农村已婚女性骨质疏松危险因素研究

目的 探讨农村妇女骨质疏松的危险因素。方法 对1726名农村已婚妇女运用外周双能X光吸收比色法（pDXA）测定非优势侧前臂近端桡骨骨密度，并进行统一问卷调查。对所获得的资料进行二变量相关分析、t检验、方差有多元逐步回归分析。结果 绝经年限、低体重、年龄是引起骨密度（BMD）降低的3个重要因素，身高体重指数（BMI）、饮食、生育次数多可导致BMD增高。结论 绝经后高龄妇女及其低体重的妇女是骨质疏的高危人群，对绝经后的妇女使用雌激素将有助于预防骨质疏松。     

三种不同时期妇女骨密度测量值研究分析

目的:调查具有正常生育能力、围绝经期和绝经早期妇女骨密度(BMD)测量值和身体成分的变化,分析身体成分对BMD的影响。方法:采用韩国Osteo Sys公司生产的EXA-3000型前臂双能X线骨密度测定器,检测在体检中心健康体检者非惯用手前臂远端BMD,对300例围绝经期妇女、300例绝经早期妇女和300例正常生育妇女进行BMD测量,记录身高、体重及体质量指数(BMI)。结果:围绝经期和绝经早期妇女的体质量、BMI和BMD均低于对照组。结论:低体重是绝经后妇女发生骨质疏松(OP)的重要危险因素之一;骨量流失从围绝经期开始,绝经后骨质疏松防治工作应及早实施。     

绝经后妇女骨密度与年龄、体质量关系的分析

目的探讨绝经后妇女骨密度(BMD)与年龄、体质量的关系.方法调查142例健康的绝经后妇女的年龄、绝经年龄、绝经年限,测量身高、体质量、腰椎和股骨的骨密度,并进行统计分析.结果随着年龄的增长,腰椎及股骨的BMD值逐渐下降,骨量减少及骨质疏松的发生率呈明显上升趋势;低体质量组的BMD显著的低于正常体质量组;高风险组的年龄远大于中、低风险组;高、中风险组与低风险组比,体质量轻、腰椎及股骨的BMD小.结论年龄、体质量与骨密度有关.对绝经后女性,尤其是年龄大、绝经时间长、低体质量瘦小体型绝经后妇女,应及时监测骨密度,采取适当措施防治骨质疏松,以免发生骨折.     

嘉峪关市绝经前后妇女骨质疏松影响因素研究

目的了解嘉峪关市绝经前后妇女骨质疏松症发生的可能影响因素,为有效预防妇女骨质疏松、增进其骨健康水平提供依据。方法对189名≥45岁的绝经前后妇女采用问卷调查,并通过骨密度(BMD)测定、X线摄片、骨代谢指标、激素水平测定及数量不平衡传递试验方法(QTDT)进行横断面研究。结果对象的年龄、教育程度、经济收入、饮食习惯等与骨质疏松的发生有关。在相关基因领域中等位基因(TA)21与BMD显著相关,雌激素受体α基因与BMD无显著相关。低密度受体相关蛋白5(LRP5)多态性位点显示,ERB基因位点1730G/A多态性与股BMD显著相关,ERB的CA的重复多态性与股骨颈BMD相关。等位基因G显示与股BMD负相关。结论本地区绝经前后妇女对骨质疏松症相关知识及危害性认知水平偏低,骨健康状况及相关影响因素应引起足够的重视并对其风险进行干预。     

绝经前合理应用维生素D和钙剂与绝经后妇女骨密度的关系

目的:调查绝经前后妇女的体成分与绝经年龄、身高及应用维生素D和钙剂后骨密度的关系。方法:采用1∶1配对设计方法,将196例妇女分为绝经期前未用维生素D和钙剂者和用维生素D和钙剂者两组,采用米尺和磅秤测量两组妇女的身高和体重,采用双能X线骨密度仪检测两组妇女的骨质疏松值,采用超声骨密度仪检测两组妇女的左侧跟骨的超声速度、骨硬度指数和低骨量。观察两族妇女体内骨密度指标。结果:绝经前后不同年龄组妇女体质指数、超声速度、骨硬度指数、低骨量及骨质疏松值比较差异有统计学意义(P<0.05)。应用维生素D和钙剂的妇女骨密度较未应用维生素D和钙剂的妇女同年龄组相比,骨质疏松值有所下降。结论:绝经前后妇女合理应用维生素D和钙剂安全、有效,可早期预防骨质疏松,值得推荐,特别适用于绝经后妇女。     

基因多态性及环境因素与绝经后妇女骨密度的相关性研究

目的探讨雌激素受体(ER)基因多态性、维生素D受体(VDR)基因多态性以及环境因素与绝经后农村妇女的骨密度(BMD)的关系。方法随机抽取武汉农村绝经后妇女90名,汉族,年龄在45~65岁,应用问卷调查了解膳食摄入及户外活动情况;采用双能X线吸收仪(DXEA)测量腰椎及髋部的BMD;应用多聚酶联反应-限制性片断长度多态性(PCR-RFLP)检测ER和VDR的多态性。结果ER的Px单倍体型对各部位BMD均无显著性影响。VDR的BsmⅠ酶切位点多态性会影响腰椎的骨密度,Bb型的BMD比bb型要低,差异有显著性(P<0·05),但调整了年龄、体重、身高和膳食后,差异未见显著性。当联合研究ER和VDR基因多态性时,发现Px单倍体型同时伴有Bb的基因型的BMD最低,差异有显著性(P<0·05),调整年龄、体重、身高和膳食后,差异未见显著性。膳食钙、蛋白质、碳水化合物及能量与BMD简单相关;多元回归分析发现年龄(负相关)和体重(正相关)是绝经后妇女骨密度的最重要的预测因子,另外,与腰椎相关的因素还有绝经年龄及碳水化合物的摄入量;与股骨颈相关的因素还有绝经年龄。结论绝经后妇女BMD与ER的Px单倍体型未显示相关,与VDR的BsmI多态性可能相关,但环境因素会影响基因型与BMD的相关性。     

上海城区40岁以上女性骨密度影响因素研究

目的探讨影响上海城区40岁以上女性骨密度的危险因素，为预防骨质疏松提供依据。方法对上海市区40岁以上1840名女性应用外周双能X线骨密度仪测定非优势侧前臂远端骨密度并进行问卷调查，对所获得的资料进行相关分析、t检验和多元逐步回归分析。结果年龄、体重、月经初潮年龄、怀孕次数、生育次数、母乳喂养子女数、母乳平均喂养月数、绝经年龄、绝经年数、喝牛奶习惯、母亲骨折史、本人骨折史、哮喘史、高血压史均与骨密度值有关。结论年龄、低体重、绝经、月经初潮年龄是影响骨密度的重要因素。     

绝经后妇女营养状况与骨质疏松

目的:探讨绝经后妇女膳食营养素摄入对骨密度的影响。方法:对159例健康的绝经后妇女进行膳食调查及超声骨密度仪测定桡骨远端骨密度。结果:非骨质疏松者平均每日蛋白质、脂肪、维生素A、硫胺素、核黄素、维生素C、维生素E以及钾、钙、镁、锌、磷、铁、锰、硒的摄入量均显著高于骨质疏松者(P0.05或P0.01)。结论:膳食中多种营养素与妇女的骨密度(BMD)存在一定的关系,预防骨质疏松应注意全面而合理的膳食。     

湖南邵阳地区608例绝经后妇女骨密度调查及骨质疏松危险因素分析

目的分析邵阳地区绝经后妇女各年龄段骨密度的变化情况和骨质疏松（OP）的患病率及其相关危险因素。方法采用美国Lunar公司的双能x线骨密度仪对邵阳地区608例绝经后女性进行腰椎3～4和髋部骨密度测定。结果绝经后妇女wardg三角,股骨颈,股骨粗隆,腰椎2～4的BMD随年龄增加而降低,与绝经年龄45～49岁组比较,各年龄组BMD下降比较差异均有统计学意义（P〈0．05）。wardg三角,股骨颈,股骨粗隆,腰椎2～4的年均骨丢失率分别为1．4％;1．0％;0．93％;0．71％。其中以wardg三角骨丢失率为最高。超重组和肥胖组的腰椎2～4,股骨颈,wardg三角,股骨粗隆,BMD显著高于正常体重组（P〈0．05）。消瘦组各部位BMD显著低于正常体重组（P〈0．05）。女性绝经后开始出现OP,患病率缓慢上升,各年龄组OP总发病率依次为5．2％;16．8％;35．5％;36．4％;55．3％;64．5％;90．6％。其中腰椎2～4OP发生率最高,整体髋部OP发生率最低,相关危险因素分析示,年龄、文化程度、高钙饮食及体重指数是绝经后妇女OP的危险因素（OR=1．121,0．788,0．627,0．823）。结论邵阳地区绝经后妇女骨密度随年龄增长而降低,OP的患病率随之增加。年龄、文化程度、高钙饮食及体重指数是绝经后OP的危险因素。     

148例围绝经期妇女双能X线骨密度结果分析

目的:探讨围绝经期妇女年龄、月经情况、身高、体重与骨密度(BMD)的关系,筛选绝经后骨质疏松症的高危人群。方法:随机选取148例2004年9～11月青岛市部分金融系统女职员健康查体中的围绝经期(40～60岁)妇女,加查双能X线BMD(已筛除影响骨代谢性疾病如糖尿病、甲亢等及药物因素,如性激素补充),将BMD测定结果与其年龄、月经情况、体重、身高进行相关分析。结果:148例围绝经期妇女平均腰椎低骨量发生率为26.35%。50～60岁妇女腰椎低骨量发生率为48.44%,明显高于40～50岁妇女(9.52%);绝经者腰椎低骨量发生率为61.70%,明显高于未绝经者(9.90%);体重低于60kg者腰椎低骨量发生率为36.92%,高于体重在60kg以上者(18.07%);身高在160cm以下者腰椎低骨量发生率为44.12%,高于身高在160cm以上者(21.05%),其差异均有统计学意义;年龄、绝经与否、身高、体重与左髋部BMDt值无相关性。结论:围绝经期妇女腰椎低骨量发生率与绝经、年龄及其身高体重有关,绝经、年龄50岁以上、体重60kg以下、身高160cm以下的妇女是发生绝经后骨质疏松症的高危人群。     

Factors Associated with Postmenopausal Osteoporosis: A Case-Control Study of Belgrade Women

The aim of this study was to investigate factors related to osteoporosis in postmenopausal women in Belgrade. A case-control study was conducted during 2006–2007. The study group consisted of 100 newly diagnosed osteoporosis patients and 100 age-matched controls (±2 years). The inclusion criteria for the case group were newly diagnosed osteoporosis confirmed by dual-energy X-ray absorptiometry of the lumbar spine and being menopausal (at least 2 years of amenorrhea). The inclusion criteria for the control group were postmenopausal women with confirmed normal bone mineral density of the lumbar spine by dual-energy X-ray absorptiometry. All study participants were interviewed using a structured questionnaire. Univariate and multivariate logistic regression analyses were used. The following factors were significantly independently related to osteoporosis: low body weight (P < 0.001), thin constitution in childhood (P = 0.002), history of previous fracture (P = 0.033), menopause at age <47 years (P < 0.001), family history of fracture (P = 0.005), and less frequent consumption of cheese (P = 0.027) and fish (P = 0.020). The majority of factors identified may be modifiable and could be influenced to prevent postmenopausal osteoporosis.     

Exercise and physical activities for the prevention of osteoporotic fractures: a review of the evidence

According that osteoporosis is the common condition in an aging society such as in Japan, much progress has been made in understanding the treatment and prevention of osteoporosis. Among potential risk factors, exercise and physical activities have been recognized as lifestyle factors that might influence the risk of osteoporosis and osteoporotic fractures. To assess the relationship between exercises including physical activities and the risk for low bone mass and osteoporosis-related fractures, a literature search over past 13 years was conducted. Accumulating evidence indicates that exercises decrease the risk for hip fractures among middle aged and older men and women. Exercises also help to maintain muscle strength, muscle volume, balance, and joint flexibility, which might prevent falls and fall-related fractures. One randomized controlled trial showed back-stretching exercise reduced the risk for vertebral fractures. The literature search also indicates that high-impact and/or weight-bearing exercise might increase the bone density in the elderly and the peak bone mass among young women, while there is no association between moderate or lower-impact exercise and bone mineral density. Future research should be required to evaluate the types and quantity of physical activity needed for the prevention of osteoporosis.     

A LONGITUDINAL STUDY OF BONE DENSITY IN MIDLIFE WOMEN

A longitudinal study of 386 healthy Black and White women aged 35-60 years was conducted to determine the effects of physical activity and other related factors on lumbar bone mineral density over 24 months. Bone mineral density of the lumbar spine, L2-L4, was measured using dual energy x-ray (Hologic 1000). Physical activity levels in three dimensions (leisure, household, and occupational) from both a lifelong and current perspective were obtained by questionnaire. Body mass index was calculated from measured weight in kilograms divided by measured height in meters squared. Calcium, caffeine, and alcohol intake was estimated using a food frequency questionnaire. Age, race, and smoking were determined by self-report. Radioimmunoassays of follicle stimulating hormone (FSH) and estradiol were used to validate self-reports of menopausal status. Multiple regression analysis revealed that race, age, weight, FSH, calcium, and years of tobacco intake formed the best model at baseline ( r 2 = 0.32) and at 24 months ( r 2 = 0.303). Physical activity was not a significant predictor for bone mineral density at either time point. There were cross-sectional changes of bone mineral density with race, age, and menopausal status. Black women had significantly higher bone mineral density than White women. However, an age-related decline in bone mineral density was exhibited in both Black and White women. Perimenopausal women had significantly lower bone mineral density as compared with premenopausal women. Furthermore 37 (9.6%) women at baseline and 34 (11%) at 24 months were designated at risk for fracture.     

A longitudinal study of bone density in midlife women

A longitudinal study of 386 healthy Black and White women aged 35-60 years was conducted to determine the effects of physical activity and other related factors on lumbar bone mineral density over 24 months. Bone mineral density of the lumbar spine, L2-L4, was measured using dual energy x-ray (Hologic 1000). Physical activity levels in three dimensions (leisure, household, and occupational) from both a lifelong and current perspective were obtained by questionnaire. Body mass index was calculated from measured weight in kilograms divided by measured height in meters squared. Calcium, caffeine, and alcohol intake was estimated using a food frequency questionnaire. Age, race, and smoking were determined by self-report. Radioimmunoassays of follicle stimulating hormone (FSH) and estradiol were used to validate self-reports of menopausal status. Multiple regression analysis revealed that race, age, weight, FSH, calcium, and years of tobacco intake formed the best model at baseline (r(2) = 0.32) and at 24 months (r(2) = 0.303). Physical activity was not a significant predictor for bone mineral density at either time point. There were cross-sectional changes of bone mineral density with race, age, and menopausal status. Black women had significantly higher bone mineral density than White women. However, an age-related decline in bone mineral density was exhibited in both Black and White women. Perimenopausal women had significantly lower bone mineral density as compared with premenopausal women. Furthermore 37 (9.6%) women at baseline and 34 (11%) at 24 months were designated at risk for fracture.     

珠海地区575名女性骨密度测定及骨质疏松症危险因素初析

目的了解珠海地区女性骨密度和骨量分布情况以及影响骨质疏松症(OP)的危险因素。方法采用双能X线骨密度仪对珠海地区的575例女性进行骨密度检测,并对个人疾病史、生活习性及月经史进行调查,根据OP发生与否,进行单因素和多因素分析。结果女性骨密度和骨量呈现年龄分布趋势;单因素分析结果显示年龄、绝经年限、体重指数(BMI)、糖尿病、骨折以及慢性病对OP存在影响;多因素分析结果显示年龄和慢性病是OP发病的危险因素,而BMI是OP的保护因素。结论女性骨密度随年龄的增长、绝经年限的增加而逐步下降,而保持一定体型及体重,有利于骨密度的维持及提高;及时发现、治疗糖尿病、慢性病(如甲亢、风湿)等,对防治骨质疏松有积极作用。     

妊娠期糖尿病母亲新生儿低骨密度危险因素分析及相关模型构建

目的探究影响妊娠期糖尿病(gestational diabetes mellitus,GDM)母亲新生儿低骨密度的危险因素,并构建预测模型。方法选取2017年1月至2019年12月在广西壮族自治区江滨医院进行产检与分娩的200例GDM孕妇及其所产新生儿作为研究对象,根据新生儿是否出现低骨密度分为低骨密度组(50例)与正常骨密度组(150例),收集两组GDM孕妇的年龄、体质量指数(body mass index,BMI)、孕期增重、胎次、分娩方式、居住环境、孕期日均户外活动时间、孕期规律补钙情况、规律补充维生素D情况、家庭收入、血清钙水平、血清骨钙素(bone gla protein,BGP)、血清碱性磷酸酶(alkaline phosphatase,ALP)、25-羧基维生素D等资料并比较。经多因素Logistic回归分析探究影响GDM母亲新生儿低骨密度的危险因素,并建立预测模型。结果多因素Logistic回归分析得出孕期未规律补钙、未规律补充维生素D、低BGP水平及低ALP水平是GDM母亲新生儿低骨密度的危险因素。模型经ROC曲线分析得出AUC为0.869,灵敏度为79.64%,特异度为88.69%,通过验证得出模型预测灵敏度为81.82%,特异度为86.49%。结论孕期未规律补充钙与维生素D、BGP与ALP较低是GDM母亲新生儿低骨密度危险因素,根据危险因素建立预测模型能有效评估GDM母亲新生儿低骨密度发生风险。     

女性原发性骨质疏松症危险因素研究

目的探索女性原发性骨质疏松症(Primary Osteoporosis,POP)的危险因素,为制定群体综合防治POP对策提供依据。方法共纳入研究对象413例;采用问卷调查收集研究对象人口学特征及POP危险因素的信息;运用双能X骨密度测量仪(DEXA)测定骨密度值,并进行POP诊断;使用χ2检验、Logistic回归分析POP的危险因素。结果随绝经年限增加,POP发生率增加,χ2检验差异具有统计学意义。单因素分析结果显示年龄、初潮年龄、月经状态、BMI、补钙情况、吸烟情况与POP患病的关系有统计学意义;多因素分析结果表明,在控制了其他因素后,年龄和吸烟情况与POP患病的关系有统计学意义。结论年龄增加、绝经年限增加、吸烟是患POP的危险因素。     

绝经妇女肌力改变对骨量的影响

流行病学显示骨质疏松症是老年人常见的疾患其可导致骨折,使患者骨折后,生活质量明显下降.由于女性期望寿命长于男性,老年妇女发生慢性疾病如肌力异常和骨质疏松症增加,该文对高风险人群绝经妇女肌力改变对骨量影响进行分析,认为肌力衰变是绝经妇女骨质疏松的重要影响因素,通过改善肌力,可能是积极预防、治疗绝经妇女骨质疏松或骨质疏松症的较好策略.