracture risk was observed in the risedronate
5 mg group compared with the placebo group (P= 0.01). Risedronate was efficacious in both men and women, irrespective of underlying disease and duration of corticosteroid
therapy, and had a favorable safety profile, with a similar incidence of upper gastrointestinal adverse events in the placebo
and active treatment groups. Daily treatment with risedronate 5 mg significantly increases BMD and decreases vertebral fracture
risk in patients receiving moderate-to-high doses of corticosteroid therapy.
Received: 11 October 1999 / Accepted: 1 May 2000 / Online publication: 27 July 2000 相似文献