苏州地区1931名健康成人腰椎骨密度调查分析

目的了解苏州地区正常成年人群腰椎骨密度(BMD)的正常参考值及其变化规律。方法应用双能X线骨密度仪,对1931名成年健康男女进行腰椎(L_(1-4))骨密度测量,并将所得结果标准化处理后进行统计学分析。结果①男性腰椎(L_(1-4))BMD值在20～29岁达到峰值,女性在30～39岁达到峰值,女性较男性晚10年;②男性BMD值在30岁以后逐渐降低,但无明显加速丢失期;女性BMD在40岁以后开始丢失,且存在迅速丢失现象;苏州地区健康成年人腰椎BMD峰值:男性为(1.084±0.135)g/cm~2,女性为(1.096±0.119)g/cm~2,男性腰椎BMD峰值略低于女性。结论初步明确苏州地区健康人群腰椎BMD峰值,发现不同性别和不同年龄组人群骨密度的变化规律及其差异,为本地区骨质疏松的预防和诊治提供了有用的信息。     

医学新闻

40岁以上人群有 16 .1%患骨质疏松症　　据健康报 2 0 0 1年 6月 7日报道 ,由卫生部北京医院流行病学研究室牵头完成的国家“九五”攻关课题“中国部分地区老年人群骨质疏松症流行病学研究” ,是全国首次开展的较大规模专题调查 ,采用分层多阶段整群抽样方法 ,对全国五大行政区 5 0岁以上的 5万人开展问卷调查 ,并用 3种不同型号的双能Ｘ线骨密度仪测量了 2 0岁以上 70 0 0人的骨密度 ,通过校正、标化各种数据 ,确定了我国一般人群不同性别、不同年龄的腰椎、股骨上端骨密度正常参考值和骨峰值。研究发现 ,我国目前 40岁以上人群骨质疏松患…     

中国人群定量CT椎体骨密度正常参考数据库及与BMI、年龄的相关性:基于中国健康定量CT大数据队列研究

目的 分析中国健康定量CT大数据(China Biobank)相关数据,旨在建立中国人群腰椎骨密度(bone mineral density,BMD)的正常参考值数据库.方法 2018年6月到2019年6月,China Biobank共纳入69811例低剂量胸部CT肺癌筛查健康体检志愿者.所有志愿者按照统一设定定量CT...     

骨密度超声波测量法对老年性骨质疏松的诊断价值

目的通过比较正常组和骨质疏松组跟骨骨密度，探讨老年性骨质疏松的诊断价值。方法用ＬＵＮＡＲＡｃｈｉｌｅｓ系统对４０６名日本正常老年人群和３１５名老年性骨质疏松患者进行跟骨骨密度测定。结果老年性骨质疏松患者ＢＵＡ、ＳＯＳ和ＳＩ明显低于正常老年人群（Ｐ＜０．０１），正常老年人群中女性的超声波测量值明显低于男性（Ｐ＜０．０５）。结论超声波法测量跟骨骨密度可以很好地将骨质疏松患者从正常人群中区别开来。     

老年男性红细胞计数正常参考值与环境因素的回归分析

目的为制定中国老年男性红细胞计数正常参考值的统一标准提供科学依据。方法收集中国301个单位测定的37685例老年男性红细胞计数正常参考值,运用相关分析和回归分析的方法,研究其与八个地理因素的关系。结果老年男性红细胞计数正常参考值与中国地理因素之间有很显著的相关关系(F=246.91,P=0.000)。采用逐步回归分析的方法推导出了一个回归方程:Y^=2.590 0.0003800X1 0.007702X3 0.02821X5 0.009705X6 0.0003191X7±0.54。结论可以用回归方程计算不同地区的老年男性红细胞计数正常参考值。     

中国男性收缩压参考值的地理分布规律

目的 探讨中国男性收缩压参考值和地理因素之间的相关性.方法 收集中国30个省份的6178例健康男性收缩压参考值,应用SPSS统计软件,运用相关分析和回归分析的方法,研究其与九项地理因素指标的关系.不同的地方相关地理因素不同,运用多元回归分析、曲线估计和主成分分析估计收缩压四项指标的正常参考值,得出不同的收缩压预测模型.结果 健康男性收缩压参考值与中国地理因素之间显著相关(F=6.231,P=0.000).结论 健康男性收缩压参考值的预测模型为:YSBP =73.211 +0.671 +0.374X8 +0.386X9.同时精确地拟合并绘制出男性的收缩压正常参考值的空间趋势分布图,通过分布图可以明确地读出中国各个地区男性收缩压参考值.     

正常人前臂桡骨数字X射线骨密度测量结果:全国流行病学调查

目的分析全国流调中数字X射线测量正常人群前臂桡骨骨密度的结果及其特点。方法收集全国12个流调点4 982例正常受试志愿者行数字X射线测量前臂桡骨骨密度的测量结果。桡骨测量部位和感兴趣区为非优势侧前臂桡骨远端1/3处。其中男性2 110人,平均年龄(54. 8±14. 2)岁(20～89岁);女性2 872人,平均年龄(55. 5±13. 0)岁(20～89岁)。结果前臂桡骨骨密度峰值均位于30～40岁年龄组,男性骨峰值(0. 990±0. 118) g/cm2,显著高于女性骨峰值(0. 844±0. 100) g/cm2(P0. 001);峰值后,随年龄组的增加而下降,女性各年龄组的下降率均高于男性,特别是50～60岁年龄组女性骨密度下降最为明显(12. 87%/10年)。结论前臂X线骨密度检测系统用于此次流调时的测量结果可反映正常人群前臂桡骨骨密度、骨密度随年龄变化及老年人群骨密度不同程度下降的状况。     

民普及碘盐后人群吸碘率正常值探讨

目的 确定我省实施新浓度碘盐供应后,人群吸碘率正常值范围。方法被检测对象空腹口服２ｕｃｉ碘１３１示踪剂后,用闪烁探测器分别测定４ 小时及２４小时甲状腺吸碘率。结果全民普及新浓度碘盐后,人群甲状腺吸碘率明显降低,不同人群甲状腺吸碘率有显著性差异。结论建议我省成人甲状腺吸碘率正常参考值为３．８１％－２４．５０％,学生甲状腺吸碘率正常参考值为２．３３％－２０．４０％。     

脑钠尿肽参考值与地理环境的主成分分析

目的分析成年人脑钠尿肽参考值与地理因素之间的关系,探索该人群脑钠尿肽参考值的地理分布规律,为制定中国成年人脑钠尿肽参考值的统一标准提供科学依据。方法应用SPSS19.0分析软件对收集整理的全国134个市(县)级医院和有关科研单位的11 717例18~93岁的健康成年人的脑钠尿肽参考值与10项地理因素指标进行相关分析;然后应用主成分分析建立中国各地成年人脑钠尿肽参考值的预测模型;最后应用ARCGIS10.0软件中地理统计分析模块对中国2 322个地区的成年人脑钠尿肽指标预测值进行析取克里格插值,分析拟合出脑钠尿肽参考值的空间分布趋势图。结果健康成年人脑钠尿肽参考值与地理因素间存在显著相关关系;建立的回归模型能够较好地预测不同地区成年人脑钠尿肽参考值。结论脑钠尿肽参考值预测模型的建立应考虑地理因素的影响,若已知中国某地的地理因素,即可运用建立的预测模型预测出该地区成年人的脑钠尿肽参考值。     

上海地区正常成人第1秒用力吸气容积正常值及预计方程式的探索

目的探索上海市正常人群第1秒用力吸气容积（forcedinspiratoryvolumeinonesecond，FIV1）的预计值和医学参考值范围。方法对上海地区521名健康成年人，采用德国耶格公司生产的MasterScreendifiusion（SN：694855）型肺功能仪测定FIV1，探索正常人群FIV1的预计值和医学参考值范围，分析正常人群FIV1与年龄、体质量以及身高的相关性。结果肺功能参数FIV1与身高和年龄呈正相关，但FIV。与身高的关系最为密切，与体质量无关。正常成年男性FIV。预计值的回归方程为FIV1=-．351＋0．061＊身高-0．027＊年龄（身高、年龄P〈0．001，体质量P〉0．05），医学参考值范围为2．1075-4．9591；正常成年女性FIV。预计值的回归方程为FIV1=-2．457＋0．04＊身高-0．025＊年龄（身高、年龄P〈0．001，体质量P〉0．05），医学参考值范围为1．2783～3．5171。结论FIVl值与身高和年龄有关，建立并推荐上海地区使用本成人FIV，正常预计值。     

Reduced bone mineral density is associated with breast arterial calcification

BACKGROUND: Arterial calcification, a marker of atherosclerosis, results from a complex process of biomineralization resembling bone formation. Breast arterial calcification (BAC) has been associated with angiographic and clinical cardiovascular disease. The purpose of this study was to determine the association between reduced bone mineral density (BMD) and BAC, which may share a common pathophysiology. METHODS: We conducted a retrospective study of 228 women (55% Hispanic, mean age 64 +/-10 yr) who had both mammography and BMD evaluation at Columbia University Medical Center from 2001-2003. Each mammogram was reviewed for the presence of BAC using standardized methods. BMD was measured using dual-energy x-ray absorptiometry and categorized as normal, low bone density (osteopenia), or osteoporosis as defined by the World Health Organization. Univariate and multivariate logistic regression analyses were performed to evaluate the association between reduced BMD and BAC. RESULTS: The prevalence of BAC, low bone density (osteopenia), and osteoporosis was 39, 42, and 29%, respectively. Women with BAC were significantly more likely to be older, Hispanic, and postmenopausal and have osteoporosis as compared with women without BAC. In age-adjusted analyses, women with BAC were more likely to have reduced BMD (odds ratio 3.0, P < 0.01) as compared with women without BAC. Furthermore, osteoporosis was strongly associated with the presence of BAC (odds ratio 3.5, P < 0.01). CONCLUSION: These data suggest that osteoporosis and arterial calcification are strongly and independently correlated. Reduced BMD may identify women at risk of vascular disease.     

Relationship between carotid atherosclerosis and lumbar spine bone mineral density in postmenopausal women

Osteoporosis and increased carotid intima-media thickness (IMT) have been associated with atherosclerosis. We investigated the correlation between carotid IMT and lumbar spine bone mineral density (BMD) in postmenopausal women. We studied the carotid IMT in 175 postmenopausal women, including 43 women (control) with normal spinal BMD, 73 women with osteopenia, and 59 women with osteoporosis. Carotid IMT was assessed by ultrasonography. BMD at the lumbar spine (lumbar 2 to 4 vertebrae) was measured by dual-energy X-ray absorptiometry. Age, years since menopause, and carotid IMT were significantly greater in the osteoporosis group than in the control (all p<0.01) and osteopenia groups (all p<0.01). Estradiol was significantly lower in the osteoporosis group than in the control group (p<0.05). BMD was significantly lower in the osteoporosis group than in the osteopenia or control group (both p<0.01) and in the osteopenia group than in the control group (p<0.01). After adjusting for age, years since menopause, and estradiol, women with osteoporosis had significantly greater carotid IMT than controls (p<0.05). The univariate linear regression analysis revealed that carotid IMT was significantly positively correlated with age, years since menopause, and low-density lipoprotein (LDL) cholesterol (all p<0.05) and was significantly negatively correlated with estradiol and BMD (all p<0.05), but showed no significant association with other clinical variables. In multivariate regression analysis, the carotid IMT was significantly positively correlated with LDL cholesterol (p<0.01) and negatively correlated with BMD (p<0.01), but not with other variables. Carotid atherosclerosis might be associated with lumbar spine bone mass in postmenopausal women, suggesting that postmenopausal women with osteoporosis may have more advanced carotid atherosclerosis than those with a normal bone mass.     

Relationship between brachial arterial endothelial function and lumbar spine bone mineral density in postmenopausal women.

BACKGROUND: Osteoporosis and endothelial dysfunction have been associated with atherosclerosis. The correlation between brachial arterial endothelial function and lumbar spine bone mineral density (BMD) in postmenopausal women will be investigated. METHODS AND RESULTS: The endothelial function in 85 postmenopausal women, including 28 women with normal spinal BMD, 27 women with osteopenia, and 30 women with osteoporosis were studied. Brachial arterial flow-mediated vasodilatation (FMD) after reactive hyperemia was assessed by ultrasonography. The BMD at the lumbar spine (lumbar 2 to 4 vertebrae) was measured by dual-energy X-ray absorptiometry. Age, years since menopause, and FMD were significantly greater in the osteoporosis group than in the normal BMD group (p<0.01, p<0.05, and p<0.05, respectively). The BMD was significantly lower in the osteoporosis group than in the osteoporosis or normal BMD group (both p<0.01). After adjusting for age and years since menopause, women with osteoporosis had significantly lesser FMD than those with normal BMD (p<0.05). The univariate linear regression analysis revealed that brachial arterial FMD was significantly positively correlated with BMD (r=0.31, p<0.01), but showed no significant association with other clinical variables. In multivariate regression analysis, the FMD was significantly positively correlated with BMD (p<0.01), but not with other variables. CONCLUSIONS: Postmenopausal women with osteoporosis might have impaired brachial arterial endothelial function, suggesting that brachial artery endothelial function might be associated with lumbar spine bone mass in postmenopausal women.     

Osteoporosis in beta-thalassaemia major patients: analysis of the genetic background

Regular blood transfusions from infancy until adulthood in beta-thalassaemia major patients have substituted severe bone deformities with less marked skeletal lesions as osteoporosis. Osteoporosis is characterized by low bone mass and disruption of bone architecture, resulting in reduced bone strength and increased risk of fractures. Genetic factors have an important role in determining bone mineral density (BMD). We have investigated the possible association between BMD and two polymorphisms in 135 beta-thalassaemic patients: (i) a substitution G-->Tau in a regulatory region of the COLIA1 gene encoding for the major protein of bone (type 1 collagen), and (ii) a one-base deletion in intron 4 (713-8del C) of transforming growth factor beta 1 (TGF-beta1) gene. We have found a remarkable incidence (90%) of osteopenia and osteoporosis among regularly transfused patients. Bone mass was lower in men than in women (P = 0.0023), with a more prevalent osteopenia/osteoporosis of the spine in men than in women (P = 0. 001). The sample was stratified on the basis of BMD expressed as Z-score, i.e. normal, osteopenic and osteoporotic patients, and genotype frequencies of each group were evaluated. TGF-beta1 polymorphism failed to demonstrate a statistical difference in BMD groups. However, subjects with heterozygous or homozygous polymorphism of the COLIA1 gene showed a lower BMD than subjects without the sequence variation (P = 0.012). The differences among genotypes were still present when the BMD was analysed as adjusted Z-score and when men and women were analysed separately (P = 0.022 and 0.004 respectively), with men more severely affected. Analysis of COLIA1 polymorphism could help to identify those thalassaemic patients at risk of osteoporosis and fractures.     

Osteoporosis and bone fractures in alcoholic liver disease:A meta-analysis

AIM: To evaluate the association between alcoholic liver disease(ALD) and bone fractures or osteoporosis. METHODS: Non-randomized studies were identified from databases(Pub Med, EMBASE, and the Cochrane Library). The search was conducted using Boolean operators and keywords, which included "alcoholic liver diseases", "osteoporosis", or "bone fractures". The prevalence of any fractures or osteoporosis, and bone mineral density(BMD) were extracted and analyzed using risk ratios and standardized mean difference(SMD). A random effects model was applied. RESULTS: In total, 15 studies were identified and analyzed. Overall, ALD demonstrated a RR of 1.944(95%CI: 1.354-2.791) for the development of bone fractures. However, ALD showed a RR of 0.849(95%CI: 0.523-1.380) for the development of osteoporosis. BMD was not significantly different between the ALD and control groups, although there was a trend toward lower BMD in patients with ALD(SMD in femur-BMD:-0.172, 95%CI:-0.453-0.110; SMD in spine-BMD:-0.169, 95%CI:-0.476-0.138). Sensitivity analyses showed consistent results. CONCLUSION: Current publications indicate significant associations between bone fractures and ALD, independent of BMD or the presence of osteoporosis.     

Effect of glucocorticoids on bone mineral density in patients with idiopathic thrombocytopenic purpura

To elucidate the effects of glucocorticoid on bone mineral density in idiopathic thrombocytopenic purpura (ITP) patients, we retrospectively evaluated the relationship between bone mineral density (BMD) and the total dose of glucocorticoid or the mean daily dose given. We found decreased BMD in 66.7% of the patients with ITP to whom glucocorticoid was given, though rather normal bone BMD was observed in 28.6% of ITP patients treated without steroids. The mean level of BMD was markedly decreased in steroid-treated patients compared with steroid non-treated patients (p < 0.01). The relationship between BMD and the total dose of glucocorticoid (p = 0.023) or the mean daily dose revealed a negative correlation (p = 0.022). This study showed that glucocorticoid-induced osteoporosis was observed in patients with ITP, similar to other diseases already reported. When we think of this disease, many cases tend to be followed for a long time, and as the majority of ITP patients is female, we should pay particular attention in the prevention of glucocorticoid-induced osteoporosis.     

Forearm endothelial function and bone mineral loss in postmenopausal women

It is widely believed that the vasculature plays an important role in bone remodeling. We investigated the relationship between forearm endothelial function and bone mass in the lumbar spine in early postmenopausal women without a history of smoking or diabetes mellitus. We studied the forearm resistance artery endothelial function in 110 Japanese women-52 postmenopausal women with normal spinal bone mineral density (BMD), 36 postmenopausal women with osteopenia, and 22 osteoporotic postmenopausal women. Forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin (NTG) administration was measured by strain-gauge plethysmography. BMD of the lumbar spine (L2-L4) was measured by dual-energy X-ray absorptiometry. After adjustment for age, body mass index, years since the start of menopause, and basal FBF, women with osteoporosis had a lower maximal FBF response to reactive hyperemia (28.4 +/- 3.8 mL/min per 100 mL tissue) than those with normal BMD (39.8 +/- 2.8 mL/min per 100mL tissue) or osteopenia (35.6 +/- 2.5 mL/min per 100mL tissue) (P = 0.029). A significant increase in serum angiotensin-converting enzyme (ACE) activity (P = 0.042) and a significant decrease in the serum concentrations of nitrite/nitrate (P = 0.041) were noted in osteoporotic women compared to women with normal BMD or osteopenia. The present findings suggest that postmenopausal women with low BMD, especially those with osteoporosis, have impaired endothelial function in the forearm resistance arteries.     

Correlation of different bone markers with bone density in patients with rheumatic diseases on glucocorticoid therapy

Osteoporosis is a common concomitant disease in patients with rheumatic diseases on glucocorticoid (GC) therapy. Bone status is usually evaluated by determination of bone density in combination with clinical examinations and laboratory tests. However, the strength of individual biochemical bone makers in GC-induced osteoporosis has yet to be fully clarified. For this reason, different bone markers were investigated in correlation with bone density in patients with rheumatic diseases. Approximately 238 patients (212 women, 26 men) with a rheumatic disease and under GC therapy were examined consecutively for the first time with regard to bone density (BMD) and bone markers {osteocalcin, bone-specific alkaline phosphatase (precipitation method/tandem-MP ostase), crosslinks [pyridinoline (PYD), deoxypyridinoline (DPX), N-terminal telopeptide (NTX)]}. The daily glucocorticoid dose was 10 mg prednisone equivalent (median), and the cumulative dose was 12 g prednisone equivalent (median). None of the patients had previously taken medication for osteoporosis. Osteoporosis was demonstrated in 35.3% of the patients, osteopenia in 47.5%, and a normal BMD in 17.2%. The results of tandem-MP ostase correlated with the BMD of the lumbar spine and of the femoral neck. The values for N-terminal telopeptide and pyridinoline correlated only with the bone density of the femoral neck. All results were statistically significant, although the correlation coefficients were low. After classification of the patients according to their BMD values (osteoporosis, osteopenia and normal BMD), there were significantly more patients with bone markers above the norm in the osteoporosis group and in the osteopenia group than in the group with normal bone density. All bone markers recorded behaved similarly in relation to the bone density values. The same analysis was also undertaken for the different disease groups. In these subgroups there was also a correlation between ostase/crosslinks with BMD, but the correlation coefficients were low. A general recommendation for the routine use of a specific bone marker in patients with rheumatic diseases on glucocorticoid therapy cannot be made from a cost-benefit point of view mainly because of limited predictive power (low correlation coefficients, incomplete correlation with different sites of BMD measurement).     

Relation of bone mineral density to frequency of coronary heart disease

Coronary angiography was performed because of chest pain in 198 patients (146 women, 52 men; mean age 66 years) who had dual-energy x-ray absorptiometry scans of the spine and left hip because of suspected osteoporosis or osteopenia. Of the 198 patients, 53 (27%) had osteoporosis, 79 (40%) had osteopenia, and 66 (33%) had normal bone mineral density (BMD). Obstructive coronary artery disease with >50% narrowing of > or =1 major coronary artery was present in 40 of 53 patients (76%) with osteoporosis, in 54 of 79 patients (68%) with osteopenia, and in 31 of 66 patients (47%) with normal BMD (p <0.005 comparing osteoporosis with normal BMD, p <0.01 comparing osteopenia with normal BMD). In conclusion, in patients who undergo coronary angiography because of chest pain, patients with osteoporosis or osteopenia have a higher prevalence of obstructive coronary artery disease than those with normal BMD.