不同ER-α基因型绝经妇女补充大豆异黄酮和钙后血脂成分的变化

[目的]观察血脂正常的不同ER-α基因型别绝经妇女补充钙和大豆异黄酮片剂（不含蛋白）一年后机体血脂成分的变化。[方法]从武汉郊区绝经妇女中筛选60例血脂正常但骨量减少或骨质疏松的绝经妇女为受试对象随机分为两组，每组各30人，并确定其ER-α基因PvuⅢ和XbaⅠ酶切型别。一组给予液体钙440mg/d．VD 100IU／d：另一组给予液体钙440mg／d，VD 100IU／d和大豆异黄酮片剂100mg／d（不含蛋白），跟踪1年。测定每位受试对象各血脂成分，包括甘油三脂（TG）、总胆固醇（CHO）、低密度脂蛋白胆固醇（LDL）和高密度脂蛋白胆固醇（HDL）。[结果]补钙和补钙＋大豆异黄酮均能显著性降低血总胆固醇（P〈0．05）。Px单倍体型的TG在补钙＋大豆异黄酮后下降，而补钙组non-Px单倍体的TG升高，两者间差异有显著性（P〈0．05）；P）（单倍体型的HDL在补钙＋大豆异黄酮后升高，而补钙组non-Px单倍体的HDL下降，两者间有显著性差异（P〈0．05）。[结论]足量的钙和适量的大豆异黄酮摄入不仅有益于绝经妇女的骨骼代谢，还可影响血脂代谢，且因ER-α基因酶切型别而异。     

COMT基因多态性及大豆异黄酮摄入与绝经后女性乳腺癌关系的病例对照研究

Background and Objective:Genetic polymorphism Val158Met of catechol-O-methyltransferase(COMT) may contribute to estrogen-induced carcinogenesis of breast cancer.Soy isoflavones possesses chemical structure similar to endogenous estrogen and may promote the carcinogenesis of breast cancer.This study was to investigate the relationship between the polymorphism of COMT,soy isoflavones,and breast cancer in postmenopausal women.Methods:In total,176 patients newly diagnosed histopathologically with breast cancer ...     

降钙素在骨质疏松骨折治疗中的应用

降钙素作为抗骨吸收药物在骨质疏松临床治疗中已有广泛应用,大多数研究认为降钙素临床疗效主要表现在抑制破骨细胞,缓解疼痛,骨质量（骨结构、骨力学性能1改善比骨密度上升明显,且能有效地降低骨质疏松椎体骨折的发生率[1]。著名的PROOF研究和降钙素改善骨质量的研究（qualitativeeffectsofsalmoncalcitonintherapy,QUEST）证明,降钙素能有效降低绝经后妇女椎体压缩性骨折风险,在骨质量改善的同时伴或不伴有骨密度的增加回[2]。     

绝经后骨质疏松的细胞凋亡与骨局部因子

绝经后雌激素低落引起骨形成、骨吸收脱偶联，这一绝经后骨质疏松(postmanopausal ostcoporosis，PMOP)的形成机制已为既往研究所证明，但骨形成、骨吸收脱偶联的确切原因及机制尚未完全明了。为此，近年来学们进行了大量的研究。Tobia(1989)较早将骨细胞凋亡概念引入骨质疏松研究     

早期预防性治疗对绝经后骨质疏松症影响的动物实验研究

目的评价早期预防性抗骨吸收治疗对绝经后骨质疏松症骨量、骨代谢指标和骨组织形态的变化特点,提供早期监测和预防绝经后骨质疏松症的依据.方法以去卵巢大鼠为实验对象、抑制骨吸收的唑来膦酸注射液为赋形药物,建立绝经后骨质疏松症的动物模型.选取44只3个月龄雌性SD大鼠,除假手术组行假手术外,其余各组均行双侧卵巢切除.假手术组(sham)、去势对照组(ovx)以安慰剂处理,其余两组分别在去势后3d、1个月给予唑来膦酸注射液(zoledronic acid,ZOL) 500μg/kg静脉单次注射,分别在实验开始、术后1个月及术后3个月测定大鼠股骨骨密度(BMD),收集血清测定I型前胶原氨基端前肽(PINP)、抗酒石酸酸性磷酸酶5b (TRACP-5b)的值变化,并光镜下观察大鼠股骨病理学变化,图像分析系统观察骨形态计量学静态指标骨小梁面积百分率(TBV)、骨小梁厚度(Tb.Th)、骨小梁间距(Tb.sp)的变化.结果应用去卵巢大鼠成功建立绝经后骨质疏松模型.去势对照组在1个月股骨BMD、血清PINP和TRACP-5b、TBV、Tb.Th及Tb.sp等指标变化上和正常对照组存在显著性差异(P＜0.01);去势3d即行ZOL治疗者和假手术对照组的BMD、骨代谢、骨形态学指标比较变化无显著性差异(P＞0.05);1个月后开始ZOL治疗者仅部分恢复骨密度,血清PINP、TRACP5b、骨组织形态指标变化和早期治疗组比较存在非常显著性差异(P＜0.01),且其骨小梁连接有明显的退变.结论骨代谢指标可用于抗骨吸收治疗的疗效监测;去势大鼠早期进行预防性抗骨吸收治疗,能抑制其骨量的丢失,减慢骨小梁退变,恢复骨密度.     

绝经后妇女雌激素受体基因多态性与骨和脂代谢的相关性研究

目的 研究绝经后妇女雌激素受体（ER）基因PvuⅡ、XbaⅠ限制性片段长度多态性与骨和脂代谢的关系。方法 随机选取57名已排除影响骨代谢、脂代谢疾病的绝经后妇女，采空腹血和晨尿，用PCR—RFLP法对ER基因多态性进行分析，DEXA测定腰椎正侧位及股骨骨密度，同时检测血骨钙素、尿Ⅰ型胶原N末端肽和血脂指标。结果 基因型分析xx29例，Xx24例，XX4例。XX组股骨干（SHAFT）骨密度明显低于Xx组（P〈0．05）。XbaI限制性片段长度多态性与股骨干骨密度相关（r=0．367，P=0．039）：XX组骨钙素高于xx（P=0．041）和Xx（P=0．011）组。apoAl含量和A1／B比值在xx、Xx、XX三组呈递增，各组间差异有显著性（P〈0．05）。脂蛋白a[Lp（a）]与股骨骨密度（除SHAFT外）呈负相关。结论ER基因XbaⅠ—RFLP是影响绝经后妇女骨和脂代谢的重要因素；X基因型可维持股骨骨量，xx基因型与低载脂蛋白A1（apoAl）含量和A1／B比值相关，Lp（a）也影响股骨骨密度。     

骨疏康冲剂与钙剂联合应用治疗绝经后骨质疏松症的临床研究

目的 观察骨疏康冲剂与钙剂联合应用治疗绝经后骨质疏松症的效果。方法 对年龄为50～75岁、绝经5～30年确诊为骨质疏松症的妇女62例,随机分为骨疏康冲剂加钙剂联合用药组和单用骨疏康冲剂组和单用钙剂组。分别于治疗前、治疗后3个月和6个月观察患者临床症状,用DEXA监测髋部骨密度,测定血清碱性磷酸酶(ALP)、血钙、血磷。结果 骨疏康冲剂加钙剂联合用药组服药后6个月,临床症状改善明显优于单用骨疏康冲剂组(P<0.01),其骨密度也高于单用骨疏康冲剂组(P<0.05),但骨代谢指标各组间无显著差异(P>0.05)。结论 骨疏康冲剂与钙剂联合应用治疗绝经后骨质疏松症较单用骨疏康冲剂有着较好的疗效。     

老年女性绝经后疏松性骨折的药物治疗进展

随着新药的研制、医疗水平的提高和人们的生活环境的不断改善，人口的寿命不断延长，人口老龄化越来越明显。上世纪末全世界人口约为53亿，而65岁以上老人就占6．2％，其中发达国家占12．1％，发展中国家占4．2％。1996年我国人口统计显示60岁以上的人口为1．3亿，约占总人口的10％左右。随着年龄的增加，骨质疏松症患病率也随之增加，特别是老年女性在绝经后卵巢功能的下降引起了雌激素水平的降低，使得在原来生理条件下维持骨量的骨形成和骨吸收的平衡被打破，骨吸收大于骨形成而引起骨质疏松症（osteoporosis，OP）。骨质疏松的严重后果是骨折。     

TCT及HC2-HPV-DNA检测对绝经后妇女宫颈癌筛查的应用价值评估

目的:评价TCT、HC2-HPV-DNA单一及联合检测在绝经后妇女宫颈癌筛查中的应用价值。方法:收集北京市海淀妇幼保健院155例TCT检测提示异常的绝经后妇女,进一步行HC2-HPV-DNA检测和病理学活检。以病理诊断结果为金标准,计算TCT、HC2-HPV-DNA及两者联合检测筛查宫颈C IN1/湿疣及以上病变的敏感度、特异度、假阳性率、假阴性率等指标,评价其诊断价值。结果:HC2-HPA-DNA对绝经后妇女C IN1/湿疣以上病变的筛查敏感性高于TCT检测(分别为84.0%及76.0%),但其特异度明显低于后者(分别为52.4%及74.3%),两种检测均存在较高的假阳性率(25.7%及47.6%),两者联合检测可明显降低假阳性率(19.0%),并且明显提高诊断的特异度(81.0%)及诊断符合率(78.1%),两种检测方法单一或联合检测的阴性预测值无差异显著性。结论:TCT、HC2-HPA-DNA联合检测可降低筛查假阳性率,提高特异度及诊断符合率,在绝经后妇女宫颈癌筛查中具有较高的应用价值。     

TCT及HC2-HPV—DNA检测对绝经后妇女宫颈癌筛查的应用价值评估

目的：评价TCT、HC2-HPV—DNA单一及联合检测在绝经后妇女宫颈癌筛查中的应用价值。方法：收集北京市海淀妇幼保健院155例TCT检测提示异常的绝经后妇女,进一步行HC2-HPV—DNA检测和病理学活检。以病理诊断结果为金标准,计算TCT、HC2-HPV—DNA及两者联合检测筛查宫颈CINl／湿疣及以上病变的敏感度、特异度、假阳性率、假阴性率等指标,评价其诊断价值。结果：HC2-HPA—DNA对绝经后妇女CINl／湿疣以上病变的筛查敏感性高于TCT检测（分别为84．0％及76．0％）,但其特异度明显低于后者（分别为52．4％及74．3％）,两种检测均存在较高的假阳性率（25．7％及47．6％）,两者联合检测可明显降低假阳性率（19．0％）,并且明显提高诊断的特异度（81．0％）及诊断符合率（78．1％）,两种检测方法单一或联合检测的阴性预测值无差异显著性。结论：TCT、HC2-HPA—DNA联合检测可降低筛查假阳性率,提高特异度及诊断符合率,在绝经后妇女宫颈癌筛查中具有较高的应用价值。     

大豆异黄酮抗瘤效应及其机制的研究进展

大豆异黄酮（SIF）是具有能与雌激素受体结合、诱导产生弱雌激素样作用的植物化学物质。最近的研究表明,SIF是一种很有潜力的癌症化学预防剂,对乳腺癌、结肠癌和前列腺癌、肺癌等发生具有一定的预防作用。其可能的抗瘤机制包括雌激素和抗雌激素作用、抑制酪氨酸蛋白激酶（TPK）活性、诱导癌细胞凋亡分化及与抗癌药协同作用等。     

大豆异黄酮抗瘤效应及其机制的研究进展

大豆异黄酮(SIF)是具有能与雌激素受体结合、诱导产生弱雌激素样作用的植物化学物质。最近的研究表明,SIF是一种很有潜力的癌症化学预防剂,对乳腺癌、结肠癌和前列腺癌、肺癌等发生具有一定的预防作用。其可能的抗瘤机制包括雌激素和抗雌激素作用、抑制酪氨酸蛋白激酶(TPK)活性、诱导癌细胞凋亡分化及与抗癌药协同作用等。     

Plasma isoflavone levels versus self-reported soy isoflavone levels in Asian-American women in Los Angeles County

In a case-control study conducted among Asian-American women in Los Angeles County, we reported that the risk of breast cancer was significantly reduced in association with soy intake [Wu,A.H., Wan,P., Hankin,J. et al. (2002) Carcinogenesis, 23, 1491-1496]. In a subset of cases (n = 97) and controls (n = 97) we investigated the relationship between self-reported usual adult intake of soy isoflavones which was determined from a food frequency questionnaire and levels of plasma isoflavones (genistein and daidzein) and isoflavone metabolites (equol, dihydrogenistein and dihydrodaidzein) from a randomly timed blood specimen. In analyses conducted in cases and controls separately, levels of plasma genistein, daidzein and total isoflavones increased with increasing levels of self-reported intake of soy isoflavones. Breast cancer cases and control subjects did not differ in their respective associations between total plasma isoflavone levels and self-reported intake (P = 0.48). Among all subjects, there was a 3-fold difference in geometric mean plasma levels of total isoflavones [81.8 (95% CI = 53.4, 125.1) versus 26.4 nmol/l (95% CI = 16.6, 41.8)] between women in the highest quartile of soy isoflavone intake (>12.68 mg isoflavones/1000 kcal) compared with those in the lowest quartile of intake (相似文献   

Overnight urinary isoflavone excretion in a population of women living in the United States, and its relationship to isoflavone intake.

Dietary isoflavones are biologically active in humans, but few observational data exist on the relationship between isoflavone intake and excretion in Western populations. We examined associations between self-reported soy intakes and overnight urinary isoflavone excretion in a population-based sample of western Washington State women, and we investigated the usefulness of one versus two overnight urine samples, collected 48 h apart, as a biomarker of intake. Isoflavones (genistein, daidzein, O-desmethylangolensin, and equol) were measured in two overnight urine collections from 363 women recruited from a health maintenance organization. Soy food intakes were assessed using two 1-day diet records completed on each day prior to the urine collections and a food frequency questionnaire (FFQ) that had been completed by 312 of the women with regard to their dietary habits 3.5 years (range, 2-5 years) before the urine collections. Twenty-one percent of the women consumed soy on either day of the diet recall, and 13% and 34% of the women consumed soy at least once a week or at least once a month, respectively, according to the FFQ. Women who consumed soy at either of the two diet recalls or at the FFQ (at least once a week or at least once a month) had a significantly higher urinary excretion of isoflavones than women who did not consume soy (P < 0.01). Among women who consumed soy at either of the two diet recalls or at the FFQ (soy consumed at least once a month), isoflavone intake and excretion correlated significantly (P < 0.01). Excretion of the individual isoflavones correlated significantly between the two urine samples collected 48 h apart (genistein, r = 0.41 and P < 0.001; daidzein, r = 0.30 and P < 0.001; O-desmethylangolensin, r = 0.46 and P < 0.001; equol, r = 0.60 and P < 0.001). Differences between soy consumers and nonconsumers and associations between intakes and excretion remained significant whether one or both urine collections were considered. Measuring isoflavone excretion in one overnight urine collection serves as a biomarker of recent or past isoflavone intake, even in populations whose intake of soy foods is relatively low.     

A randomized isoflavone intervention among premenopausal women.

Isoflavones, phytoestrogens contained in soy foods, may play a role in breast cancer prevention. This randomized double-blinded trial with 34 premenopausal women investigated whether 100 mg of isoflavones per day versus placebo affects the ovulatory cycle during 1 year. Compliance with the study regimen was confirmed by the increase of urinary isoflavone excretion among the intervention group. Blood samples were taken 5 days after ovulation as determined by an ovulation kit, at baseline, and at months 1, 3, 6, and 12. Serum levels of estrone, estradiol, estrone sulfate, progesterone, sex hormone-binding globulin, follicle-stimulating hormone, and luteinizing hormone were quantified by immunoassay; free estradiol was calculated. We applied the method of least squares to fit general linear models to test for an intervention effect while taking into account the repeated measurement design. Except for a small difference in age, the two groups were comparable at baseline. Menstrual cycle length did not change significantly during the intervention [F(1,32) = 0.69; P = 0.44]. During 1 year, we did not observe any significant changes in hormone levels by treatment group. The difference in change between intervention and control group was -13.0 pg/ml (95% confidence interval, -57.5 to 31.5) for estradiol and 6.9 pg/ml (95% confidence interval, -17.8 to 31.5) for estrone. Exclusion of 22 non-ovulatory cycles, noncompliant women, or non-Asian women did not affect the results. These findings do not support the hypothesis that isoflavones affect the ovulatory cycles of premenopausal women over a 1-year period. However, isoflavones alone may have different effects on the reproductive cycle than isoflavones present in soy foods.     

Mammographic densities in a one-year isoflavone intervention.

The estrogenic and antiestrogenic effects of isoflavones, phytoestrogens contained in soy foods, have been proposed as mechanisms for the possible involvement of soy products in the development of breast cancer. We investigated the hypothesis that isoflavones reduce mammographic density, a predictor of breast cancer risk. We conducted a double-blind randomized trial in premenopausal women who received a daily 100 mg isoflavone supplement or a placebo over 12 months. Compliance with the study regimen was confirmed by urinary isoflavones and tablet counts. We used a computer-assisted method to measure mammographic density and paired t-tests to assess changes in mammographic characteristics from baseline to follow-up mammogram. Complete sets of mammograms were available for 30 women. The two groups differed by age and mammographic density at baseline, but were similar in body weight and nutritional intakes. We detected no significant changes either in the size of the dense areas or in the per cent densities. A non-significant decrease in breast area among intervention group subjects was probably the result of methodological issues in comparing mammograms taken under different conditions. In conclusion, our findings do not support the hypothesis that isoflavones decrease mammographic density during a one-year intervention. Although this exploratory study had limited power, it appears that isoflavones do not exert an estrogenic effect similar to hormone replacement therapy on mammographic density.