围绝经期与绝经早期妇女骨密度及身体成分分析

目的 探讨围绝经期与绝经早期妇女骨密度(BMD)和身体成分的变化,分析身体成分对BMD的影响.方法 选择2008年3月在本院行健康体检的40～60岁围绝经期和绝经≤5年的妇女,记录身高和体质量,计算体质指数(BMI).采用双能X线检测仪检测腰椎1～4和左侧股骨颈、大转子及全髋的BMD,以及全身脂肪含量和肌肉含量.结果 符合条件的妇女共157例,其中围绝经期组69例,绝经早期组88例.绝经早期组身高明显低于围绝经期组[(156.8±4.9)cm和(159.2±5.1)cm],BMI明显高于围绝经期组[(24.2±2.8)kg/m2和(23.2±2.5)kg/m2];两组妇女的体质量、脂肪含量和肌肉含量间差别无统计学意义(P>0.05).绝经早期组腰椎1～4的BMD和股骨颈BMD均显著低于围绝经期组[分别为(1.09±0.14)g/cm2和(1.19±0.15) g/cm2,(0.90±0.11)g/cm2和(0.94±0.12) g/cm2,P<0.05];两组妇女其他部位BMD间差别无统计学意义(P>0.05).逐步多元回归分析显示,各部位BMD与肌肉含量均有相关性(P<0.05),BMI和脂肪含量与各部位BMD均无相关性(P>0.05).结论 绝经早期腰椎和股骨颈的BMD明显降低,而脂肪含量和肌肉含量的变化不明显.绝经后骨质疏松症的预防工作应尽早开始.     

初孕年龄、产次与绝经后妇女骨密度的关系

目的　探讨初孕年龄、产次与绝经后妇女骨密度(BMD)的关系。方法　调查180名健康绝经后妇女年龄、初孕年龄、产次、绝经时间,并测量身高、体重、腰椎L2~4及左侧股骨近端(Neck、Ward三角、Troch)BMD。结果　①初孕年龄≤20岁的绝经后妇女在L2~4及股骨近端各部位BMD值均低于初孕年龄在21~25岁者(Neck、Ward三角、TrochP<0 .01,L2~4 P<0 .05 )和初孕年龄在26 ~30岁者(L2~4、Neck、Ward三角、TrochP<0. 01 ),在L2~4、Neck、Ward三角部位低于初孕年龄>30岁者(Ward三角P<0 01,L2~4、NeckP<0 .05)。②随着产次的增加,股骨近端各部位BMD逐渐下降,产3次,产4次,产次≥5次各组BMD显著低于产1次和产2次组(P<0 .01)。③多因素分析显示:产次与股骨近端各部位BMD呈显著负相关,绝经年限与L2~4、Neck和Troch部位BMD呈显著负相关,初孕年龄与Neck和Troch部位BMD呈负相关。结论　初孕年龄≤20岁的绝经后妇女腰椎和股骨近端BMD减低,产次影响绝经后妇女股骨近端各部位BMD。     

围绝经期妇女骨密度与肌肉及脂肪含量的关系

目的 分析围绝经期妇女骨密度(BMD)与身体不同部位总肌肉含量(TLM)和总脂肪含量(TFM)的关系.方法 选择围绝经期健康女性141名,采用双能X线吸收仪检测腰椎1～4(L1-4)及左侧髋部各部位包括股骨颈、大转子和全髋部的BMD、TLM和TFM,分析BMD与身体成分的相关性.结果 逐步多元回归分析显示,L1-4、股骨颈、大转子和全髋部BMD与TLM均显著正相关(β值为0.261、0.284、0.388和0.335,P<0.01),但与TFM均无相关性(P>0.05).结论 围绝经期妇女腰椎及髋部各部位BMD与TLM呈显著正相关;加强运动,增加身体TLM,对预防骨质疏松具有重要作用.     

1型糖尿病患者骨密度变化及相关因素研究

目的探讨1型糖尿病患者骨密度(BMD)变化及相关影响因素。方法收集我院就诊的1型糖尿病患者47例,对照组为40例非糖尿病健康人群。体格检查计算腰臀比(WHR)及体质指数(BMI),葡萄糖氧化酶法检测空腹血糖(FPG)及餐后2 h血糖(2 hPG)、高效液相法检测糖化血红蛋白(HbA1c)、放免法检测空腹C肽(FCP)及餐后2 hC肽(2 hCP)水平,双能X线骨密度仪测定腰椎(L2-L4)及左股骨颈BMD。结果两组间年龄差异无统计学意义(P>0.05),1型糖尿病组BMI、WHR、FCP、2 hCP、腰椎及股骨颈BMD低于对照组,但FPG、2 hPG及HbA1c高于对照组,差异有统计学意义(P<0.05)。糖尿病病程、HbA1c与腰椎及股骨颈BMD呈负相关(P<0.05),FCP、2 hCP与腰椎及股骨颈BMD呈正相关(P<0.05)。进行多因素回归分析发现,进入方程的为病程、HbA1c、FCP及2 hCP(P<0.05)。结论 1型糖尿病患者BMD低于健康人群,1型糖尿病患者的病程、HbA1c、FCP、2 hCP水平与BMD关系密切。     

围绝经期与绝经早期妇女骨密度分析

目的:讨论围绝经期与绝经早期妇女骨密度(BMD)和身体成分的变化,分析身体成分对BMD的影响。方法:选择2009年10月以来在本院行健康体检的(40～60)岁围绝经期和绝经≤5年的妇女,记录身高和体质量,计算体质数(BMI)。采用双能X线检测仪检测腰椎2～4和左侧股骨颈、大转子及全髋的BMD。结果:符合条件的妇女共157例,其中围绝经期组69例,绝经早期组88例。绝经早期组身高低于围绝经期组,体质量和BMI高于围绝经期组,绝经早期组腰椎2～4、股骨颈、大转子、全髋BMD均低于围绝经期组。结论:绝经早期的BMD降低。绝经后骨质疏松预防工作应及早展开。     

广西壮、汉族妇女骨密度初步分析

目的　探讨广西壮、汉族妇女骨密度 (bonemineraldensity ,BMD)和绝经后壮、汉族妇女骨质疏松 (osteoporosis,OP)发生率是否存在差异性 ,为骨质疏松防治提供依据。方法　居住南宁 1 0年以上的健康绝经前妇女 1 79名 ,绝经后妇女 1 6 3名 ,记录其祖父母、外祖父母的民族 ,祖父母和外祖父母均为同一民族 (汉族或壮族 )者纳入本研究。同时记录受试者的年龄、初潮年龄、绝经年限 (绝经后妇女 )、孕次、产次。受试前 3个月内至少有 1次月经来潮者纳入绝经前妇女组 ;绝经 1年或以上者纳入绝经后妇女组。测量身高、体重 ,计算体重指数 (BMI)。用法国DMS公司的DEXA检测受试者腰椎 (L2 ～L4)正位、左髋部(股骨颈、Word s三角、大转子 )、左前臂 (超远端、远端 )的BMD ,并进行比较。结果　绝经前壮族妇女除股骨颈、前臂BMD略高于 (0 93%～ 1 4 4 % )或等于汉族妇女外 ,其余检测部位的BMD均低于汉族妇女 (0 92 %～ 5 92 % ) ,其中L2 ～L4的BMD分别较汉族妇女低 4 92 % (P =0 0 6 7)、5 2 6 % (P =0 0 5 4 )、5 92 % (P =0 0 37) ;相反 ,绝经后壮族妇女除L2 和前臂超远端的BMD略低于 (0 1 5 %～ 0 99% )汉族妇女外 ,其余部位的BMD均高于 (0 1 3%～ 2 79% )汉族妇女 ,虽然差异无统计学意义 (P >0 0 5     

长期应用质子泵抑制剂对老年男性消化性溃疡患者骨密度的影响

目的:探讨长期应用质子泵抑制剂(PPI)对老年男性消化性溃疡患者骨密度(BMD)的影响.方法:40例老年男性消化性溃疡患者,PPI服用时间均长于12个月,以双能X线骨密度仪测量其腰椎L1-L4及双侧股骨颈的骨密度;同时选择健康老年男性40例为对照组.结果:长期应用PPI组较对照组腰椎L1-L4及双侧股骨骨密度降低.结论...     

雌激素受体α基因XbaⅠ、PvuⅡ位点基因多态性与南昌地区绝经后妇女骨密度的关系

探讨雌激素受体α(ERα)基因XbaⅠ、PvuⅡ位点基因多态性与南昌地区绝经后妇女骨密度(BMD)的关系。方法选取符合调查要求的160名绝经后妇女,通过双能X线吸收法测量BMD,PCR-RFLP技术检测ERα基因PvuⅡ和XbaⅠ限制性酶切位点基因多态性。结果 XbaⅠ位点XX、Xx、xx 3个基因组的腰椎L1-L4、股骨颈、大转子、Wards三角的BMD差异无统计学意义(P>0.05);PvuⅡ位点PP、Pp、pp 3个基因组的腰椎L1-L4、股骨颈、大转子、Wards三角的BMD差异无统计学意义(P>0.05)。结论 ERα基因XbaⅠ、PvuⅡ位点基因多态性与南昌地区绝经后妇女BMD无关。更多还原     

妊娠晚期及产后早期促红细胞生长素水平的观察分析

目的检测妊娠晚期及产后早期(产后7d内)促红细胞生成素(EPO)浓度变化,探讨EPO与血细胞比容(Hct)之间的相关性.方法用放射免疫测定法测定健康非妊娠妇女15例,正常妊娠晚孕服妇27例、妊娠合并贫血孕妇32例及产后早期合并贫血产妇15例.结果上述4组EPO水平分别为(9.85±38.52)U/L、(14.42±6.80)U/L、(99.82±78.70)U/L、(59.50±38.52)U/L.妊娠晚期合并贫血的孕妇及产后早期合并贫血的产妇EPO水平均明显高于非妊娠妇女及正常妊娠晚期孕妇,P＜0.01.4组血清EPO与Hct呈相反关系.结论妊娠晚期及产后早期合并贫血时EPO水平明显升高,且对贫血有极强的反应.     

围绝经期妇女慢性牙周炎与骨密度改变的相关关系

目的探讨围绝经期妇女慢性牙周炎与全身骨密度(bone mineral density,BMD)之间的相关关系。方法 2012-07~2014-03在深圳市妇幼保健院口腔疾病防治中心及妇女健康中心随机选择围绝经期慢性牙周炎妇女和牙周健康对照妇女各100例。采用双能X线骨密度测量仪测量正位腰椎和左侧股骨颈的骨密度值;拍摄下颌骨数字曲面断层片,测量下颌骨骨高度、测定牙槽骨骨密度;比较两组患者骨密度之间的差异。牙周检查包括牙周附着丧失(clinical attachment loss,CAL)和牙周探诊深度(periodontal probing depth,PPD)。分析各骨密度测量值与牙周临床指标的相关性。结果病例组与对照组分别有98例和96例完成了全部检查,两组妇女在平均年龄、平均体重指数、基础疾病情况、烟酒史、绝经情况等方面差异均无统计学意义(P>0.05),具有可比性。牙周炎组妇女股骨颈、牙槽骨BMD测定值,下颌骨高度均明显低于对照组妇女,且差异有统计学意义(P<0.001)。围绝经期慢性牙周炎妇女的腰椎、股骨颈、牙槽骨BMD与下颌骨高度均呈正相关关系(P<0.001),牙槽骨BMD与PPD均呈负相关关系(P=0.006),股骨颈、牙槽骨BMD与CAL呈负相关关系(P<0.001)。结论围绝经期妇女全身骨密度降低可能会增加慢性牙周炎的发病风险,而定期进行口腔检查并拍摄X线片是发现骨质疏松及口腔疾病有效手段之一。     

库欣综合征病人与正常妇女骨密度比较研究

目的 探讨年龄对库欣综合征（CS）病人骨密度改变的影响。方法 将不同年龄段CS病人与正常妇女的骨密度进行比较。收集1996年6月至2004年2月期间因CS住院且做过骨密度检查的女性病例,共57例,选取同期健康查体的正常女性49例作为正常对照组。根据不同年龄段将两组进行分层分析,20～29岁CS组14例,对照组14例;30～39岁CS组27例,对照组15例;40-49岁CS组16例,对照组20例。对骨密度进行比较。结果 正常对照组腰椎的骨峰值出现在30-39岁,髋部的骨峰值出现在20～29岁。CS组的骨密度低于正常对照组,以20～29岁层最显著;腰椎和Wards三角的骨密度降低最为明显。CS病人年龄越轻,其骨量丢失越显著。CS病人骨质疏松者占29．8％（17／57）,骨量减少者占50．9％（29／57）,骨折发生率为26．3％（15／57）。发生骨折的CS病人腰椎骨密度Z值明显低于未发生骨折者（P=0．003）。结论 CS病人的骨密度较正常妇女明显降低,以腰椎和Wards三角下降更为显著,年轻CS病人骨量丢失较年长者明显,腰椎骨密度低者更易发生骨折。     

Relationship between subclinical thyroid dysfunction and femoral neck bone mineral density in women

BACKGROUND: Osteoporosis associated with thyroid dysfunction has been traditionally viewed as a secondary consequence of altered thyroid function, but there was recently a report about the direct effects of thyroid-stimulating hormone (TSH) on bone remodeling, which was mediated via the TSH receptor found on osteoblast and osteoclast precursor cells. Endogenous subclinical thyroid dysfunction seems to be an appropriate model to examine the direct effect of TSH on bone metabolism while ruling out the direct effect of thyroid hormone on bone metabolism. Thus, we aimed to investigate the relationship between subclinical thyroid dysfunction and bone mineral metabolism in women. METHODS: We enrolled 413 women (mean age: 52.2 +/- 6.6 years) in our study. Serum levels of TSH, free T4 and the biochemical markers of bone turnover were measured by the standard methods. BMD at the lumbar spine and femoral neck were measured by dual energy X-ray absorptiometry. RESULTS: Femoral neck BMD was significantly reduced both in the subclinical hyperthyroid group and in the subclinical hypothyroid group as compared with the euthyroid group (one-way ANOVA, p <0.001; post-hoc analysis, p = 0.041, p = 0.033). In contrast to the femoral neck BMD, the lumbar spine BMD showed no difference between the two groups. Additionally, serum calcium and alkaline phosphatase levels, urine deoxypyridinoline levels, and urine calcium to creatinine ratio showed no differences between the two groups. CONCLUSIONS: Women having subclinical hyperthyroidism and women with subclinical hypothyroidsm have reduced femoral neck BMD. Additional studies are required to elucidate the mechanism for this finding.     

Effect of Two Kinds of Different Combined Oral Contraceptives Used on Bone Mineral Density in Women of Reproductive Age

Objective To compare bone mineral density (BMD) among users of ethinylestradiol/desogestrel, ethinylestradiol/cyproterone acetate and nonhormonal control subjects. Methods The study included 154 women aged 25-40 years. Forty-six women were using ethinylestradiol/desogestrel (group A) and 55 women using ethinylestradiol/cyproterone acetate (group B) for 24 months and 53 women using nonhormonal contraception as control subjects (group C). BMD of the lumbar spine and femoral neck were obtained using dual energy X-ray absorptiometry, comparing mean BMD changes in combined oral contraceptives (COCs) users with nonusers. Results For 24 months of treatment, lumbar spine and femoral neck BMD values in women who used ethinylestradiol/desogestrel and ethinylestradiol/cyproterone acetate were not significantly different compared with the baseline and the values of subjects in nonuser (P>0.05). Conclusion There was no statistical difference in BMD between the users of ethinylestradiol/desogestrel or ethinylestradiol/cyproterone acetate and nonusers.     

广西地区绝经后妇女骨密度影响因素分析

目的 探讨广西地区门诊就诊或住院的绝经后妇女年龄、绝经年龄及绝经年限对女性骨密度的影响,为骨质疏松症的预防提供科学依据.方法 对门诊就诊或住院、以腰背痛和关节痛为主诉的633例中老年妇女,采用美国GE公司生产Lunar Prodigy型骨密度检测仪,测量腰椎及双侧股骨颈骨密度,根据不同的民族、不同年龄、绝经年龄、绝经年限进行分组,并进行统计学分析.结果 汉族妇女骨质疏松患病率为35.3％,壮族妇女骨质疏松患病率为32.5％,两组差异无统计学意义（P＞0.05）;腰椎及股骨颈骨密度降低随年龄、绝经年限的增加逐渐降低,各组间差异均有统计学意义（P＜0.05）;腰椎骨密度随绝经年龄的增加逐渐降低,除46岁以下组与46～50岁组之间差异无显著性（P＞0.05）外,46岁以下组与50岁以上组、46～50岁组与50岁以上组之间差异均有统计学意义（均P＜0.05）.结论 绝经年龄早更容易引起骨密度降低,年龄越大、绝经年限越长,骨密度降低越明显,就更容易出现骨质疏松.     

雌激素受体2基因多态性与绝经后女性骨密度的相关性研究

目的探讨雌激素受体2(estrogen receptor beta,ESR2)基因的单核苷酸多态性(single nucleotide polymorphism,SNP)与绝经后女性的骨密度(bone mineral density,BMD)是否相关。方法使用双能X线骨密度仪测量重庆市140例绝经后女性第2～4腰椎(L2～L4)及左股骨颈BMD值。采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术分析ESR2基因第5外显子T1057G和G1082A及第8外显子G1730A SNPs。结果在全部受试者中,ESR2基因第5外显子1057T位点仅检测到VV1种基因型;G1082A基因型RR、Rr及rr频率分别为81.43%、17.14%及1.43%;G1730A基因型AA及Aa频率分别为87.86%及12.14%,aa基因型缺失;G1082A和G1730A SNPs的基因型分布符合Hardy-Weinberg平衡(P>0.05)。校正年龄、体质量、绝经年限等BMD影响因素后,G1082A SNP与L2和L4BMD显著相关(P<0.05),而与L3及股骨颈BMD无明显关联(P>0.05);G1730ASN...     

骨硬化蛋白与绝经后妇女脆性骨折的相关性

目的 了解绝经后跌倒骨折妇女及跌倒无骨折妇女人群血液循环中骨硬化蛋白与血清骨代谢标志物、骨密度之间的关系,探讨骨硬化蛋白是否可作为一种新的预测脆性骨折的生化标志物.方法 采用横向前瞻性研究,对50例健康的未绝经女性(A组)、50例绝经后跌倒股骨颈骨折妇女(B组)及50例绝经后跌倒无骨折妇女(C组)进行评估,评估内容包括血清骨硬化蛋白水平、骨代谢标志物及骨密度.结果 骨代谢标志物如Ⅰ型胶原交联C-端肽(CTX)、CTXⅡ、骨特异性碱性磷酸酶(b-ALP)、前胶原1型N端前肽(P1NP)、核因子出受体激活因子(RANK)和核因子出受体激活因子配体(RANKL)在3组间差异均有统计学意义(P＜0.05,P＜0.01);相较于A组,B组及C组的骨硬化蛋白水平升高(P＜0.05,P＜0.01)、骨钙素水平降低(P＜0.01),但B、C两组间骨硬化蛋白水平和骨钙素水平差异无统计学意义.股骨颈、全髋、转子间及L1～L4部位的骨密度在3组之间差异有统计学意义(P＜0.01),B组中骨密度较A、C两组降低(P＜0.01).在所有研究对象中,骨硬化蛋白水平与股骨颈骨密度(r=-0.228,P=0.004)、转子间骨密度(r=-0.199,P=0.002)和全髋骨密度(r=-0.273,P＜0.001)均呈负相关.结论 绝经后妇女中骨折人群与未骨折人群血清骨硬化蛋白水平差异无统计学意义,提示血清骨硬化蛋白水平无法预测脆性骨折风险.     

Estrogen receptor gene polymorphisms and bone mineral density in Chinese postmenopausal women

Objective To investigate the relationships between the polymorphisms of estrogen receptor (ER) gene, bone mineral density (BMD) and bone biochemical markers in Chinese postmenopausal women. Methods BMD of lumbar spine and femoral neck were measured using dual-energy X-ray absorptiometry （DEXA）in 186 Chinese postmenopausal women. The PvuⅡ and XbaⅠ polymorphisms of the ER gene were detected using polymerase chain reaction (PCR). Bone biochemical markers, serum alkaline phosphatase, osteocalcin and pyridinoline were measured by ELISA. Results The femoral neck(FN) BMD (Z score) was higher in pp compared to Pp (-0.01±0.12 vs. -0.35±0.09, P&lt;0.05) while lumbar spine BMD (Z score) was higher in XX type compared to Xx and xx genotypes (0.01±0.45 vs -1.53±0.17, -1.29±0.10, P&lt;0.001 and 0.001, respectively). Women without Px haplotype (n=79) had a higher BMD Z-score for the lumbar spine (-1.03±0.14 vs -1.45±0.11, P&lt;0.05) and femoral neck (-0.01±0.11 vs -0.31±0.09, P&lt;0.05) than those who had it (n=107). Conclusions The present study suggested that the pp and XX genotypes of ER gene might play a certain role in maintaining FN and lumbar spine BMD. ER genotypes without Px haplotype might be favorable to bone mass, while those with it might exert some harmful effect on bone mineral density.     

腰椎骨质增生对老年女性腰椎和髋部骨矿密度的影响

目的：研究腰椎骨质增生对老年女性腰椎和髋部骨矿密度（BMD）的影响。方法：用双能量X线吸收骨密度仪对1502例50岁以上的女性患者进行腰椎和髋部BMD检查，对有和无腰椎椎体缘骨质增生者进行比较分析。结果：腰椎骨质增生组与无骨质增生组比较，腰椎前后位BMD在55岁后及腰椎侧位BMD在70岁以后显著增高（2．90％－13．64％，P＜0．05），股骨颈、Ward区和髋部平均BMD增高3．79％－5．24％，但无统计学意义（P＞0．05）。结论：老年女性腰椎骨质增生患者的腰椎和髋部BMD增高。     

Longitudinal study on physical fitness parameters influencing bone mineral density reduction in middle-aged and elderly women: bone mineral density in the lumbar spine, femoral neck, and femur

The prolongation of the average life span of women has been associated with the rapidly aging society. However, serious problem have arisen as a result, such as an increase in the number of bed-ridden elderly patients with osteoporosis-associated femoral neck fracture. As preventive measures against osteoporosis for middle-aged to elderly women, 10,000 steps per day and intense exercise have been reported to inhibit bone mineral density (BMD) reduction. However, only a few studies have concretely reported on the type of physical fitness that is effective for BMD in particular parts of the body. In this study, a one-year longitudinal survey was performed involving generally healthy postmenopausal women to investigate physical fitness parameters influencing BMD in the lumbar spine, femoral neck, and femur. The subjects were 38 female residents of M City, aged 49-73 years. As physical fitness parameters, sit-ups, anteflexion in a sitting position, grip strength, mean amount of exercise (kcal), and area of outer body sway on standing straight with the eyes closed (m2) were measured. The BMD was measured in the lumbar spine (L2-L4), femoral neck, and femur. Logistic regression analysis was performed regarding the physical fitness parameters as explanatory variables and groups with and without BMD reduction over one year as those with and without risk as dependent variables. The number of sit-ups (odds ratio: 0.76, 95% CI: 0.61-0.96, p=0.022) was a preventive factor against BMD reduction of the lumbar spine, and ante flexion in a sitting position was a preventive factor against BMD reduction of the femoral neck (odds ratio: 0.88, 95% CI: 0.78-0.99, p=0.029). Regarding BMD reduction of the femur, the area of outer body sway on standing straight with the eyes closed tended to be not significant to the risk. It is suggested that physical fitness and local muscle strength are associated with BMD reduction in the lumbar spine, femoral neck, and femur.     

Effect of Depot Medroxyprogesterone Acetate （DMPA） on Bone Mineral Density in Women of Reproductive Age

Objective To compare bone mineral density （BMD） between users of intramuscular depot medroxyprogesterone acetate（DMPA ） and nonhormonal control subjects. Methods The study included 68 women aged between 25 and 40 years using depot medroxyprogesterone acetate for 24 months and 59 women aged between 25 and 40 years using nonhormonal contraception as control subjects. BMD of the lumbar spine and femoral neck were obtained using dual energy X-ray absorptiometry. Results At 24 months of treatment, as compared with baseline, the mean BMD in lumbar spine and femoral neck was decreased by 5.5% and 5.9%, respectively. Lumbar spine and femoral neck BMD in women who used DMPA were significantly decreased compared with the subjects in nonuser （P〈0.001）. Conclusion These results show BMD declined during using DMPA in women aged 25 -40 years old.