Bone density patterns after normal and premature menopause

Objectives: The investigation of the effect of time and type of menopause on bone mineral density (BMD) at different ages. Methods: Five hundred and fourteen women, who had never received any hormonal substitution were studied in a cross-sectional design: 177 with normal (NMP), 210 with surgical (SUMP) and 127 with premature natural (EMP) menopause. Age at menopause was 49.1±3.9, 38.3±4.7 and 38.1±4.2 years (mean±1 S.D.), respectively. BMD was measured at L2–L4 vertebrae and proximal femur by the DEXA method. Results: EMP women presented significantly lower vertebral BMD than NMP women in the 45–55-years segments (P<0.001), but did not differ from SUMP women. This group exhibited lower vertebral BMD than NMP between 45 and 50 years (P<0.001). Regarding femoral neck, EMP women exhibited lower values than SUMP in the 45–50 and 55–65 age segments (P<0.001) whereas SUMP women presented significantly higher BMD values than NMP women after 55 years of age (P<0.001). The percentages of women with vertebral BMD (T-score values) in the osteoporotic range were significantly greater in EMP compared with either NMP or SUMP groups (both P<0.001) whereas in femoral neck lower in SUMP than the other two categories. Conclusions: Women with either natural or surgical premature menopause exhibit lower BMD of trabecular bone compared with normal menopause women at the age segments 45–55 and 45–50, respectively. However, surgical menopause women exceed normal menopause women in their mixed bone BMD values after 60 years as well as premature natural menopause women at almost all age segments.     

Meta-analysis of genome-wide linkage studies for bone mineral density

Genome-wide linkage studies have shown several chromosome loci that may harbor genes that regulate bone mineral density (BMD), but results have been inconsistent. A meta-analysis was performed to assess evidence for linkage of BMD across whole genome scan studies. Eleven whole-genome scans of BMD or osteoporosis containing 3,097 families with 12,685 individuals were included in this genome scan meta-analysis (GSMA). For each study, 120 genomic bins of ~30 cM were defined and ranked according to maximum evidence for linkage within each bin. Bin ranks were weighted and summed across all studies. The summed rank for each bin was assessed empirically for significance using permutation methods. A total of seven bins lie above the 95% confidence level (P=0.05) and one bin was above the 99% confidence level (P=0.01) in the GSMA of eleven linkage studies: bins 16.1 (16pter-16p12.3, Psumrnk <0.01), 3.3 (3p22.2-3p14.1), 1.1 (1pter-1p36.22), 18.2 (18p11.23-18q12.2), 6.3 (6p21.1-6q15), 20.1 (20pter-20p12.3), and 18.1 (18pter-18p11.23). GSMA was performed with seven studies with linkage scores of LOD >1–1.85 for sensitivity test, confirming the linkage on chromosome 16p and 3p and revealing evidence of new linkage in bins 10.2 (10p14-10q11.21) and 22.2 (22q12.3-22pter). In conclusion, the meta-analysis of whole-genome linkage studies of BMD has shown chromosome 16pter-16p12.3 to have the greatest evidence of linkage as well as revealing evidence of linkage in chromosomes 1p, 3p, 6, 10, 18, 20p, and 22q across studies. This data may provide a basis with which to carry out targeted linkage and candidate gene studies particularly in these regions.     

数字化摄影与双能X线吸收法在骨密度测定中的相关性研究

目的 探讨数字化摄影技术(DR)用于骨密度测定的方法和可行性.方法 门诊健康体检成年女性194例,DR拍摄标准骨盆平片,利用DR的图像后处理工作站选取股骨颈3点,Ward三角1点,股骨大粗隆3点,测量像素密度后求平均值.按年龄分层,观察DR像素密度变化规律;与双能X线吸收法(DXA)测定的相应部位骨密度值进行相关性分析.结果 不同年龄层成年女性DR像素密度不同,DR像素密度和DXA骨密度均随年龄增长呈逐渐下降趋势;左右侧股骨颈DR像素密度和DXA骨密度呈正相关(r=0.353,0.371)(均P＜0.01);左右侧Ward三角部位DR像素密度和DXA骨密度呈正相关(r=0.460,0.466)(均P＜0.01);左右大粗隆部位DR像素密度和DXA骨密度呈正相关(r=0.484,0.433)(均P＜0.01).结论 DR技术可用于髋部骨密度测定.     

骨密度定量检测方法及性能比较

随着人口老龄化,骨质疏松症已成为世界各国关注的公共健康问题.目前,骨密度的定量检测是诊断骨质疏松症的最好方法,正日益受到医学临床重视.综述了现有临床采用的X线照相或X光片密度测量、单光子和单能X线吸收测量法、双能光子和双能X线吸收法、定量CT或定量超声或定量磁共振成像（MRI）技术等主要的骨密度定量检测方法的原理,并分析比较其优缺点.     

康力龙对类固醇性大鼠骨质疏松骨密度和生物力学的影响

目的　从生物力学和骨矿含量测定角度研究康力龙对类固醇性大鼠骨代谢的影响。方法　采用 3月龄雄性SD大鼠 2 8只 ,随机分为基础对照组、年龄对照组、激素模型组和康力龙预防组。后两组给醋酸泼尼松 4 5mg·kg-1,ig ,2次 /周 ;预防组还给康力龙 0 5mg·kg-1·d-1,ig。 3个月后取股骨和第 5腰椎行骨密度测定 ,再行扭转、3点弯曲和压缩试验。结果　与年龄对照组比较 ,激素模型组股骨和第 5腰椎的总骨密度减少了 14 6 4 % (P <0 0 1) ;股骨干在 3点弯曲试验时所承受的载荷减少了17 1% (P <0 0 5 ) ;其余的力学参数都出现减少的趋势。与激素模型组比较 ,康力龙预防组股骨和第 5腰椎的总骨密度有所增加 ;股骨扭转角度明显增加 72 5 % (P <0 0 5 ) ,其余的力学参数都出现增加的趋势。结论　长期使用糖皮生激素 (GC) ,会使大鼠皮质骨和松质骨的骨密度和力学性能下降 ,从而易致骨折 ;应用康力龙则能阻止GC所致骨量丢失 ,还能增加其力学性能。     

Total and regional bone mineral content in relation to menopause

Total body bone mineral content (TBBM) and anatomical region bone mineral content (head, trunk and extremities) were measured using dual-energy X-ray absorptiometry in 188 women aged 60 ± 6 years, of whom 154 were normal and 34 were osteoporotic. Of the 154 normal subjects, 90 were premenopausal (40 aged 44 ± 3 years and 50 aged 34 ± 8 years), the remaining 64 being postmenopausal and aged 58 ± 7 years. There were no TBBM or regional changes in the premenopausal women, whereas there was a significant reduction in bone mineral content in the postmenopausal as compared with the premenopausal women in all regions. The osteoporotic subjects showed a general decrease (P < 0.001) in all measurements which was more marked in the trunk. The rate of TBBM reduction was 16% in the normal postmenopausal women and 29% in the osteoporotic subjects. All the postmenopausal women (both normal and osteoporotic) showed lower TBBM values than those in the Wisconsin trial, similar results being obtained in the case of the premenopausal group. Such differences can only be explained by hardship experienced by these now postmenopausal women during their childhood and adolescence.     

卵巢辐射损伤对大鼠腰椎骨密度和生物力学的影响

目的探讨大鼠卵巢辐射损伤后腰椎骨密度、微结构和生物力学的改变。方法手术暴露大鼠双侧卵巢并应用50Gy的γ射线局部照射,术后90d取大鼠腰椎,DEXA测定骨密度,扫描电镜显示微结构,并行压缩实验检测腰椎最大载荷。结果与假手术组相比,卵巢辐射组大鼠的腰椎骨密度显著减少(P<0.05),骨微结构破坏,生物力学性能下降(P<0.05)。结论卵巢辐射损可导致大鼠腰椎的骨质疏松样改变。     

Changes in metacarpal bone mineral density with age and menopause using computed X-ray densitometry in Japanese women: Cross-sectional and longitudinal study

Background: Bone mineral density (BMD) loss with age and menopause is widely accepted in elderly women. However, only a few studies have utilized a multiple regression model that includes physical characteristics to assess comprehensive lifetime changes in BMD.

Objective: A prospective study was conducted to characterize the normal patterns in metacarpal BMD changes in Japanese women, and to assess the applicability of a fitting model using cross-sectional data compared with longitudinal variability.

Subjects and methods: The study consisted of 5422 healthy women in cross-sectional data and a 1-year follow-up of 359 women. The metacarpal BMD was measured by computed X-ray densitometry. Multiple linear and nonlinear regression analyses were performed in cross-sectional subjects. Nonparametric analysis was used to compare percentage rates of BMD changes between actual and estimated values.

Results: The cross-sectional data showed that the best-fit equation was a nonlinear change model using the variables of age and height in premenopausal women, and years since menopause (YSM), age and height in postmenopausal women. The results of longitudinal data indicated the following. In premenopausal women, the actual BMD changes were greater in the 30–39 age group than the 20–29 age group and were less in the 50–59 group than the 40–49 group. The rates of annual change in BMD between the actual value and estimated value by change model were very similar. In postmenopausal women, the actual changes in BMD indicated that the rapid rate of reduction observed was over 3% at 0–5 YSM and 1.5% at 6–10 YSM, and thereafter showed a slower rate of decline at 11 YSM. The change model represented the trend of actual change in BMD for postmenopausal women, whereas the rates of estimated BMD loss underestimated the actual changes at 1–10 YSM.

Conclusion: The change model for premenopausal women using cross-sectional data is beneficial in evaluating the actual metacarpal BMD variability, whereas that for postmenopausal women is insufficient in estimating the longitudinal BMD variability.

Résumé. Arrière plan: On accepte communément que les femmes âgées aient connu une perte de densité minérale osseuse (DMO) avec l’âge et la ménopause, cependant seulement un petit nombre d’études ont utilisé un modèle de régression multiple, qui inclut des caractéristiques physiques afin de suivre de manière adéquate les changements de DMO au cours de la vie

Objectif: Une étude prospective a été menée afin de caractériser les modalités normales du changement de la DMO métacarpienne chez les femmes japonaises et pour estimer la possibilité d’appliquer un modèle d’ajustement utilisant des données transversales comparées avec la variabilité longitudinale.

Sujets et méthodes: L’étude consiste en sonnées transversales de 5422 femmes en bonne santé et d’un suivi d’un an pour 359 femmes. La DMO métacarpienne a été mesurée par densitométrie radiographique calculée par ordinateur. Des analyses de régression linéaires multiples et non linéaires, ont été effectuées sur les données transversales. Une analyse non paramétrique a été utilisée pour comparer les pourcentages de changement de DMO entre valeurs estimées et valeurs observées.

Résultats: Les données transversales indiquent que la meilleure équation ajustée est un modèle non linéaire employant les variables d’âge et de stature des femmes avant la ménopause, les années depuis la ménopause (ADM) et l’âge et la stature après la ménopause. Les résultats des données longitudinales indiquent qu’avant la ménopause, le changement en DMO est plus élevé dans le groupe d’âge 30–39 ans que dans le groupe d’âge 20–29 ans et ceux-ci sont inférieurs aux valeurs de des groupes 40–49 et 50–59 ans. Les taux annuels de changement de DMO que ce soit par les valeurs mesurées ou par les valeurs estimées sont similaires. Chez les femmes ménopausées, les changements en DMO observés indiquent que le rapide taux de réduction est supérieur à 3% entre 0 et 5 ans après la ménopause, puis de 1,5% entre 6 et 10 ans après la ménopause et décline à un rythme plus lent à partir de 11 ans après la ménopause. Le modèle de changement coïncide avec les changements en DMO observés chez les femmes ménopausées, tandis que les taux de perte de DMO du modèle sous estiment les changements effectifs entre 1 et 10 ans après la ménopause.

Zusammenfassung. Hintergrund: Es ist allgemein bekannt, dass bei älteren Frauen die Knochendichte (bone mineral density, BMD) im Alter und mit der Menopause abnimmt. Allerdings haben nur wenige Studien ein multiples Regressionsmodell benutzt, das körperliche Merkmale einschließt, um die komplexen Änderungen der Knochendichte im Verlauf des Lebens zu erfassen.

Ziel: Es wurde eine prospektive Studie durchgeführt, um das normale Muster von Mittelhandknochendichte-Änderungen bei Japanischen Frauen zu charakterisieren und um unter vergleichender Verwendung von Quer- und Längsschnittsdaten die Anwendbarkeit eines rechnerischen Anpassungsmodells zu prüfen.

Probanden und Methoden: Die Studie umfasste Querschnittsdaten von 5422 gesunden Frauen und eine Einjahres-Nachuntersuchung von 359 Frauen. Die Mittelhandknochendichte wurde radiologisch mittels Rechner-Densitometrie gemessen. Multiple lineare und nicht-lineare Regressionsanalysen wurden an den Querschnittsdaten durchgeführt. Eine nicht-parametrische Analyse wurde benutzt, um die prozentuale Veränderung der Knochendichte zwischen tatsächlich gemessenen und geschätzten Werten zu vergleichen.

Ergebnisse: Die Querschnittsdaten zeigten, dass die beste rechnerische Anpassung durch ein nicht-lineares Modell unter Verwendung der Variablen Alter und Körperhöhe bei Frauen vor der Menopause erzielt wurde, und unter Verwendung der Variablen Jahren seit der Menopause (years since menopause, YSM), Alter und Körperhöhe bei Frauen nach der Menopause. Die Ergebnisse der longitudinalen Daten zeigten folgendes. Bei Frauen vor der Menopause waren die tatsächlichen Knochendichteänderungen in der Gruppe der 30–39-jährigen größer als in der Gruppe der 20–29-jährigen und geringer in der Gruppe der 50–59-jährigen als in der der 40–49-jährigen. Das prozentuale Ausmaß der jährlichen Veränderung der Knochendichte zwischen den tatsächlich gemessenen und den über das Anpassungsmodell geschätzten Werten war sehr ähnlich. Bei Frauen nach der Menopause zeigten die tatsächlich gemessenen Veränderungen der Knochendichte, dass die beobachtbare Abnahmerate der Knochendichte 0 bis 5 Jahre nach der Menopause größer als 3% war, 6 bis 10 Jahre nach der Menopause 1,5% betrug, und erst 11 Jahre nach Menopause langsamer wurde. Das rechnerische Anpassungsmodell zeigte zwar den Trend der tatsächlichen Knochendichteänderung bei Frauen nach der Menopause, unterschätzte allerdings die tatsächlichen Knochendichteänderungen in den ersten 10 Jahren nach der Menopause.

Resumen. Antecedentes: La pérdida de densidad mineral ósea (BMD) con la edad y en la menopausia está ampliamente reconocida en las mujeres ancianas. Sin embargo, muy pocos estudios han utilizado un modelo de regresión múltiple que tuviera en cuenta características físicas para evaluar los cambios globales que se producen lo largo de la vida en la BMD.

Objetivo: Se realizó un estudio prospectivo para caracterizar los patrones normales de cambio en la BMD de los metacarpos en mujeres japonesas y para estimar la aplicabilidad de un modelo ajustado, utilizando datos transversales comparados con la variabilidad longitudinal.

Sujetos y métodos: Se obtuvieron datos transversales de 5422 mujeres sanas y se realizó un seguimiento de 359 mujeres durante 1 año. La BMD de los metacarpos se determinó mediante densitometría de rayos X computerizada. Se realizaron análisis de regresión lineal y no lineal múltiple en los sujetos de la muestra transversal. Se utilizó un análisis no paramétrico para comparar las tasas porcentuales de los cambios en la BMD entre los valores reales y los estimados.

Resultados: Los datos transversales mostraron que la ecuación con el mejor ajuste era un modelo de cambio no lineal, que usaba como variables la edad y la estatura en las mujeres premenopaúsicas, y los años que habían transcurrido desde la menopausia (YSM), así como la edad y la estatura, en las mujeres postmenopaúsicas. Los resultados de los datos longitudinales indicaron lo siguiente: en las mujeres premenopaúsicas, los cambios reales en la BMD fueron mayores en el grupo de 30–39 años de edad que en el de 20–29 años, y menores en el grupo de 50–59 años que en el de 40–49. Las tasas de cambio anual de la BMD entre el valor real y el estimado por el modelo de cambio eran muy similares. En las mujeres postmenopaúsicas, los cambios reales en la BMD indicaban que la rápida tasa de reducción observada era superior al 3% a los 0–5 YSM y del 1,5% a los 6–10 YSM; posteriormente, mostraban una menor tasa de disminución a los 11 YSM. El modelo de cambio representaba la tendencia del cambio real en la BMD en las mujeres postmenopaúsicas, mientras que las tasas estimadas de pérdida de la BMD subestimaban los verdaderos cambios a los 1–10 YSM.     

Association between bone mineral density and lumbar disc degeneration

ObjectivesHigher vertebral bone mineral density (BMD) has been found to be related with lumbar disc degeneration (LDD), while relationship between femoral neck BMD and LDD remains controversial. The aim of our research was to study the relationship between LDD and BMD of the lumbar spine and femoral neck.Study designThe study population consisted of 168 postmenopausal women (aged 63.3–75.0 years, mean 68.6 years) from the prospective OSTPRE and OSTPRE-FPS study cohorts. The severity of LDD was graded from T2-weighted MRI images using the five-grade Pfirrmann classification. Four vertebral levels (L1-L4) were studied (total 672 discs). The association between lumbar BMD and Z-score and the severity of LDD was studied separately for each vertebral level with AN(C)OVA analysis, using potential confounders as covariates.ResultsHigher lumbar BMD and Z-score were associated with more severe LDD at all studied levels (L1-L4): between L4-L5 disc and L4 BMD (p = 0.044) and L4 Z-score (p = 0.052), between L2-L3 disc and L3 BMD (p = 0.001) and at all other levels (p < 0.001). The mean degeneration grade of the studied discs was associated with the mean L1-L4 BMD and Z-score (p < 0.001). Statistical significance of any result did not alter after controlling for confounding factors. There was no significant association between femoral neck BMD and LDD.ConclusionsHigher lumbar BMD/Z-score were associated with more severe LDD. There was no significant association between femoral neck BMD and disc degeneration. Femoral neck BMD may be a more reliable measurement for diagnosing osteoporosis in postmenopausal women with degenerative changes in the lumbar spine.     

Association between bone mineral density and lumbar disc degeneration

Objectives

Higher vertebral bone mineral density (BMD) has been found to be related with lumbar disc degeneration (LDD), while relationship between femoral neck BMD and LDD remains controversial. The aim of our research was to study the relationship between LDD and BMD of the lumbar spine and femoral neck.

Study design

The study population consisted of 168 postmenopausal women (aged 63.3–75.0 years, mean 68.6 years) from the prospective OSTPRE and OSTPRE-FPS study cohorts. The severity of LDD was graded from T2-weighted MRI images using the five-grade Pfirrmann classification. Four vertebral levels (L1-L4) were studied (total 672 discs). The association between lumbar BMD and Z-score and the severity of LDD was studied separately for each vertebral level with AN(C)OVA analysis, using potential confounders as covariates.

Results

Higher lumbar BMD and Z-score were associated with more severe LDD at all studied levels (L1-L4): between L4-L5 disc and L4 BMD (p = 0.044) and L4 Z-score (p = 0.052), between L2-L3 disc and L3 BMD (p = 0.001) and at all other levels (p < 0.001). The mean degeneration grade of the studied discs was associated with the mean L1-L4 BMD and Z-score (p < 0.001). Statistical significance of any result did not alter after controlling for confounding factors. There was no significant association between femoral neck BMD and LDD.

Conclusions

Higher lumbar BMD/Z-score were associated with more severe LDD. There was no significant association between femoral neck BMD and disc degeneration. Femoral neck BMD may be a more reliable measurement for diagnosing osteoporosis in postmenopausal women with degenerative changes in the lumbar spine.     

Cross-sectional study of muscle strength and bone mineral density in a population of 106 women between the ages of 44 and 87 years: relationship with age and menopause

This study examined the correlations between isokinetic muscle strength of knee and elbow flexors and extensors with vertebral and femoral bone mineral density in a population of 106 women between the ages of 44 and 87 years. The absolute value of muscle strength correlated significantly with bone mineral density; muscle strength of the upper limb appeared to be more closely correlated with bone mass, while muscle strength in the lower limb was more specific for femoral mineral bone density. The most important finding that these results demonstrated was a concomitant decline in muscle strength of the upper limb and bone mineral density between the 5th and 6th decades. In contrast, they also showed a decline in muscle strength of the lower limbs after the 6th decade, occurring before the decline in bone mineral density observed between the 7th and 8th decades. From these results it would appear that other studies are required to examine the relationship between the essentially hormonal role in postmenopausal decline in muscle strength and the decline in physical activity during the senile period. These elements are important because they must be taken into account in physical exercise programmes designed to prevent osteoporosis.     

Prospective evaluation of bone mineral density among middle-aged HIV-infected and uninfected women: Association between methadone use and bone loss

Objective

We undertook a prospective study to assess the impact of HIV infection on BMD in a cohort of HIV-infected and uninfected women that included illicit drug users, and to measure the contribution of traditional risk factors as well as HIV-related factors to loss of BMD over time.

Methods

We analyzed BMD at baseline and after ≥18 months in 245 middle-aged HIV-infected and 219 uninfected women, and conducted linear regression analysis to determine factors associated with annual BMD change at the femoral neck, total hip and lumbar spine.

Results

HIV-infected women had lower baseline BMD at the femoral neck and total hip compared with controls; unadjusted rates of BMD change did not differ by HIV status at any site. In multivariable analyses, we found that HIV seropositivity without protease inhibitor (PI) use was associated with BMD decline at the lumbar spine (−.009 g/cm² per year, p = .03). Additional factors associated with BMD decline were: postmenopausal status, lower BMI, and methadone use at the lumbar spine; postmenopausal status and hepatitis C seropositivity at the femoral neck; and postmenopausal status, age, smoking, and lower BMI at the total hip (all p < .05). Among HIV-infected women, ≥3 years of PI use was associated with an increase in lumbar spine BMD (.013 g/cm² per year, p = .008).

Conclusions

Bone loss among HIV-infected middle-aged women was modest, and possibly mitigated by PI use. Methadone use was associated with BMD decline, and should be considered when evaluating women for osteoporosis risk.     

Impact of lean mass and fat mass on bone mineral density: The Hordaland Health Study

OBJECTIVES: To examine the relationship between soft tissue composition and bone mineral density (BMD) of the hip and whether these relationships differ by gender and age. METHODS: Femoral neck BMD and total body soft tissue composition were measured by dual X-ray absorptiometry in a population-based sample of 5205 men and women 47-50 and 71-75 years old. Analysis of covariance was used to explore possible modifying effects of sex and gender on the impact of fat and lean mass on BMD. RESULTS: The difference in BMD per kilo lean mass (LM) was larger than the difference per kilo fat mass (FM). The effect of FM on BMD was significantly greater among women than among men. In multivariate adjusted analyses, 10kg increase in LM was associated with a 0.083 (95% confidence interval [CI]: 0.075, 0.092)g/cm(2) increase in BMD. A 10kg increase in FM was associated with 0.013 (0.007, 0.019)g/cm(2) increase in BMD among men and 0.021 (0.017, 0.026)g/cm(2) among women. There was indication of a steeper dose-response relationship at lower levels of FM among women. CONCLUSIONS: Compared to FM, LM was generally more strongly related to BMD of the femoral neck in middle-aged and elderly men and women. FM was a significantly stronger predictor of BMD among women than among men, particularly at lower levels of FM.     

Kinematics of the lumbar spine in elderly subjects with decreased bone mineral density

Lumbar spine kinematics was studied in subjects with normal bone mineral density, osteopenia and osteoporosis to determine the effect of bone mineral density and morphology on the flexion–extension movement patterns of the lumbar spine. Lateral radiographs and skin-mounted electromagnetic motion tracking sensors were employed to study lumbar spine kinematics using a Bayesian Belief Network model. The predicted angular displacement of the vertebrae had a high correlation (r = 0.91, p < 0.001) with the actual movements. The overall mean error was −0.51° ± 3.11°. Intervertebral angular displacement and velocity consistently increased from L1/L2 to L5/S1. Differences were observed in the movement pattern between normal subjects and those with decreased bone density. In normal subjects, vertebral angular acceleration consistently decreased from the upper to the lower vertebrae but the same consistent predictable pattern was not observed in the subjects with decreased bone mineral density. It is possible that these changes in kinematic behaviours are related to morphological changes as well as altered neuromuscular functions.     

Bone mineral density in healthy Tunisian women

Interpretation of densitometric results requires a comparison with reference bone mineral density (BMD) values of normal age and sex-matched persons. Thus the aim of this study was to determine these values for healthy Tunisian women, to estimate the prevalence of osteoporosis and to compare our findings with other populations. A cross-sectional study of 1378 Tunisian women aged between 20 and 96 years was carried out using DXA (GE-Lunar Prodigy). Subjects with suspected conditions affecting bone metabolism were excluded. Measurements were taken at the lumbar spine and femoral neck. These values were expressed at T-scores, with reference to the mean BMD values of the group aged 20–40 years. The peak bone mass, estimated in this age group was 1.174 + 0.127 g/cm² at the lumbar spine and 1.016 ± 0.118 g/cm² at the femoral site. It was attained respectively within the age of 25 years and 36 years. For both sites, the expected decline in BMD was shown when the successive age groups [40–49 years] and [50–59 years] were compared. Bone loss was rapid during the first 5 years after menopause. Thereafter BMD declined slowly but continually. The prevalence of osteoporosis in the women over 50 years of age, taking account of peak bone mass observed in our cohort, was 23.3% at the spine and 17.3% at the femoral neck with a combined prevalence of 23.4%. These rates attained respectively 30.4%, 11.8% and 32.9% when we considered the Italian values, which demonstrate the variability of osteodensitometric depending to the reference population adopted.     

不同治疗方法对绝经后乳腺癌患者骨密度的影响

目的 探讨不同治疗方法 对绝经后乳腺癌患者骨密度(BMD)的影响.方法 研究分为健康对照组(50例)、肿瘤组[48例,其中24例再行他莫昔芬(TAM)组治疗].采用双能X线骨密度仪(DEXA)测定所有研究对象的基线BMD.肿瘤组术后均进行辅助化疗,其中24例(TAM组)化疗后继续使用TAM行内分泌治疗.用DEXA测量腰椎和左髋部位的BMD,比较肿瘤组化疗前、后以及TAM组行内分泌治疗8个月后BMD变化.结果 肿瘤组化疗后腰椎部位BMD(0.87±0.15)g/cm2比化疗前(0.93±0.15)g/cm2明显降低(P<0.05);TAM组行内分泌治疗8个月后腰椎BMD(0.90±0.04)g/cm2和股骨颈(0.74±0.05)g/cm2等左髋部位的BMD均有明显增加(P<0.05).结论 化疗可能导致绝经后乳腺癌患者BMD的下降,而TAM治疗能缓解化疗引起的BMD降低.     

LRP5, low-density-lipoprotein-receptor-related protein 5, is a determinant for bone mineral density

Osteoporosis is a multifactorial trait with low bone mineral density (BMD). We report results of an association study between BMD and nine candidate genes (TGFB1, TGFBR2, SMAD2, SMAD3, SMAD4, IFNB1, IFNAR1, FOS and LRP5), as well as of a case-control study of osteoporosis. Samples for the former association study included 481 general Japanese women. Among the nine candidate genes examined, only LRP5 showed a significant association with BMD. We identified a strong linkage disequilibrium (LD) block within LRP5. Of five LPR5 single nucleotide polymorphisms (SNPs) that are located in the LD block, three gave relatively significant results: Women with the C/C genotype at the c.2220C>T SNP site had higher adjusted BMD (AdjBMD) value compared to those with C/T and T/T (p=0.022); and likewise, G/G at IVS17–30G>A and C/C women at c.3989C>T showed higher AdjBMD than those with G/A or A/A (p=0.039) and with C/T or T/T (p=0.053), respectively. The case-control study in another series of samples consisting of 126 osteoporotic patients and 131 normal controls also gave a significant difference in allele frequency at c.2220C>T (²=6.737, p=0.009). These results suggest that LRP5 is a BMD determinant and also contributes to a risk of osteoporosis.     

Association of polymorphisms of paraoxonase 1 and 2 genes,alone or in combination,with bone mineral density in community-dwelling Japanese

Oxidative stress may affect cellular functions in various pathological conditions, including osteoporosis. Paraoxonase 1 confers antioxidant properties on high-density lipoprotein, with which it is associated, by reducing the accumulation of lipid peroxidation products. We have now examined whether the 584AG (Gln192Arg) and 172TA (Leu55Met) polymorphisms of the paraoxonase 1 gene and the 959GC (Cys311Ser) polymorphism of the paraoxonase 2 gene are associated with bone mineral density (BMD) in community-dwelling Japanese (1,087–1,094 women and 1,112–1,125 men). The subjects were aged 40 –79 years and were randomly recruited to a population-based prospective cohort study of aging and age-related diseases. BMD for the lumbar spine and right femoral neck was measured by dual-energy X-ray absorptiometry. Genotypes were determined with a fluorescence- or colorimetry-based allele-specific DNA primer-probe assay system. The 584AG and 172TA polymorphisms of the paraoxonase 1 gene and the 959GC polymorphism of the paraoxonase 2 gene were associated with BMD for the lumbar spine or femoral neck in postmenopausal women, with the 584GG, 172TT, and 959CC genotypes representing risk factors for reduced bone mass. None of these three polymorphisms was associated with BMD in premenopausal women or in men. Our results suggest that the paraoxonase 1 and 2 genes are candidate loci for reduced bone mass in postmenopausal Japanese women.     

Association between depression and bone mineral density in community-dwelling older men and women in Korea

Objectives

Previous research suggested a significant correlation between depression and osteoporosis, but little is known for the elderly Asian population. We investigated an association between depression and bone mineral density (BMD) in the Korean elderly.

Study design

Cross-sectional data analysis of a community-based study, Kangwha Island, South Korea.

Main outcome measures

BMD, measured at the os calcis using a quantitative ultrasound device, was expressed as stiffness index and T-score. Depressive symptoms were evaluated by the Korean version of Beck Depression Inventory (K-BDI). Depression was defined as a K-BDI score of 16 or higher. Participants also completed a questionnaire, including demographic factors, metabolic abnormalities, and health-related lifestyle factors.

Results

A total of 932 local residents (422 men and 510 women) aged 60–80 years completed the questionnaires and baseline BMD evaluation. Men with depression had a significantly lower stiffness index compared to those without depression in an age-adjusted (77.2 ± 5.2 vs. 86.0 ± 1.5, p = 0.002) and a multivariate-adjusted model (78.5 ± 5.2 vs. 85. 9 ± 1.5, p = 0.007). Correspondingly, men with depression had an increased probability of having an osteoporosis (T-score ≤ −2.5) compared to those without depression; the age-adjusted odds ratio was 2.86 (95% CI, 1.36–6.01) and the multivariate-adjusted odds ratio was 2.69 (95% CI, 1.26–5.76). However, no significant association was observed in older women.

Conclusions

Depression was significantly associated with lower BMD in Korean older men, but not in women.     

Comparison between 60 matched pairs of postmenopausal black and white women: analysis of risk factors related to bone mineral density

PURPOSE: Osteoporosis is a systemic disease in which bone density is reduced, leading to weakness of the skeleton and increased vulnerability to fractures. The purpose of this study was to compare known or suspected risk factors (medical, gynecological, and lifestyle characteristics) related to bone loss between 60 matched pairs of black and white postmenopausal women. METHODS: The two racial groups were matched one for one on selective anthropometric variables [age (years), standing height (cm), and body weight (kg)] in order to equate age and body size between groups. Information on risk factors was obtained from an orally administered questionnaire and body composition variables (in addition to those used for matching) assessed by anthropometry and total body dual energy X-ray absorptiometry (DXA). Four skinfold sites (chest, triceps, mid-axillary, and abdomen) were measured with Harpendon calipers and four body circumferences (chest, forearm contracted, waist, and gluteal) were assessed with a Gulick tape. DXA radius, spine, femur, and whole body measurements were obtained on a Hologic QDR-2000 with software version 7.20. RESULTS: White women reported significantly higher proportions of alcohol use, family history of broken bones, and a greater utilization of hormones, calcium and vitamins than did black women. Black women reported a greater numbers who had other diseases (i.e., overactive thyroid, diabetes, rheumatoid arthritis, or kidney stones). Although age and body weight were similar in both groups, black women had greater lean tissue and less body fat than white women. Blacks had significantly higher bone mineral density across all body sites with the exception of the mid- and ultra-distal radius. CONCLUSION: On the basis of these data, it was concluded that part of the difference often observed in bone density between black and white postmenopausal women might be due to lifestyle factors.