绝经后2型糖尿病患者骨质疏松相关因素分析

目的 探讨绝经后2型糖尿病(T2DM)患者骨质疏松的相关因素.方法 采用双能X线骨密度仪测定79例绝经后T2DM患者的正位腰椎(L1-4)、左股骨颈与左股骨粗隆及左全髋骨密度,根据骨密度值分为骨质疏松组与非骨质疏松组,并对测定的相关化验指标、年龄、病程、绝经年龄、绝经年限及体质指数(BMI)等进行对比分析.结果 两组年龄、BMI、白细胞介素6(IL-6)、骨钙素、绝经年限差异均有统计学意义,直线相关分析显示IL-6与骨质疏松(r=0.260,P=0.020)及糖化血红蛋白(GHbAlc)(r=0.259,P=0.023)相关;Logistic多因素回归分析显示,绝经后T2DM患者骨质疏松的发生与年龄独立相关,与BMI独立负相关.结论 年龄与低BMI可能是绝经后T2DM患者骨质疏松发生的独立危险因素.     

2型糖尿病内脂素和脂联素水平与颈动脉内膜中膜厚度的相关性

目的研究2型糖尿病患者血浆内脂素和脂联素水平的变化,并探讨其与颈动脉内膜中膜厚度的关系。方法73例2型糖尿病患者根据颈动脉超声结果分为颈动脉内膜中膜厚度增厚组37例,颈动脉内膜中膜厚度正常组36例;分别测定其血浆内脂素和脂联素,分析两者与颈动脉内膜中膜厚度变化的关系。结果2型糖尿病患者内脂素水平高于对照组,且颈动脉内膜中膜厚度增厚组高于颈动脉内膜中膜厚度正常组(P<0.01)。2型糖尿病组的脂联素水平低于对照组,且颈动脉内膜中膜厚度增厚组低于颈动脉内膜中膜厚度正常组(P<0.01)。多元逐步回归分析显示,内脂素与颈动脉内膜中膜厚度、内脏脂肪厚度、空腹胰岛素呈正相关;脂联素与颈动脉内膜中膜厚度、胰岛素抵抗指数呈负相关,与高密度脂蛋白胆固醇呈正相关。颈动脉内膜中膜厚度与内脂素、年龄、糖化血红蛋白呈正相关,与脂联素呈负相关。结论血浆内脂素增高及脂联素水平的降低可能是2型糖尿病患者合并早期动脉粥样硬化的危险因素之一。     

绝经后2型糖尿病患者体成分与骨密度关系初步探讨

目的探讨绝经后2型糖尿病患者骨密度与体成分的关系。方法选择绝经后2型糖尿病患者(DM组)68例,绝经后血糖正常女性(NC组)73例。详细记录全部受试者年龄、身高、体重、体重指数、绝经年限,双能X线吸收测定仪检测正位腰椎(L_(2-4))、股骨(股骨颈、大转子、粗隆间)骨密度(BMD)与全身各部位的脂肪和肌肉含量,并进行临床指标测定,分析骨密度与对应的肌肉和脂肪含量的相关关系。结果 2组受试者的年龄、BMI、绝经年限差异无统计学意义(P0.05);DM组空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbAlc)均明显高于NC组,差异有统计学意义(P0.05);DM组L_(2-4)、股骨颈、大转子BMD较NC组显著下降,差异有统计学意义(P0.05);DM组躯干、腿部、总肌肉含量均较NC组显著下降,差异有统计学意义(P0.05);DM组躯干、总脂肪含量较NC组明显增加,(P0.05)。根据骨密度测定结果将糖尿病组进一步分为糖尿病骨质疏松组(DM-OP组)和糖尿病非骨质疏松组(DM-NP组):2组受试者年龄、BMI、绝经年限的差异无统计学意义(P0.05);DM-OP组DM病程、FBG、PBG、HbAlc明显高于DM-NP组(P0.05),DM-OP组躯干、腿部、总肌肉含量均明显低于DM-NP组(P0.05);总脂肪含量DM-OP组明显高于DM-NP组(P0.05),其他部位脂肪含量2组间的差异无统计学意义(P0.05)。多元线性回归分析显示,糖尿病患者L_(2-4)、股骨均值BMD与年龄、绝经年限、糖尿病病程、BMI、TLM、TKLM关系最为密切。结论绝经后2型糖尿病患者较血糖正常女性容易发生骨质疏松,绝经后2型糖尿病患者肌肉含量、脂肪含量均与骨密度密切相关,肌肉含量较脂肪含量对骨密度影响更为显著。     

老年患者代谢综合征不同组合成份与颈动脉内膜的关系

目的探讨老年患者代谢综合征不同组合成份与颈动脉内膜中层厚度的关系。方法选择老年代谢综合征患者79例、年龄60岁以上,按组成成份不同分为老年伴糖尿病组41例,老年非糖尿病组38例,同时选年龄<60岁年轻伴糖尿病组37例。用彩色多普勒超声心动图仪检测颈动脉内膜中层厚度。结果老年伴糖尿病组与老年非糖尿病组颈动脉内膜中层厚度均较年轻伴糖尿病组明显增厚,二者之间有统计学意义(P<0.01),而老年伴糖尿病组又较老年非糖尿病组增厚明显,二组统计有显著意义(P<0.05)。相关分析显示颈动脉内膜-中膜厚度与年龄(r=0.300,P<0.01)、高血压病程(r=0.255,P<0.01)呈显著正相关,斑块发生率以老年伴糖尿病组最高(73.2%),其次为老年非糖尿病组(50%),年轻伴糖尿病组最少(21.6%)三组差异有显著性(P<0.05和0.01)。结论合并糖尿病的代谢综合征患者颈动脉内膜中层厚度较非糖尿病代谢综合征患者明显增厚,老年代谢综合征患者的颈动脉内膜-中膜厚度又较非老年患者增厚明显。     

2型糖尿病患者颈动脉硬化斑块形成的相关因素分析

目的 探讨2型糖尿病患者颈动脉硬化斑块形成的相关因素.方法 123例2型糖尿病患者,根据颈动脉彩色超声结果分为颈动脉无硬化斑块组、颈动脉硬化斑块组,分别检测各组血清C反应蛋白、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血浆致动脉硬化指数、血尿酸、血肌酐,并记录年龄、糖尿病病程、体重指数、收缩压、舒张压、脉压差、吸烟史、高血压史、微血管并发症、颈动脉内膜厚度等指标,进行统计学处理.结果 颈动脉硬化斑块组中年龄(P<0.01)、C反应蛋白(P<0.05)、颈动脉内膜厚度(P<0.01)以及微血管并发症发生率(P<0.05)均比颈动脉无硬化斑块组显著增高,差别均有统计学意义.Logistic回归分析显示,颈动脉内膜厚度与颈动脉硬化斑块形成独立相关(P<0.05).结论 2型糖尿病患者颈动脉硬化斑块形成与颈动脉内膜厚度、年龄、C反应蛋白等多因素有关,颈动脉内膜厚度增加是颈动脉硬化斑块形成的危险因素,颈动脉硬化斑块形成的同时微血管并发症的发生率增加.     

老年男性2型糖尿病患者下肢血管病变与骨质疏松的关系

目的探讨老年男性2型糖尿病患者下肢血管病变与骨质疏松的关系。方法老年男性2型糖尿病患者148例,采用双能X线吸收法测定腰椎骨和股骨区的骨密度,同时用超声探测双下肢动脉内膜中膜厚度及粥样斑块等情况。结果无血管病变组33例,轻中度血管病变组65例,重度血管病变组50例,三组间骨密度值依次降低(P<0.05或0.01);多元Logistic回归分析显示,仅年龄、体质指数、下肢血管病变积分为决定骨质疏松的独立危险因素(OR值分别为1.50、0.52及1.87)。结论老年男性2型糖尿病下肢血管病变患者骨密度减低,骨质疏松风险增加。     

年龄、身高、体重、体重指数与武汉地区绝经后骨质疏松症患者骨密度的关系

目的探讨年龄、身高、体重、体重指数等指标对武汉地区绝经后骨质疏松症患者骨密度的影响,为骨质疏松防治提供参考依据。方法用DEXA法测定118例武汉地区绝经后骨质疏松症患者腰椎、股骨颈、大转子、转子内区、髋部总体和Ward's三角的BMD值,同时记录受试者年龄、体重、身高等指标,并计算体重指数。用SPSS12.0统计软件进行年龄、身高、体重、体重指数与各部位骨密度Pearson相关分析,不同年龄组间比较采用t检验。结果年龄与Ward's三角骨密度呈负相关;身高与股骨颈及髋部总体的骨密度呈正相关;体重与股骨颈、转子内区、髋部总体和Ward's三角骨密度呈正相关;体重指数与转子内区骨密度呈正相关。相对高龄组患者较相对低龄组患者股骨颈骨密度差异有统计学意义。结论年龄、身高、体重和体重指数均是影响绝经后骨质疏松症患者BMD的因素;以体重对骨密度的影响最大。保持体重有利于延缓绝经后骨质疏松症的发生。高龄绝经后骨质疏松症患者尤其要防止股骨颈骨折的发生。     

老年女性糖尿病患者的骨密度和骨丢失率与人体测量学指标

目的 探讨老年女性2型糖尿病患者骨密度和骨丢失率与人体测量学指标的关系.方法 采用双能X线吸收法(DXA),测定754例老年女性2型糖尿病患者腰椎和髋部骨密度.人体测量学指标采用四分位数(Q)分组,比较各组间骨密度和骨丢失率的差异.结果 体质量分组的Q1～Q4各组的平均骨密度(g/cm2):股骨颈分别为0.555±0.097、0.585±0.086、0.637±0.089和0.673±0.099,髋部总体分别为0.611±0.111、0.657±0.103、0.713±0.100和0.755±0.110;平均骨丢失率(%):股骨颈分别为30.4±12.2、26.6±10.8、20.1±11.2和15.6±12.5,髋部总体分别为29.2±12.8、23.9±11.9、17.5±11.6和(12.6±12.8).骨密度分别依次为Q1组＜Q2组＜Q3组＜Q4组,骨丢失率依次为Q1组＞Q2组＞Q3组＞Q4组,各组间差异均有统计学意义(均为P＜0.01).骨丢失率与年龄和绝经年限呈负相关(r=-0.108～0.277,均为P＜0.01),与身高、体质量和体质指数呈正相关(r=0.146～0.503,均为P＜0.01).结论 老年女性2型糖尿病患者的骨密度和骨丢失率随人体测量学指标而变化,体质量和体质指数较大者,骨密度较高和骨丢失率较小.     

老年男性2型糖尿病患者骨密度及相关因素分析

目的 探讨老年男性2型糖尿病患者骨质疏松发病的危险因素. 方法 应用双能X线骨密度仪测定80例老年男性2型糖尿病患者的腰椎和股骨骨密度.并检测血清和尿液中骨代谢及血糖相关的生化指标,分析影响患者骨密度的相关危险因素. 结果所有患者中依据任一部位的骨密度值,骨质疏松的检出率为18.6%,骨量减少的检出率为53.8%.体质量和体质量指数(BMI)与腰椎、股骨颈和Ward's三角的骨密度呈正相关(r=0.202～0.298,P<0.05或P<0.01),年龄、糖化血红蛋白(HbAlc)与腰椎和股骨颈的骨密度呈负相关(r=-0.172～-0.211,均P<0.05).瘦素除与股骨颈和Ward's三角骨密度呈正相关外,尚与体质量、BMI、空腹血糖、血清总胆固醇、HbAlc相关(r=0.219～0.509,P<0.05或P<0.01).多元逐步回归分析显示,体质量是所有部位骨密度的影响因素,HbAlc影响股骨颈骨密度,瘦素影响Ward's三角区骨密度(r~2=0.196～0.276,均P<0.01). 结论 老年男性2型糖尿病患者中,不同部位的骨密度受不同的因素影响.     

糖调节受损患者颈动脉内膜中膜厚度与丙二醛、超氧化物歧化酶的关系及普罗布考的干预作用

目的 探讨糖调节受损患者颈动脉内膜中膜厚度与丙二醛、超氧化物歧化酶之间的关系,同时评估普罗布考对丙二醛、超氧化物歧化酶及颈动脉内膜中膜厚度的影响.方法 选取2型糖尿病患者50例、糖调节受损患者24例及糖耐量正常者28例,用高分辨彩色多普勒超声仪测量颈动脉内膜中膜厚度.硫代巴比妥酸显色法及黄嘌吟氧化酶法分别测定血清丙二醛浓度和超氧化物歧化酶活性,放射免疫分析法测定内皮素1水平.将2型糖尿病患者和糖调节受损患者随机纳入治疗组和对照组,治疗组在常规用药基础上给予普罗布考(0.5 g,每天2次)治疗,对照组保持原有常规用药,12周末重复测量上述指标.结果 2型糖尿病组、糖调节受损组颈动脉内膜中膜厚度、丙二醛和内皮素1水平均明显高于糖耐量正常者组(P<0.01),前两组问血清内皮素1水平亦具有明显差异(P<0.01),血清超氧化物歧化酶活性在三组问均有显著差异(P<0.01).颈动脉内膜中膜厚度与丙二醛、内皮素1、空腹血糖、糖负荷后2 h血糖、糖尿病痛程、糖化血红蛋白及低密度脂蛋白胆固醇呈正相关(P<0.05),与血清超氧化物歧化酶活性呈负相关(P<0.01).多元逐步回归分析显示,对颈动脉内膜中膜厚度有显著影响的因素有丙二醛、内皮素1及低密度脂蛋白胆固醇.普罗布考治疗后,丙二醛、内皮素1水平有所下降,超氧化物歧化酶活性增强.结论 在糖代谢紊乱初期颈动脉内膜中膜厚度、丙二醛已显著升高,超氧化物歧化酶活性下降,表明在糖调节受损阶段,氧化抗氧化平衡系统及内皮功能已经开始发生紊乱,普罗布考可抑制氧化应激,改善内皮功能,为糖调节受损患者动脉粥样硬化的早期预防提供新的思路.     

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.     

老年2型糖尿病发生骨质疏松的临床多因素分析

目的 探讨老年2型糖尿病(T2DM)患者发生骨质疏松的影响因素. 方法 根据患者的骨密度值将患者分为骨量正常(NOP)组、低骨量(LBMD)组、骨质疏松(OP)组,对比3组在年龄、糖尿病病程、体质量指数(BMI)、胱抑素C(Cys C)、经皮氧分压检查(TcPO2)、糖化血红蛋白(HbA1c)、尿C肽(U-CP)等指标之间的差异,并进行相关性分析. 结果 (1)与NOP组相比,LBMD及OP组年龄、病程显著性升高,U-CP显著性下降;(2)OP组BMI、Cys C显著低于NOP组;(3)OP组年龄显著高于LBMD组,而BMI显著低于LBMD组(P＜0.05或P＜0.01).老年T2DM患者的BMD与年龄、病程呈负相关,与BMI、U-CP呈正相关.逐步多元回归分析显示U-CP是BMD的正性预测因子. 结论 老年T2DM患者并发骨质疏松与多因素有关,包括高龄、低体质量、病程长、胰岛功能差等.     

阿仑膦酸钠和骨化三醇对绝经后女性糖尿病伴骨质疏松症患者动脉硬化的影响

目的:探讨阿仑膦酸钠结合骨化三醇对绝经后女性2型糖尿病伴骨质疏松症(OP)患者的动脉粥样硬化的影响。方法:绝经后女性2型糖尿病患者48例,行双侧颈动脉彩色多普勒检查,并进行各项生化指标检测。研究对象被分为OP组(23例)与非骨质疏松对照(NOP)组(25例),OP组给予阿仑膦酸钠每周一片(70mg)结合骨化三醇(0.25μg/d),为期12个月。结果:治疗前OP组颈动脉内膜中厚度[IMT,(0.88±0.16)mm:(0.78±0.11)mm]和动脉粥样斑块积分[PS,(0.78±0.16):(0.52±0.15)]显著高于NOP组(P均0.05)。治疗后,OP组IMT和PS与治疗前比较无显著性改变,而NOP组IMT[(0.85±0.87)mm:(0.78±0.11)mm]和PS[(0.63±0.08):(0.52±0.15)]均显著增加(P均0.05)。OP组动脉粥样硬化进展率[IMT(21.74%:52.0%),PS(30.43%:72.0%),P均0.05]显著低于NOP组(P0.05)。结论:绝经后女性2型糖尿病合并骨质疏松症患者的动脉粥样硬化程度较无骨质疏松患者高。阿仑膦酸钠结合骨化三醇的治疗可以延缓绝经后女性2型糖尿病合并骨质疏松患者的动脉粥样硬化进展。     

绝经后妇女脊椎压缩性骨折与骨密度的关系

目的探讨绝经后妇女脊椎压缩性骨折与骨密度（BMD）的关系。方法为病例一对照研究，入选250例有脊椎压缩性骨折的绝经后妇女，另有250名无脊椎压缩性骨折的绝经后妇女作为对照组。两组均有胸腰椎正侧位X线摄片，并应用双能X线吸收仪检测腰椎1～4和左股骨近端各部位BMD。结果脊椎压缩性骨折组身高、体重、腰椎2～4和股骨近端各部位BMD值均显著低于对照组（均P〈0．01）。腰椎2～4BMD是发生脊柱骨折的预报因子（r=-0．416，P〈0．01）。身高和全髋部BMD与骨折次数和骨折椎体数目呈负相关（均P〈0．01）。按股骨颈和全髋部BMD值，骨折组骨质疏松检出率各为50．8％和50．4％；另外剔除在腰椎2～4发生椎体骨折53例，按腰椎2～4BMD检出骨质疏松占64．5％。同时，腰椎2～4、股骨颈或全髋部BMD值低于-2．5s者发生脊柱压缩性骨折的风险分别是BMD正常者的4．76、2．36和3．52倍。结论腰椎呈低骨量是发生脊椎压缩性骨折的重要危险因素。身高的下降和全髋部低BMD值是骨折发生次数和受累椎体数目的危险因子；对绝经后妇女在重视BMD测量的同时，应重视脊柱X线正侧位检查。     

绝经后2型糖尿病患者骨质疏松影响因素及骨转换特点

目的 探讨绝经后2型糖尿病(T2DM)人群骨质疏松影响因素及骨转换特点及其防治策略.方法 150例绝经后T2DM住院患者测定骨密度(BMD)后分为骨量正常(NP)、骨量减低(DP)和骨质疏松(OP)组.登记年龄(Age),绝经年限(LOP),糖尿病病程(YSM),计算体重指数(BMI),测定空腹血糖(FPG)、餐后2 h血糖(PPG),空腹胰岛素(FIns)、餐后2 h胰岛素(2 h Ins),血Ⅰ型胶原C端肽(CTX-Ⅰ)、抗酒石酸酸性磷酸酶5b(TRACP5b)、骨特异性碱性磷酸酶(BALP)、雌激素(E2).结果 ①绝经后T2DM人群OP发病率54%;②绝经后T2DM并发OP患者与骨量减少和骨量正常组比较绝经年限、糖尿病病程及血糖水平明显增高,胰岛素和E2水平明显降低(P<0.05);③OP组患者与骨量减少和骨量正常组比较CTX-Ⅰ、TRACP5b、BALP等骨转换指标明显升高(P<0.05);④CTX-Ⅰ与腰椎2～4、股骨颈BMD呈明显负相关(P<0.05),与大转子、粗隆间BMD无明显相关性;TRACP5b、BALP与腰椎2～4、股骨颈、大转子、粗隆间BMD呈明显负相关(P<0.05).结论 LOP、血糖、YSM、FIns和E2水平可影响绝经后T2DM患者骨量;该人群骨重建特点为高转换型,骨吸收标记物TRACP5b可作为早期预测绝经后T2DM骨量减少及OP的敏感指标.     

Usefulness of bone densitometry in postmenopausal women with clinically diagnosed vertebral fractures

OBJECTIVE: To analyse whether bone mineral density (BMD) assessment is required in postmenopausal women presenting with low trauma vertebral fracture. METHODS: Women with vertebral fracture diagnosed over a 10 year period were recruited from our database. The following were excluded: (a) patients with high energy trauma; (b) patients with malignancies; (c) patients with a metabolic bone disease other than osteoporosis. All postmenopausal women were included in whom BMD had been evaluated at both the lumbar spine and femoral neck by dual energy x ray absorptiometry during the six months after the diagnosis. Patients with a potential cause of osteoporosis other than age and menopause were not considered. A total of 215 patients were identified. RESULTS: The mean (SD) age of the patients was 65.9 (6.9) years. BMD at the lumbar spine was 0.725 (0.128) g/cm(2) and the T score was -2.94 (1.22); BMD at the femoral neck was 0.598 (0.095) g/cm(2) and the T score was -2.22 (0.89). The BMD of the patients was significantly lower than that of the general population at both the lumbar spine and femoral neck. When the lowest value of the two analysed zones was considered, six patients (3%) showed a normal BMD, 51 (23.5%) osteopenia, and 158 (73.5%) osteoporosis. The prevalence of osteoporosis at the femoral neck increased with age; it was 25% in patients under 60, 35% in patients aged 60-70, and 60% in patients over 70. CONCLUSION: These results indicate that bone densitometry is not required in postmenopausal women with clinically diagnosed vertebral fractures if it is performed only to confirm the existence of a low BMD.     

2型糖尿病患者骨密度变化及相关危险因素分析

目的研究2型糖尿病（T2DM）患者骨密度（BMD）变化情况。方法测定336例T2DM患者BMD,采用不同诊断标准,统计骨质疏松症（0P）检出率;对比OP组与非OP组生化指标差异并进行相关性分析。结果以低于峰值BMD2．5s及2．0s为诊断标准,OP检出率分别为8．90％和17．26％。BMD与年龄负相关（P〈0．01）,与BMI正相关（P〈0．05）,与女性绝经年数负相关（P〈0．01）。40-49岁组BMD与DM病程相关（P〈0．05）。结论年龄越大、BMI越低,绝经年数越长,越易发生骨质疏松。T-Score≤-2．0SD诊断OP可能适合本地区T2DM患者,但需进一步积累资料证实。     

Prognostic factors of low bone mineral density in systemic sclerosis

OBJECTIVE: To analyse the results of bone densitometry in patients with systemic sclerosis (SSc), evaluating the prognostic factors of low bone mineral density (BMD) in fertile and postmenopausal patients, and comparing to a control healthy group. METHODS: Cross-sectional study analysing 61 female SSc patients, aged 25 to 51 years, who performed a bone densitometry using dual x-ray absorptiometry. BMD values (lumbar spine, femoral neck, Ward and trochanter) infertile and postmenopausal patients were compared according to SSc clinical variant (limited and diffuse), race, previous use of drugs (corticosteroids and cyclophosphamide) and bone mass index (BMI). These results were compared with 47 fertile and 60 postmenopausal healthy women; multivariate linear regression analysis was used to study the influence of the variables of interest in the BMD results. RESULTS: Twenty-seven SSc patients presented osteopenia and 14 densitometric osteoporosis. No statistical association was found between BMD values and SSc clinical variants, race and previous use of corticosteroids and cyclophosphamide, in the fertile and in the postmenopausal groups. Fertile SSc patients were paired by age and race with the control group, but BMI (p = 0.035) was significantly lower in the SSc group. BMD values of lumbar spine (p = 0.070, statistical trend), femoral neck (p = 0.003), Ward (p < 0.001) and trochanter (p = 0.003) were significantly lower in the SSc group. Postmenopausal SSc patients were paired by age and race with the control group, but BMI (p < 0.001) was also significantly lower in the SSc group. Age at menopause (p = 0.006) was also significantly lower and time from menopause (p < 0.001) was significantly higher in the SSc group. BMD values of femoral neck (p < 0.001), Ward (p < 0.001) and trochanter (p = 0.001) were significantly lower in the SSc group. Multivariate linear regression analysis showed that BMI was the main variable influencing BMD in the fertile and postmenopausal groups. CONCLUSION: In the present study, BMD results in fertile and postmenopausal SSc patients were independent of the SSc clinical variants, race and previous use of corticosteroids and cyclophosphamide. A low BMD in appendicular sites was observed infertile and postmenopausal SSc patients when compared to a control healthy group, associated to a low BMI.     

Bone mineral density in postmenopausal Chinese patients with systemic lupus erythematosus

The objective was to study the bone mineral density (BMD) and its clinical determinants in a cohort of postmenopausal patients with systemic lupus erythematosus (SLE). All postmenopausal SLE patients receiving long term glucocorticoids were identified from our medical clinics. Lumbar and femoral BMDs were measured by dual X-ray absorptiometry. Clinical determinants of BMD were studied by simple and multiple linear regression. Variables evaluated were: age, body mass index, parity, duration of menopause, smoking and alcohol drinking, duration of SLE and steroid treatment, cumulative prednisone dose, clinical and serological profile, disease activity, damage index and the use of medications. In total, 34 patients were studied. The mean age was 52.9+/-4.9 years and the median duration of SLE was 75.5 months. The mean duration of menopause was 5.2+/-3.9 years and the daily maintenance dose of prednisone was 4.0+/-2.5 mg/day. At the lumbar spine, 33% of the patients were osteopenic and 48% were osteoporotic. Two patients had thoracic and lumbar vertebral compression fractures. At the nondominant femoral neck, 74% of patients were osteopenic but only 3% was osteoporotic. In a multivariate model, the current or past use of hydroxychloroquine (HCQ) was associated with a higher spinal BMD. The presence of anti-Sm and the absence of anti-Ro were associated with a higher femoral BMD. It was concluded that osteoporosis, especially at the spine, is a common and serious problem in postmenopausal Chinese SLE patients receiving long term glucocorticoid therapy. Active intervention should be considered. The protective role of HCQ has to be confirmed with further studies.