尿脱氧吡啶啉排泄率在矿工骨质疏松症中临床监测意义

目的观察尿脱氧吡啶啉(DPD)排泄率在井下和井上矿工中的变化。方法对60名矿工, 分两组,井下30人,井上30人,用化学发电免疫法测定尿脱氧吡啶啉的浓度。结果井下井上受检人员不同年龄阶段之间DPD排泄浓度有差异,P<0．05。结论井下工人骨量丢失的早并且丢失量多,应早期预防。     

井上、井下矿工跟骨定量超声测定分析

目的 通过对井下、井上煤矿工人跟骨定量超声测定进行对比观察，探讨井下工作因缺氧、有机气体、煤尘、潮湿、阳光照射不足等因素对骨代谢的影响。方法 采用UBIS3000型定量超声仪，对200名工人跟骨进行定量超声测定，并将井下、井上测定结果分别进行对比分析，年龄为井下20～48岁。井上为20～54岁。均为男性。结果 井下工作跟骨超声振幅衰减(BUA)，骨刚度(STI)和超声声速(SOS)明显低于井上。结论 井下工作因受环境因素的影响。导致骨代谢的异常，骨吸收增加，提示井下工人及时进行预防治疗，避免骨质疏松的发生，减少骨折发生的因素。     

山西地区正常人骨定量超声测定及评价

目的 测定山西地区健康成人跟骨定量超声参数，并经体重指数标准化后，分不同年龄段进行比较。方法 采用UBIS5000型定量超声仪，对山西地区811名20-80岁正常成人(女468人，男343人)行跟骨定量超声参数测量。结果 跟骨超声振幅衰减(BUA)和刚度(STI)的峰值女性在45—49岁，BUA峰值男性在50—54岁。经体重指数校正后，不论男性或女性BUA、STI及超声波传导速度(SOS)峰值均在20—24岁。结论 跟骨BUA、SOS和STI随年龄增长而变化，消除体重指数影响后差异仍明显存在，且随着增龄逐年降低，其中男性变化趋势不如女性明显。     

重庆市区中老年人跟骨定量超声测定分析

目的通过对重庆市区中老年人进行跟骨定量超声测定,分析重庆市区中老年人骨质疏松现状,为该病的防治提供依据和借鉴。方法采用SONOST2000型定量超声仪对855例中老年人右跟骨宽波段超声衰减(BUA)、超声速度(SOS)、骨量指数(BQI)、T值(T-Score)进行检测。结果受检中老年人群骨质疏松发生率约为41．1％,其中女性(58．4％)明显高于男性(33．9％, P<0．01);随着年龄增长,骨质疏松发生率明显增高(P=0．001);女性各项跟骨定量超声测定参数均显著低于老年男性(P<0．01);各项参数随年龄增长而显著减低(BUA:P=0．04,其余P< 0．01)。结论增龄和女性是老年人骨质疏松的重要危险因素,跟骨定量超声检测可以作为骨质疏松人群防治的有效筛选手段。     

重庆地区2480例20?89岁年龄段人群跟骨定量超声骨密度检测结果分析

目的 明确重庆地区人口跟骨超声骨密度检测参数的变化特点.方法 用定量超声骨密度仪对重庆地区2480例体检人员的跟骨进行测定,获得9个年龄组的骨质量指数(BQI)、超声速率(SOS)、宽波带超声衰减(BUA),并进行统计学分析.结果 女性各项参数值均显著低于男性,在30～39、50～59、60～69、70～79、80～89岁年龄段女性跟骨SOS较男性偏低,在40～49、50～59、60～69、70～79、80～89岁年龄段女性骨质疏松发生率高于男性,男女性跟骨SOS与年龄有关.结论 40岁以上女性及60岁以上男性进入骨量快速丢失期,应及早预防,并每年定期检查骨密度.     

高强度体力劳动者跟骨定量超声测定结果的分析研究

目的 测定高强度体力劳动者(建筑工人)和脑力劳动者(中学教师)跟骨定量超声参数,分析评价体力劳动强度对骨量变化的影响。方法 采用UBIS3000型定量超声仪,对兰州市区217名建筑工人和183名中学教师(男,年龄20-49岁)跟骨定量超声参数进行测定。结果 建筑工人跟骨超声振幅衰减(BUA)和刚度(STT)在20-49岁呈递增趋势,超声声速(SOS)递减,但无统计学差异。教师的三项数据峰值都在30-39岁,各年龄组均低于建筑工人组。结论 跟骨三项指标随年龄增长改变,体力劳动的强度对骨量变化有重要影响,强体力劳动者骨质量优于脑力劳动者,提示运动有助于保持骨量,预防骨质疏松的发生。     

跟骨定量超声法评价正常女性骨丢失和骨质疏松患病率

目的　评价正常女性跟骨超声随增龄骨量丢失及骨质疏松患病率。方法　用定量超声法测定了 2 72例正常女性右跟骨宽带超声衰减 (BUA) ,超声声速 (SOS)及骨硬度指数 (STI)。结果女性跟骨峰值骨量出现在 30～ 39岁。 5 0～ 84岁 3组与峰值组以及两两之间比较 ,差异均有显著性(P <0 0 1)。老年组骨质丢失率和骨质疏松患病率分别为 2 6 %～ 37%和 4 2 %～ 6 9%。在各个年龄组中 ,STI丢失率最高 ;STI和BUA骨质疏松检出率相近 ,均大于SOS。结论　跟骨超声的 3项指标均可用于区分绝经前、后的妇女 ;STI检测骨量丢失和OP患病率最敏感     

南京地区正常人骨定量超声测定及评价

目的 评价南京正常人跟骨超声随增龄骨量丢失及骨质疏松(OP)患病率和骨折发生率。方法 采用美国Iamar Achilles跟骨定量超声仪，对南京地区3018名20～89岁健康人(男1120人、女1898人)行跟骨定量超声参数测量。结果 男女跟骨峰值骨量出现在20～29岁，男性随增龄参数值缓慢下降，女性从50岁开始各参数值陡然迅速下降，持续约20年，此后下降稍缓慢。男女两性在各年龄组中STI丢失率最高，OP患病率男性32％；女性53％，骨折发生率男性7％；女性13％。结论 跟骨BUA、SOS、和STI值随年龄增长而逐年减少，其中男性变化趋势不如女性明显，女性OP患病率和骨折发生率均显著高于男性。     

昆山地区336例青年人胫骨定量超声骨量研究

目的　为昆山地区胫骨定量超声骨量峰值的建立提供标准化方法并积累数据。　方法以社区 2 4～ 43岁青年健康志愿者 3 3 6例为研究对象 ,用QUA测定胫骨定量超声骨量值。结果　昆山地区男、女性人群的定量超声骨量峰值均出现在 3 2～ 3 5岁年龄段 ,其值分别为 (40 42 6± 76 6)m/s(男性 )和 (40 3 4 8± 70 2 )m/s(女性 )。 40岁以前 ,SOS值无明显性别差异 ,40岁以后 ,女性SOS值明显低于男性。结论　胫骨定量超声骨量峰值无明显性别差异 ,建立的峰值骨量值可作为临床和流行病学研究诊断骨质疏松症的基础参考值     

高原汉族农民跟骨定量超声测定结果的分析研究

目的：探讨高原环境对体力劳动者骨量变化的影响。方法：采用UBIS3000型定量超声仪，对生活在海拔3000m高原的567名汉族农民跟骨定量超声参数进行测定。结果：超声振幅衰减(BUA)、刚度(STI)的峰值男性为40～49岁，女性为30～39岁，超声声速(SOS)峰值男女性均为40～49岁，50岁以后各项指标均明显下降。结论：体力劳动和高原环境因素都对骨量变化产生重要影响，高原农民年轻时高强度的体力劳动对骨量的影响大于高原环境因素的影响，老年后随劳动量减少骨量迅速丢失。     

不同工作环境下煤矿矿工骨质疏松症的对照研究

目的 通过比较煤矿井上井下工人维生素D和骨密度,探究不同工作环境对骨质疏松症发生的影响。方法 采用对照研究的方法,前瞻性选择开滦集团唐山矿工人共计120名,其中井下男性工人60名,年龄在45?55岁;井上男性工人60 名,年龄在45?55岁。通过检测两组矿工25-羟维生素D含量及腰椎和髋部的骨密度值,比较不同工作环境下煤矿矿工骨质疏松发生情况。结果 井上井下矿工年龄、工作时间、体重指数、吸烟、饮酒、血钙、碱性磷酸酶、血尿素氮等基本情况具有一致 性和可比性;与井上矿工相比,井下矿工静脉血甲状旁腺激素含量高(P <0. 05),而静脉血维生素D含量低（P <0. 05).包括腰椎和股骨颈骨密度均低(P <0. 05)。井下矿工骨质疏松占井下矿工总数的8. 3% ,骨量减低占40% ;井上矿工骨质疏松占井上矿工总数的5%,骨量减低占26. 7%。井下矿工维生素D缺乏占井下矿工总数的85% ,维生素D减低占10% ;井上矿工维生素D缺乏占井上矿工总数的18. 3% ,维生素D减低占11. 7%。结论 井下矿工维生素D和骨密度均低于井上矿工。     

不同强度跑步运动与二甲双胍联用对2型糖尿病并发骨质疏松大鼠的骨密度、骨吸收、胰岛素敏感性的影响效果研究

目的讨论不同运动强度跑步与二甲双胍联用对2型糖尿病并发骨质疏松(diabetic osteoporosis,DOP)模型大鼠骨密度、骨吸收、胰岛素敏感性的影响效果,为在运动处方与药物处方联用方案中药物使用和运动强度的合理制定提供依据。方法对120只SD大鼠购回后进行15 d适应性饲养。选取100只大鼠建立DOP动物模型,剩余20只大鼠正常饲养。检验DOP动物模型情况,建模成功的大鼠随机分为模型对照组(DM组)、二甲双胍组(metformin,MF组)、低强度跑步+二甲双胍组(LM组)、中强度跑步+二甲双胍组(MM组)、高强度跑步+二甲双胍组(HM组),正常饲养的20只大鼠为对照组(C组)。全部大鼠进行前测,内容包括骨密度(bone mineral density,BMD)、空腹血糖浓度(fasting plasma glucose,FPG)、空腹胰岛素水平(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment insulin resistance,HOMA-IR)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesteroll,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesteroll,HDL-C)、抗酒石酸盐酸性磷酸酶(tartrate resistant acid phosphatase,TRACP)、尿脱氧吡啶喏啉(deoxypyridinoline,DPD)、生物力学性能等指标。前测结束后,各组大鼠按计划进行为期12周的干预,干预结束后进行后测。结果大鼠体质量方面,在干预的第4、8、12周C组大鼠体质量显著高于DM组、LM组、MM组、HM组、MF组(P0. 05),LM组大鼠体质量显著低于DM组(P0. 05)。骨密度方面,LM组、MM组、HM组、MF组大鼠后测骨密度显著高于前测和DM组后测结果,但仍然明显低于C组(P0. 05)。在骨代谢方面,LM组、MM组、HM组、MF组大鼠后测尿羟脯氨酸、尿DPD、血浆TRACP值显著高低于前测和DM组后测结果,但仍然明显高于C组(P0. 05)。在糖代谢方面,LM组、MM组、HM组、MF组大鼠FPG、FINS后测值显著低于本组前测值、DM组和HM组后测结果,但明显高于C组(P0. 05)。在胰岛素抵抗方面,MM组、HM组、MF组大鼠HOMA-IR后测值显著高低于本组前测值、MF组和HM组后测结果,但明显高于LM和MM组(P0. 05)。在脂代谢方面,LM组、MM组、HM组、MF组大鼠甘油三酯(triglyceride,TG)、TC、LDL-C后测值显著低于本组前测值、DM组后测结果,但明显高于C组(P0. 05)。LM组TG、TC、LDL-C指标后测值显著低于HM组、MF组(P0. 05)。LM组、MM组、HM组、MF组大鼠HDL-C指标后测值显著高于本组前测值、DM组后测结果,但明显低于C组(P0. 05)。结论二甲双胍搭配跑步的干预方案能够保持大鼠体重,降低血脂、血糖,缓解胰岛素抵抗,增加骨密度,减少骨吸收。其中二甲双胍搭配中低强度跑步方案在体重控制、降低血脂血糖、缓解胰岛素抵抗方面优于二甲双胍搭配高强度跑步方案。二甲双胍搭配高强度跑步方案对于2型糖尿病并发骨质疏松大鼠骨密度改善效果与二甲双胍搭配中低强度跑步方案相比具有优势。     

Interleukin-6, Transforming Growth Factor-Beta 1, and Bone Markers After Kidney Transplantation

The aim of this study was to investigate the relationship between interleukin 6 (IL-6), transforming growth factor (TGF)-beta 1, IL-6 soluble receptors, and biochemical parameters of bone turnover after kidney transplantation. Of 64 patients enrolled in the study, 19 received the kidney transplant 2 to 12 months before the study, and 45 within the previous 15 to 175 months. We measured IL-6, TGF-beta 1, intact parathyroid hormone (PTH) bone alkaline phosphatase (BALP), osteocalcin (OC), and procollagen type I propeptide (P1CP) concentrations in the serum, and deoxypyridinoline crosslinks (DPD) in the urine of the patients. In 16 patients in the first posttransplantation year, the concentrations of IL-6 (P = 0.02), TGF-beta 1 (P = 0.01), BALP (P = 0.0002), OC (P = 0.001), and DPD (P = 0.01) were significantly higher than in patients with longer posttranslation period. Statistically significant negative correlation was found between posttransplantation time and IL-6 (P = 0.04), BALP (P = 0.003), OC (P = 0.0009), P1CP (P = 0.03), and DPD (P = 0.01) concentrations. Repeated measurements of the investigated parameters in the first posttransplantation year showed a significant decrease only in TGF-beta 1 level. In all patients, IL-6 correlated positively with PTH (P = 0.0009) and DPD (P = 0.03), and IL-6 soluble receptor (IL-6 sR) with DPD (P = 0.03). A decrease in IL-6 and TGF-beta 1 concentrations that paralleled the decrease in bone turnover markers in the posttransplantation period indicated that IL-6 and TGF-beta 1 were probably involved in the bone turnover after kidney transplantation.     

Suppression of Bone Resorption in Early Postmenopausal Women by Intranasal Salmon Calcitonin in Relation to Dosage and Basal Bone Turnover

In the present study, we assessed the ability of increasing doses of intranasal calcitonin to suppress urinary deoxypyridinoline cross-link (DPD), a specific biochemical marker of bone resorption, in early postmenopausal women. Subjects consisted of 30 healthy Thai women within 5 years of postmenopause, randomly assigned to 50, 100, or 200 IU of intranasal calcitonin 5 days/week for 3 months. Calcium supplementation by calcium carbonate capsules at 750 mg of elemental calcium per day was given to all subjects. Twenty four-hour urine for DPD and creatinine assays was collected at baseline, 1 month, and 3 months after treatment. All DPD values were corrected with urinary creatinine before analyses. Data were expressed as mean ± SEM. DPD decreased significantly 1 month after intranasal calcitonin treatment (P < 0.01). However, at 3 months, DPD increased when compared with the values at 1 month (P < 0.01), suggesting that there may be a reduction in the suppression of bone resorption after prolonged calcitonin therapy. Using a stepwise multiple regression model to address whether dosage and DPD at baseline influence the response to intranasal calcitonin, it was found that DPD suppression after intranasal calcitonin was not related to dosage but was strongly associated with baseline DPD (P < 0.0001). Suppression of bone resorption in early postmenopausal women by intranasal calcitonin is determined more by the state of bone turnover at baseline than the dosage of calcitonin. Received: 10 March 1997 / Accepted: 14 November 1997     

Lifestyle factors affecting heel ultrasound in Greek females across different life stages

The use of quantitative ultrasound (QUS) of the bone is rapidly gaining in popularity, and QUS is widely used worldwide for the assessment of skeletal status. Although much has been learned about the influence of various factors on ultrasonic parameters in various populations, similar information at the local level is not available. This study was carried out to examine the effects of anthropometric, dietary, physical activity, reproductive, and other lifestyle factors on QUS parameters in healthy Greek women, including children (n=217), adults (n=235), and elderly (n=369) subjects. Calcaneal QUS measurements were performed with the SAHARA device, which measures broadband ultrasound attenuation (BUA) and speed of sound (SOS) through the os calcis; a composite parameter, the quantitative ultrasound index (QUI), and an estimate of heel bone mineral density (eBMD) were also derived. All QUS indices were higher in adult women than in girls or elderly women (P<0.05). The latter had a similar BUA to girls, but lower SOS, QUI, and eBMD (P<0.05). Most QUS parameters correlated positively with height, weight, body mass index (BMI), hip circumference, organized physical activity, and activity promoting bone mass, but negatively with the time devoted to sedentary activities and absolute carbohydrate intake (P<0.05). Age of menarche and years since menopause were negatively associated with QUS in the adult and elderly women, respectively (P<0.05). The latter relationship, however, was due to the confounding effect of advancing age. Overweight and obese females had significantly higher BUA and eBMD than normal-weight subjects (P<0.05), but similar SOS and QUI; this held true for all age groups. Likewise, in all ages, individuals spending more than 2 h/week on organized activities had significantly higher QUS indices than those spending less time on exercise (P<0.05). Further, postmenarchial girls had significantly higher age-adjusted BUA, SOS, QUI, and eBMD than premenarchial ones (P<0.05). Similarly, all QUS parameters were significantly higher in adult women with an early onset of menarche (<14 years old) than in those with a late onset (P<0.05), but no effects of menarche were detected among the elderly. No significant effects of calcium intake (which was generally adequate), smoking or alcohol drinking (which were generally low) on QUS indices were observed, in either age group. Available independent variables could explain approximately 16%–24% of the total variance in BUA, SOS, QUI and eBMD. The most important positive predictors of QUS were adulthood, time devoted to organized activities, and weight or BMI, while age and carbohydrate intake per se contributed negatively. In conclusion, age, body size, physical activity, and some aspects of reproductive history and diet appear to variably affect calcaneal QUS indices among otherwise healthy Greek women at different life stages.     

左归丸对5/6肾大部切除模型并肾性骨病大鼠骨代谢指标的影响

目的:探讨左归丸对5/6肾大部切除模型并肾性骨病大鼠骨代谢的影响。方法:SPF级Wistar大鼠进行5/6肾大部切除并给予高磷饮食诱导肾性骨病模型。造模大鼠分为模型组、左归丸组、骨化三醇组,并设假手术组。左归丸与骨化三醇治疗4周、12周时,检测血肌酐(Scr)、尿素氮(BUN)、血清碱性磷酸酶(ALP)、血清全段甲状旁腺激素(iPTH)、血钙(Ca2+)、血磷(P3-);药物干预12周麻醉处死大鼠,双能X线测量大鼠股骨骨密度(BMD)。结果:12周时,模型组大鼠出现了Scr、BUN、ALP、iPTH、磷升高,血Ca2+下降。左归丸能明显降低Scr、BUN水平,与模型组比较差异有统计学意义(P<0.01,P<0.05);与骨化三醇组比较差异有统计学意义(P<0.01,P<0.05)。左归丸组大鼠ALP、iPTH、血磷水平与模型组比较明显下降(P<0.05),血钙水平明显升高(P<0.01),左归丸组大鼠骨密度与模型组比较明显改善(P<0.01)。结论:左归丸通过调节钙磷代谢及参与成骨细胞代谢,对iPTH有直接的抑制作用,能改善肾性骨病的骨营养不良。     

Cross-sectional reference data for phalangeal quantitative ultrasound from early childhood to young-adulthood according to gender, age, skeletal growth, and pubertal development

Bone mineral status by phalangeal quantitative ultrasound (QUS, DBM Sonic, IGEA, Carpi, Modena, Italy) was examined in 3044 (1513 males and 1531 females) healthy subjects, aged 2-21 years. The aim of the study was to provide a reference database for phalangeal QUS parameters, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), both expressed as centiles and Z score, according to gender, age, height, weight, body mass index (BMI), and pubertal stage to be used for estimating bone mineral status in patients with disorders of growth or of bone and mineral metabolism. In both sexes, AD-SoS and BTT increased significantly (P<0.0001) according to all the anthropometric variables. Females showed higher values than males in the age groups 9-14 for AD-SoS (P<0.04-P<0.0001) and in the age groups 11-13 for BTT (P<0.02). Males had higher BTT values than females in the age groups 6-8 and 15-21 (P<0.04-P<0.0001). AD-SoS was higher (P<0.02-P<0.0001) in females than in males at pubertal stages 2, 3, and 4, but it was higher (P=0.001) in males compared with females at pubertal stage 5. BTT was higher in males than females at pubertal stages 1 (P<0.0001), 2 (P<0.01), and 5 (P<0.0001). In both sexes, AD-SoS and BTT were significantly correlated between them (r=0.92, P<0.0001) and with all the anthropometric variables (r=0.53-r=0.85, P<0.0001). Age, weight, BMI, and pubertal stage were independent predictors of AD-SoS in males; age and pubertal stage were independent predictors of AD-SoS in females. In both sexes, height and pubertal stage, and also age only in females, were independent predictors of BTT. In conclusion, our data show that gender, age, height, and timing of sexual maturation are main determinants of bone structure and geometry, and that both these two processes may be captured by phalangeal QUS. It may be a useful tool to assess bone mineral status from early childhood to young-adulthood with a very small confounding effect related to bone sizes and without exposing the subjects to a source of radiation.     

葛根素对骨质疏松大鼠氧化应激反应、骨代谢和骨密度的影响

目的观察研究葛根素对骨质疏松大鼠氧化应激反应、骨代谢和骨密度的影响,探讨葛根素防治骨质疏松症的作用机制。方法44只雌性SD大鼠随机分对照组、造模组、雌激素组、葛根素组,采用“双侧卵巢摘除手术法”构建骨质疏松大鼠动物模型并给予相应药物干预,对照组和造模组:0.9%NaCl 5 mL/kg,葛根素组:葛根素35 mg/kg,雌二醇组:雌二醇150μg/kg,1次/d,皮下注射,连续给药6周。检测血清和骨组织氧化应激指标,检测骨代谢指标和骨组织BMD,观察骨组织形态学变化。结果造模组大鼠血清和骨组织SOD和GSH-Px较对照组显著降低(P<0.05),雌二醇组和葛根素组SOD和GSH-Px较造模组均显著升高(P<0.05);造模组大鼠血清和骨组织H2O2和MDA较对照组显著升高(P<0.05),雌二醇组和葛根素组H2O2和MDA较造模组均显著降低(P<0.05)。造模组大鼠血清TRACP5b、RANKL、PINP和BGP较对照组显著升高(P<0.05),雌二醇组和葛根素组骨代谢指标较造模组均显著降低(P<0.05)。造模组骨组织BMD较对照组显著降低(P<0.05),雌二醇组和葛根素组BMD较造模组均显著升高(P<0.05)。造模组骨皮质明显变薄,骨质疏松改变,骨小梁数量减少,排列紊乱,髓腔明显扩大,骨细胞明显减少。葛根素组和雌激素组新生骨小梁数量增多,间隙稍小,排列较规则,连接成网。结论葛根素通过调控骨质疏松大鼠氧化应激反应,改善骨代谢相关指标,提高骨密度,改善骨组织形态学结构,发挥抗骨质疏松作用。