中药葛根对去卵巢大鼠骨代谢生化指标的影响

目的　研究中药葛根对去卵巢大鼠骨代谢生化指标的影响 ,探讨葛根治疗骨质疏松症的药理作用。方法　采用去卵巢大鼠模型 ,分A去势组、B假手术组、C去势服葛根组、D去势服西药组 (阳性对照组 ,程序治疗 ) ,去势 1个月后C、D组服药 50d ,放免法测定血清雌二醇 (E2 )、邻甲酚酞络合酮法测定尿钙 ,ELISA法测定尿脱氧吡啶啉 (Dpd) ,放免法测定血清骨钙素 (BGP)水平 ,组间进行比较。结果　E2 测定B、C、D组高于A组 (P <0 0 0 1 ) ,C、D组低于B组 (P <0 0 1 ,P <0 0 0 1 )。尿钙测定B、C、D组低于A组 (P <0 0 1 )。Dpd测定B、C、D组低于A组 (P <0 0 0 1 ) ,C、D组低于B组 (P <0 0 5 ,P <0 0 1 )。BGP测定B组低于A组 (P <0 0 1 ) ,C、D组高于A组 (P <0 0 1 ,P <0 0 5) ,同时高于B组(P <0 0 0 1 )。结论　中药葛根有增加E2 ,抑制骨吸收 ,促进骨形成 ,对骨质疏松症有治疗作用     

大豆异黄酮对骨代谢影响的研究进展

骨质疏松症主要特征表现为全身骨量减少和骨组织微细结构退化 ,引起骨脆性增加和骨密度降低 ,骨折危险性增加。 6 0岁以上女性骨质疏松发病率为 6 0 %～ 70 % ,雌激素缺乏是绝经后骨质疏松症的首要病因 ,雌激素替代疗法是治疗骨质疏松的首选方案 ,但这一治疗方案有一些副作用。大豆异黄酮的结构与雌激素相似 ,且具有雌激素样活性 ,流行病学调查结果显示以豆类食品为主的东方女性中骨质疏松和骨折发病率明显低于食用脂肪和肉类的西方女性[1 3] ,排除人种、遗传、锻炼、体型等因素 ,豆类制品中的异黄酮对骨代谢的影响成为目前研究热点。一、…     

腰腿痛飞行员骨密度变化与骨代谢生化指标的相关分析

目的 探讨腰腿痛飞行员骨密度变化与骨代谢生化指标的相关性。方法 依临床特征分６病例组,分别测定１７０名腰腿痛飞行员的骨密度（ＢＭＤ）,血清钙（Ｃａ）,磷（Ｐ）,碱性磷酸酥（ＡＬＰ）,骨钙素（ＢＧＰ）,尿钙与肌酐比值（Ｃａ／Ｃｒ）,其结果进行组间比较ｔ检验,变量间用直线相关分析。结果 下腰痛和腰腿痛两组骨密度与对照组比较呈非常显性差异（Ｐ〈０．０１）。结论 飞行员腰腿痛受航空复合环境因素的影响所致     

胶东半岛老年性骨质疏松症骨代谢生化指标 与骨密度相关性研究

目的 研究胶东半岛老年性骨质疏松症(OP)患者骨代谢生化指标与骨密度(BMD)的相关关系,探讨骨代谢生化指标对早期诊断OP的临床意义.方法 采用双能X线骨密度仪(DEXA)对胶东半岛沿海地区多中心多阶段整群抽样297名40～89岁居民进行腰椎(L2-4)BMD测量.采用酶联免疫法(ELISA)分别测定血抗酒石酸酸性磷酸酶(TRAP-5b)、I型胶原C端肽(CTX)、骨特异性碱性磷酸酶 (BALP)、骨钙素(BGP)、降钙素(CT)、25-羟基维生素D[25(OH)D]以及血钙(Ca)和磷(P)并进行比较,应用SPSS13.0软件进行统计分析.结果 OP患者各部位BMD明显低于正常组(均P<0.01).老年男性BMD与骨形成和骨吸收指标呈现降低趋势.其中,OP组较对照组BGP、TRAP-5b和25(OH)D明显下降(P<0.05),而血CTX和BALP较对照组升高.老年女性血TRAP-5b、CTX、BALP和 BGP在OP组显著升高(均P<0.01),而CT和25(OH)D明显降低.各组研究对象骨代谢生化标志物均有统计学意义.结论 骨代谢生物指标作为OP的监测指标,比BMD更加灵敏、特异.能够早期反映患者骨代谢水平,对指导OP的早期预防及治疗有重要意义.     

老年原发性骨质疏松患者骨密度、骨代谢的生化指标和骨质疏松性骨折关系的研究

目的 研究和探讨反映骨形成的生化指标骨钙素N端中分子片段(N-MID)和反映骨吸收的生化指标B-胶原降解产物(B-CTX)以及25羟维生素D(25OHD)与骨密度和骨质疏松性骨折的关系.方法 采用双能x线骨密度仪美国Lunar DPXIQ No.5689骨密度仪测定腰椎(L1-4)骨密度(BMD),采用电化学发光法(ECLIA)测定N-MID和β-CTX,采用酶联免疫法(ELISA)测定25OHD,对87例患者进行上述指标测定并按骨密度正常、骨质疏松和骨质疏松伴有骨折随机分为A组、B组和C组,应用SPSS13.0分析软件进行统计学分析.结果 B组和C组骨密度较A组骨密度下降,并有统计学差异(P<0.05,P<0.01),C组骨密度较B组骨密度下降,但无统计学意义(P>0.05)BMI C组较A组降低,并有统计学差异(P<0.05),25OHD和反映骨形成的生化指标骨钙素N端中分子片段(N-MID)B组和C组低于A组,并有统计学差异(P<0.05,P<0.05),C组较B组下降有统计学意义(P<0.05)反映骨吸收的生化指标β-胶原降解产物(β-CTX)B组和C组高于A组,并有统计学差异(P<0.05和P<0.01),C组高于B组并有统计学差异(P<0.05);骨密度与B-CTX呈负相关,与BMI、250HD、N-MID呈正相关.结论 骨代谢的生化指标更能早期反映骨代谢的变化,与骨密度联合判断骨骼的状态更加全面.对于判断老年骨质疏松患者的骨代谢状态,预测骨折危险有着重要的意义.     

绝经后女性骨密度与骨代谢生化指标的相关性分析

目的分析绝经后女性骨密度(bone mineral density,BMD)与骨代谢生化指标的相关性。方法选取西南医科大学附属医院2017年1月至2018年12月收治的绝经后女性患者151例。根据骨密度T值将患者分为骨质疏松组(83例)、骨量低下组(47例)和骨量正常组(21例),比较三组患者骨代谢生化指标的差异,并对各项指标与BMD进行相关性分析。结果骨质疏松组甲状旁腺素(PTH)、Ⅰ型前胶原氨基末端前肽(P1NP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)显著高于骨量低下组和骨量正常组(P0. 05),骨量低下组显著高于骨量正常组(P0. 05)。骨质疏松组体质量指数(bone mass index,BMI)、25(OH) D_3显著低于骨量低下组和骨量正常组(P0. 05),骨量低下组显著低于骨量正常组(P0. 05)。血钙、血磷、骨钙素(BGP)、血清的骨特异性碱性磷酸酶(BALP)在三组之间比较,差异无明显统计学意义(P0. 05)。Spearman相关分析显示,PTH、P1NP、β-CTX与骨密度呈负相关(r=-0. 538,-0. 520,-0. 462,P 0. 05),25(OH) D_3与骨密度呈正相关(r=0. 517,P0. 05),血钙、血磷、BALP、BGP与骨密度无相关性(P0. 05)。结论血清25(OH) D_3、PTH、P1NP、β-CTX与骨密度存在显著相关性,骨代谢生化指标监测有助于绝经后女性骨质疏松的早期诊断。     

产后妇女骨量和骨代谢生化指标变化的研究

目的 探讨产后妇女骨量和骨代谢生化指标的变化，同时明确年龄、身高、体重、身体指数和月经复潮时间对骨密度变化的影响。方法 对24名健康产妇（21－35岁）在产后6个月内进行了追踪观察。用双能X线吸收测量仪（DEXA）分别在产后3－5d，4月初和7月初测量了腰椎正、侧位和股骨颈BMD，同时检测了血清骨钙素，ICTP，雌二醇（放射免疫方法）及血钙、磷浓度。20名非产妇的BMD值作为对照。结果 哺乳妇女腰椎正位和股骨颈BMD在产后4月初和7月初比产后3－5d升高显著（P＜0．05），腰椎侧位BMD在产后7月初比产后4月初和产后3－5d明显升高（P＜0．01），产后6个月内腰椎和股骨颈的BMD均升高到非产妇组水平；血清骨钙素在产后4月初和7月初比产后3－5d有明显升高（P＜0．01）,而ICTP却有明显降低（P＜0．01）；血钙在产后3个月内升高明显（P＜0．01），而血磷在产后6个月内无明显变化，但两者都在正常范围；月经复潮时间对骨量增加有负性影响，而年龄、身高、体重及身体指数对骨量变化无明显影响。结论 在产后6个月内哺乳妇女的骨量持续增加，达到非产妇组水平；骨转换增快，骨形成超过骨吸收；产后停经时间的延长不利于产后骨量的增加。     

羧化不全骨钙素——值得关注的骨代谢生化指标

近年来 ,维生素Ｋ依赖性骨蛋白———骨钙素 ,尤其是骨钙素羧化程度与骨健康的关系在骨代谢生化指标的研究中引起广泛关注。一些研究结果发现血清羧化不全骨钙素(ｕｎｄｅｒｃａｒｂｏｘｙｌａｔｅｄｏｓｔｅｏｃａｌｃｉｎ ,ｕｃＯＣ)水平是反映机体维生素Ｋ营养状态的敏感指标 ,而且与骨转换、骨密度和髋部骨折有关 ,提出是否可能用ｕｃＯＣ作为预测髋部骨折危险性的生化指标。现将有关研究概述如下。一、骨钙素和羧化不全骨钙素骨钙素 (ｏｓｔｅｏｃａｌｃｉｎ ,ＢｏｎｅＧｌａｐｒｏｔｅｉｎ ,ＢＧＰ)是由成骨细胞和成牙质骨细胞合成的…     

胶东半岛健康成年人群骨代谢生化指标与骨密度相关性研究

目的 研究胶东半岛健康成年人群腰椎(L2-L4)骨密度(BMD)与抗酒石酸酸性磷酸酶(TRAP5b)、Ⅰ型胶原C端肽(CTX)、骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)、降钙素(CT)、25-羟基维生素D[25(OH)D]、血清钙(Ca)和磷(P)的相关关系.方法 采用双能X线骨密度仪(DXA)对胶东半岛沿海地区多中心多阶段整群抽样436名21～89岁居民进行BMD测量;采用美国Thermo公司酶标免疫分析仪和HITACHI日立7600-20全自动生化分析仪检测骨代谢指标.将436例受试者按不同性别,每10岁为1个年龄段分组;应用SPSS 13.0分析软件进行统计分析.结果 21～49岁人群TRAP-5b、CTX、BALP、BGP等指标性别间不存在差异;50～89岁人群性别间差异显著,女性高于男性.TRAP-5b、CTX与BMD负相关;女性BALP、BGP在50～69年龄段明显升高,与BMD负相关,70岁以后开始下降.25(OH)D与BMD正相关;CT降低出现在60～89岁年龄段,与BMD显著正相关.血清Ca和P无明显差异.结论 骨代谢指标测定是监测骨量变化及骨质疏松早期诊断的重要技术手段.不同年龄女性骨形成/骨吸收标志物比率不同,绝经后女性骨代谢呈现高转换状态.     

老年原发性骨质疏松患者骨密度、骨代谢的生化指标和骨质疏松性骨折关系的研究

目的 研究和探讨反映骨形成的生化指标骨钙素N端中分子片段(N-MID)和反映骨吸收的生化指标B-胶原降解产物(B-CTX)以及25羟维生素D(25OHD)与骨密度和骨质疏松性骨折的关系.方法 采用双能x线骨密度仪美国Lunar DPXIQ No.5689骨密度仪测定腰椎(L1-4)骨密度(BMD),采用电化学发光法(ECLIA)测定N-MID和β-CTX,采用酶联免疫法(ELISA)测定25OHD,对87例患者进行上述指标测定并按骨密度正常、骨质疏松和骨质疏松伴有骨折随机分为A组、B组和C组,应用SPSS13.0分析软件进行统计学分析.结果 B组和C组骨密度较A组骨密度下降,并有统计学差异(P<0.05,P<0.01),C组骨密度较B组骨密度下降,但无统计学意义(P>0.05)BMI C组较A组降低,并有统计学差异(P<0.05),25OHD和反映骨形成的生化指标骨钙素N端中分子片段(N-MID)B组和C组低于A组,并有统计学差异(P<0.05,P<0.05),C组较B组下降有统计学意义(P<0.05)反映骨吸收的生化指标β-胶原降解产物(β-CTX)B组和C组高于A组,并有统计学差异(P<0.05和P<0.01),C组高于B组并有统计学差异(P<0.05);骨密度与B-CTX呈负相关,与BMI、250HD、N-MID呈正相关.结论 骨代谢的生化指标更能早期反映骨代谢的变化,与骨密度联合判断骨骼的状态更加全面.对于判断老年骨质疏松患者的骨代谢状态,预测骨折危险有着重要的意义.     

广场舞对绝经期后骨质疏松患者的骨密度和骨转换指标影响的研究

目的观察广场舞对绝经后骨质疏松患者的骨密度、骨转换指标的影响。方法研究组:口服钙尔奇D600 mg每日1次的同时,联合广场舞运动方法干预,每周5次,每次平均0.5~1.0小时;对照组:单纯采用口服钙尔奇D600 mg每日1次,观察两组实验前及实验干预6个月后受试者骨密度、骨转换指标变化、骨痛。结果 (1)骨密度变化:研究组治疗6个月后,腰椎L2-4、股骨颈部的骨密度较治疗前明显升高(P0.05),Ward’s区骨密度无显著性改变。而对照组各部位骨密度较前无明显改变(P0.05)。(2)血生化中血钙、血磷及碱性磷酸酶指标值:两组生化指标在治疗前后无统计学差异(P0.05);治疗6个月后P1NP的水平明显升高(P0.05),β-CTX水平未有明显改变(P0.05)。(3)疼痛程度改善情况:两组治疗前后疼痛分级比较,研究组疼痛明显改善。结论广场舞运动能部分改善绝经后妇女骨密度,并且可以缓解骨质疏松引起的疼痛,是一种切实可行的预防和治疗骨质疏松症的临床方案。     

绝经后妇女血清OPN水平与骨密度及骨转换水平的相关性研究

目的：研究绝经后女性血清骨桥蛋白（OPN）水平与骨密度（BMD）、骨标志物的关系,探索OPN在绝经后骨质疏松症（ PMOP）中的临床应用价值。方法对125名绝经后女性进行研究,双能X线骨密度仪测量腰1－4及左股骨颈BMD,测定血中I型原胶原N－端前肽（PINP）、β－胶原降解产物（β－CTX）、25羟维生素D、甲状旁腺素、OPN、骨钙素（OC）、钙（Ca）和磷（P）。结果①骨质疏松组血清OPN水平明显高于骨量减少和正常组（ F＝0．118,P＝0．000）;②血清OPN水平与BMD（腰1－4,左股骨颈）、血Ca显著负相关,与年龄、β－CTX、OC显著正相关（ P均＜0．05）;③多元线性回归分析结果表明,左股骨颈骨密度（B,－11．971;SE,2．383;标准系数,－0．402;P＝0．000）、血钙（B,－6．696;SE,2．383;标准系数,－0．225;P＝0．006）是OPN水平独立预测因子。结论高血清OPN水平与低BMD、高β－CTX水平及钙缺乏相关,该结果丰富了现有的临床证据,为防治PMOP提供了新的思路。     

Bone mineral density and biochemical markers of bone turnover in aseptic loosening after total hip arthroplasty.

The aims of this study were to determine whether subjects with aseptic loosening after total hip arthroplasty (THA) have regional differences in periprosthetic bone mineral density (BMD) and systemic biochemical markers of bone turnover compared to subjects with successful implants.Proximal femoral and pelvic BMD were measured by dual energy X-ray absorptiometry and bone turnover markers were assayed in 49 subjects 12.6+/-4.3 (mean+/-SD) years after cemented THA. Femoral BMD was lower in Gruen zones 2, 5, 6, and 7 in subjects with a loose femoral implant (n=17) compared to those (n=32) with fixed femoral implants (P<0.05 all comparisons). This BMD difference was greatest (-31%, P=0.02) in the proximal and medial region of the femur. Subjects with femoral loosening had higher levels of the bone resorption marker N-telopeptides of type-I collagen (P=0.02) than those with a fixed femoral implant. No differences in pelvic BMD or bone turnover markers were found between subjects with loose (n=18) versus fixed (n=31) pelvic implants.This study suggests that failure of femoral components after cemented THA is associated with region-specific decreases in BMD and an increase in urinary excretion of N-telopeptide cross-links of type-I collagen. These surrogate outcome markers may be of value in monitoring response to antiresorptive therapies used to treat periprosthetic osteolysis, although the diagnosis of aseptic loosening remains clinical and radiological.     

老年男性骨质疏松患者血清胰淀素与骨密度及骨转换生化指标的关系

目的探讨老年男性骨质疏松患者血清胰淀素(Amylin)水平的变化及其与骨密度(BMD)及骨转换生化指标的关系。方法采用酶联免疫法(ELISA)测定89例老年男性骨质疏松患者和50例正常男性老年人血清Amylin、骨碱性磷酸酶(BAP)、骨钙素(BGP)、I型胶原氨基末端肽(NTX),采用美国NORLAND XR-46 Excell-plus双能X线骨密度测定仪分别测定正位腰椎(L2-L4)及左侧股骨颈BMD。结果老年男性骨质疏松患者正位腰椎及左侧股骨颈BMD、血清Amylin、BAP、BGP水平较正常男性老年人明显降低(均P<0.01),血清NTX水平较正常男性老年人明显升高(P<0.01)。老年男性骨质疏松患者血清Amylin水平与患者正位腰椎及左侧股骨颈BMD、血清BAP、BGP水平呈明显正相关(r=0.598,r=0.652,r=0.576,r=0.584,均P<0.01),与患者血清NTX水平呈明显负相关(r=-0.673,P<0.01)。结论血清胰淀素水平降低在老年男性骨质疏松的发病中可能发挥重要作用。     

重度围绝经期牙周病妇女骨密度及骨转换指标表达分析

目的分析重度围绝经期牙周病（牙周病指数6～7）妇女骨密度及骨转换指标。方法连续选择28例重度围绝经期牙周病妇女,入选对象均接受腰椎密度、双侧股骨上端BMD、骨钙素和碱性磷酸酶等指标测定,并与31例同期就诊围绝经期牙周病妇女（牙周病指数4～5）和27例同期在笔者所在医院进行体检结论健康同龄女性（对照组）比较。结果重度牙周病组的腰椎L1～4和左、右股骨Neck的BMD测定值均明显低于牙周病组和对照组,而血清BGP和AKP测定值均明显高于后两组（P均〈0.05）。结论重度围绝经期牙周病妇女存在着明确的身体各部位BMD测定值下降,同时各项骨转换指标明确增加。     

Prediction of bone loss using biochemical markers of bone turnover

Summary The association between baseline levels of eleven bone turnover markers and 5-year rate of bone density change was prospectively studied in a population-based sample of 601 75-year-old women. Several bone formation and resorption markers as well as urinary osteocalcin were modestly correlated to rate of bone density change. Introduction Prediction of bone loss by bone turnover markers (BTMs) has been investigated with conflicting results. There is limited information in the elderly. Methods Eleven bone turnover markers were analyzed in 75-year old women in the OPRA study (n = 601) and compared to the 5-year change of areal bone mineral density (aBMD) in seven skeletal regions. Results Annual aBMD change varied between +0.4% (spine) and −2.0% (femoral neck). Significant associations (p < 0.01) were found for four different serum osteocalcins (S-OCs) (standardized regression coefficient −0.20 to −0.22), urinary deoxypyridinoline (−0.19), serum TRACP5b (−0.19), serum CTX-I (−0.21), two of the three urinary osteocalcins (U-OCs) (−0.16) and aBMD change of the leg region (derived from the total body measurement). After adjustment for baseline aBMD, associations were found for all S-OCs (−0.11 to −0.16), two of the three U-OCs (−0.14 to −0.16) and aBMD change at the total hip, and for three of the four S-OCs (−0.14 to −0.15), S-TRACP5b (−0.11), two of the three U-OCs (−0.14 to −0.15) and aBMD change at the femoral neck. There were no significant results concerning aBMD change at the spine. Conclusion This study indicates that BTMs are correlated with aBMD loss in some skeletal regions in elderly women.     

Bone turnover markers and bone mineral density response with risedronate therapy: Relationship with fracture risk and patient adherence

Surrogate markers of fracture risk—bone turnover markers (BTMs) and bone mineral density (BMD)—can be used to monitor treatment response. We assessed whether changes in these markers greater than the least significant change (LSC) were associated with fracture risk reduction and greater adherence. This secondary analysis of the Improving Measurements of Persistence on ACtonel Treatment (IMPACT) study—a multinational prospective, open‐label, cluster‐randomized study of postmenopausal women on oral risedronate 5 mg/d for 52 weeks—assessed adherence by electronic monitors. Urinary N‐terminal cross‐linked telopeptide of type 1 collagen (uNTX) and serum C‐terminal cross‐linked telopeptide of type 1 collagen (sCTX) levels were assessed at baseline and weeks 10 and 22, and BMD at baseline and week 52. Fractures were recorded as adverse events. In 2302 women, responses beyond LSC in BTMs (uNTX and sCTX) and BMD (spine only) were associated with a reduced risk of nonvertebral fractures (NVFs) and all fractures. NVF incidence was about 50% lower in patients with 30% or more of uNTX reduction at week 22 (1.6%) than in those with less than 30% reduction (3.2%, p = .015). NVFs also were reduced in patients with more than 3% spine BMD increase at 52 weeks than those with 3% or less. Responses greater than LSC in BTMs and BMD were associated with greater adherence, but there was no association between adherence and fracture outcomes at 52 weeks. Changes greater than the LSC in BTMs and BMD reflect better treatment adherence, were associated with fracture risk reduction, and identify differences in individual responsiveness to risedronate. © 2011 American Society for Bone and Mineral Research.     

Relationship among dietary estimates of net endogenous acid production, bone mineral density and biochemical markers of bone turnover in an Iranian general population

Chronic, low-grade metabolic acidosis due to Western diets may be a risk factor for osteoporosis. The severity can be determined in part by net endogenous acid production (NEAP). In a population-based study, a total of 1028 healthy men and women aged 20–72 years were evaluated for dietary intakes and NEAP estimates with a validated food frequency questionnaire. Dual-energy X-ray absorptiometry (DXA) was used to determine BMD of the lumbar spine (L2–L4), distal third of radius, and proximal femur. Serum CrossLaps, degradation products of the C-terminal telopeptides of type I collagen, and osteocalcin were measured by highly specific ELISA methods. Lower estimates of energy-adjusted rates of NEAP were associated with greater femoral neck BMD (p = 0.01) in premenopausal women and with greater BMDs at the distal radius (p = 0.001) and lumbar spine (p = 0.04) in postmenopausal women. Compared with women in the highest quartile of the estimates of the energy-adjusted rates of NEAP, pre- and postmenopausal women in the lowest quartile had significantly greater means of osteocalcin [9.12 (SD ± 1.62) vs. 5.24 (SD ± 1.41) ng/ml, p = 0.02 and 11.74 (SD ± 1.69) vs. 7.79 (SD ± 2.63) ng/ml, p = 0.002, respectively]. Analysis by quartiles of the estimates of energy-adjusted rates of NEAP did not reveal a relationship between BMD and bone turnover markers in men. In conclusion, we found that a high energy-adjusted rate of NEAP was associated with a significantly lower BMD in women but not in men and the energy-adjusted rate of NEAP had a negative relationship with bone formation.     

鲑鱼降钙素联合海滨疗养因子对老年性骨质疏松症骨密度和骨转换指标影响的研究

目的观察鲑鱼降钙素联合青岛海滨疗养因子综合治疗方案对骨代谢的影响。方法研究组:口服钙尔奇D600 mg每日1次或其他钙片的同时,采用鲑鱼降钙素50IU肌肉注射,每日1次,连用2 w后改为隔日1次,连续使用6个月,同时联合海滨疗养因子,每周3~5次,每次1h以上;对照组:单纯采用口服钙尔奇D600 mg每日1次或其他钙片,连续使用6个月。观察两组及组间用药前后骨密度(BMD)、骨转换指标变化、骨痛和生活能力评价。结果 1骨密度变化:研究组治疗6个月后,腰椎L2-4、股骨颈部的骨密度较治疗前明显升高(P0.05),Ward区骨密度无显著性改变,而对照组各部位骨密度较用药前无明显改变(P0.05)。2血生化中血钙、血磷及碱性磷酸酶指标值:两组生化指标在治疗前后无显著差异(P0.05)。3治疗6个月后血清降钙素的水平明显升高,骨钙素水平明显降低。4疼痛程度改善情况:两组治疗前后疼痛分级比较,研究组疼痛明显改善。5生活质量改善情况(以生活能力提高为指标):研究组生活质量改善有效率为88.5%,而对照组仅为36.2%,两组有效率相比有显著差异(P0.01)。结论鲑鱼降钙素联合海滨疗养因子应用于老年性骨质疏松症患者,不仅能够增加骨密度而且可以减少骨质疏松症引起的疼痛,临床效果确切,患者依从性好,值得临床推广。     

Bone mineral density, bone turnover markers and fractures in patients with indolent systemic mastocytosis

Objective

We systematically assessed bone mineral density (BMD), bone turnover markers (BTM), and fractures in a large cohort of patients with Indolent Systemic Mastocytosis (ISM).

Methods

Eighty-two patients (mean age 48 years, 37 women) with ISM were studied. BMD was measured by dual X-ray absorptiometry at the lumbar spine and proximal hip. The serum markers of bone turnover included bone-specific alkaline phosphatase, C-telopeptides of type I collagen, and serum osteocalcin. Previous clinical fractures were registered and spine X-ray was obtained from all patients.

Results

Three women were excluded for concomitant diseases associated to osteoporosis. Osteoporosis according with the WHO classification (T-score < − 2.5) was found in 16 patients (20.0%) (7 females and 9 men). Mastocytosis-related low BMD (Z-score at either the spine or the hip < − 2) was found in 3 women (9%) and 13 men (28%). The BMD was generally lower at the spine than at the hip. No significant correlation was observed between serum tryptase levels and T or Z-score BMD. One or more moderate or severe vertebral fractures were found in 17 patients (12 men); in 11 of them Z-score values were > − 2 or not valuable at the spine. No significant difference was found in the prevalence of mastocytosis-related low BMD and/or vertebral fractures between patients with or without skin involvement. Two patients had radiographic and densitometric osteosclerosis-like characteristics. In osteoporotic patients higher, normal or lower serum BTM were found, without correlations with serum tryptase levels, while in patients with osteosclerosis both BTM and serum tryptase values were particularly increased.

Conclusions

Vertebral osteoporosis and fractures are frequent in patients with ISM. Spine X-ray and densitometric examination are warranted in all patients, also without skin involvement and particularly in males; Z-score other than T-score BMD must be evaluated. Patients with idiopathic osteoporosis should be evaluated for mast cell disease. Both high than low BTM can be observed in patients with osteoporosis while osteosclerosis is characterized by high bone turnover and serum tryptase levels.