中国山东某县1951年以来出生女性初潮年龄与绝经年龄长期趋势

目的：描述中国山东某县女性初潮年龄与绝经年龄长期趋势。方法：应用研究地区婚前医学检查及宫颈癌和乳腺癌筛查资料，研究1951—1998年出生女性月经初潮年龄及1951—1975年出生女性绝经年龄长期变化趋势。采用Joinpoint回归确定初潮年龄长期趋势有无拐点以及拐点年份，采用多因素加权Cox回归估计不同年代出生女性较早绝经平均风险比(average hazard ratios,AHR)。结果：1951年和1998年出生女性平均初潮年龄分别为(16.43±1.89)岁和(13.99±1.22)岁，城镇女性低于农村女性，教育水平越高女性平均初潮年龄越低；Joinpoint回归发现1959年、1973年和1993年三个拐点年份，1951—1959年、1960—1973年和1974—1993年出生者初潮年龄分别年均减小0.03岁(P<0.001)、0.08岁(P<0.001)和0.03岁(P<0.001),1994—1998年出生者初潮年龄维持平稳(P=0.968)。与1951—1960年出生女性相比，1961—1965年、1966—1970年和1971—1975年出生者较...     

定量CT测量腰椎和股骨近端骨矿含量

目的：了解椎体和股骨近端松质骨骨密度(BMD)变化的规律,为骨质疏松（OP）防治提供依据。方法：对436例20~74岁正常人的第2~4腰椎和股骨近端的松质骨做定量CT（QCT）测量,测量结果按5岁1个年龄组进行统计学相关性分析。结果：男性及女性腰椎、股骨近端BMD随年龄增加而降低,与年龄呈负相关,男性BMD与年龄的直线相关方程：腰椎BMD=218.61－1.53×年龄(r=-0.6109,P<0.001), 股骨近端 BMD=236.0－1.99×年龄(r=-0.5967, P<0.001);女性BMD与年龄的直线相关方程： 腰椎BMD=269.5－2.77×年龄(r=-.7085,P<0.001) ,股骨近端BMD=259.9－2.46×年龄 (r=-0.6289,P<0.001)。男性BMD下降较平缓,女性45岁之后腰椎BMD下降加速,统计学结果低于男性（P<0.001）;男性股骨近端累积丢失率、OP检出 率均大于腰椎,而女性腰椎骨累积丢失率、OP检出率大于股骨近端。结论：男性应注重测量髋部BMD,女性特别是绝经后妇女腰椎BMD的测量对OP的早期诊断有重要意义。     

不同绝经年限与女性跟骨骨密度的相关性

目的 研究绝经女性根骨骨密度与绝经年限、体重指数和年龄的相关性。方法：选择2014年1月至2016年12月来我院进行体检并进行根骨密度检测的383例绝经后女性作为研究对象,按照不同的绝经年限、BMI和年龄进行分组比较,并统计分析根骨BMD和T值分别与绝经年限、BMI、年龄之间的相关性。结果：不同绝经年限、BMI和年龄组别绝经女性的根骨BMD和T值之间具有显著性差异（P<0.05）。绝经期女性根骨BMD、T值与绝经年限、年龄呈显著负相关（r=-0.516、-0.428、-0.404、-0.351,P=0.002、0.007、0.001、0.003）,与BMI呈显著正相关（r=0.272、0.214,P=0.005、0.006）。结论：绝经年限是骨密度的重要影响因素,绝经年限越长,骨密度越低     

代谢综合征对颈动脉内中膜厚度影响的性别差异研究

目的 探讨代谢综合征(MS)对颈动脉内中膜厚度(CIMT)影响的性别差异。方法 选取2013-10-08至2014-02-25于皖北煤电集团总医院参加体检人群593例。受试者禁食8～12 h后,进行常规体检和生化指标检测;由经过培训的两名专业医师在短轴切面测量CIMT,取平均值。结果 男性MS患病率为29.8％（105/353）,女性MS患病率为24.6％（59/240）,差异无统计学意义（χ2=1.087,P＞0.05）。男性、绝经前后女性中,不同MS组分数者CIMT比较,差异均有统计学意义（F=12.240、8.850、9.510,P＜0.001）。男性、绝经前后女性0、1项组分者CIMT比较,差异有统计学意义（F=8.890、8.620,P＜0.001）,其中,男性、绝经后女性0、1项组分者CIMT大于绝经前女性,差异有统计学意义（P＜0.05）。男性、绝经前后女性≥3项组分者CIMT比较,差异有统计学意义（F=0.670,P=0.002）,其中,男性、绝经后女性≥3项组分者CIMT大于绝经前女性,绝经后女性CIMT大于男性,差异有统计学意义（P＜0.05）。Logistic回归分析显示,MS是女性CIMT增厚的危险因素〔OR=5.611,95%CI(1.398,22.632）,P＜0.05〕,而未发现与男性CIMT增厚有关〔OR=1.091,95%CI（0.906,1.314）,P＞0.05〕。结论 MS对CIMT的影响存在性别差异,MS对女性CIMT的影响更显著。     

辅助生殖技术单胎妊娠女性围产结局分析

目的:分析辅助生殖技术（ART）单胎妊娠女性围产期母婴结局与自然妊娠女性的差异。方法:回顾性分析了 234例ART单胎妊娠女性（ART组）和20 906名自然妊娠单胎女性（自然妊娠组）围产期妊娠结局,分别比较两组间母婴 围产期并发症差异,包括妊娠期高血压疾病、妊娠期糖尿病（GDM）、前置胎盘、早产、产后出血、分娩方式等,新生 儿结局如新生儿平均出生体重、新生儿窒息、低出生体重儿及巨大儿的发生率、新生儿转入新生儿重症监护病房 （NICU）的发生率及新生儿出生性别比。结果:ART组较自然妊娠组GDM（χ２=67.978,P=0.000）、前置胎盘（χ２ =27.565,P=0.000）、早产（χ２=11.874,P=0.001）、剖宫产分娩（χ２=92.042,P=0.000）的发生风险均显著增 加。ART组较自然妊娠组低出生体重儿（χ２=13.534,P=0.000）、巨大儿（χ２=8.328,P=0.004）、新生儿转入 NICU（χ２=5.763,P=0.016）的发生风险均显著增加。结论:与自然妊娠女性相比,ART单胎妊娠女性母婴不良围产 结局显著增加。     

前臂骨密度与骨代谢指标对绝经后女性类风湿性关节炎合并骨质疏松的诊断价值

目的：探讨前臂骨密度（BMD）与骨代谢指标对绝经后女性类风湿性关节炎（RA）合并骨质疏松（OP）的诊断价值。方法：采用双能X线吸收法（DXA）测定96例绝经后女性RA患者和25例绝经后健康女性对照者的前臂BMD、骨矿含量（BMC）,并收集、测定其年龄、BMI、红细胞沉降率、C反应蛋白、类风湿因子、I型原胶原N-端前肽（PINP）和血清I型胶原交联C-末端肽（β-CTX）水平等骨代谢指标,分析BMD与实验指标的相关性。结果：RA组前臂BMD及BMC较对照组低,差异有统计学意义（P＜0.01）;RA组骨代谢指标PINP为（79.01±44.72）μg/L,β-CTX为（0.51±0.35）μg/L;对照组PINP为（96.74±50.92）μg/L,β-CTX为（0.37±0.26）μg/L,2组比较差异有统计学意义（P＜0.05）;相关分析显示RA组β-CTX与BMD、BMC呈负相关（r=-0.259,P=0.011;r=-0.300,P=0.003）;年龄与BMD、BMC呈负相关（r=-0.706,P＜0.001;r=-0.743,P＜0.001）;DAS28与BMD、BMC呈负相关（r=-0.400,P＜0.001;r=-0.330,P=0.001）;PINP与BMD、BMC呈正相关（r=0.308,P=0.020;r=0.244,P=0.010）;logistic回归分析显示,年龄、β-CTX为发生OP的危险因素（OR=0.450,95%CI=0.606～0.921,P=0.006;OR=1.008,95%CI=1.002～1.016,P=0.031）;PINP为发生OP的保护性因素（OR=1.060,95%CI=1.005～1.118,P=0.003）。结论：绝经后女性RA患者较正常绝经后女性更易发生OP,骨代谢指标β-CTX可能为绝经后女性RA发生OP的独立危险因素。     

亚临床甲状腺功能减退症与骨密度及骨代谢指标的相关性研究

目的 观察亚临床甲状腺功能减退患者骨密度及骨代谢指标的变化,探讨甲状腺功能对骨密度及骨代谢指标的影响。方法 纳入符合亚临床甲状腺功能减退症标准的患者122例（亚临床甲减组）,应用双能X线测定仪（DEXA）检测其骨密度（BMD）,并检测其血清游离三碘甲状腺原氨酸（FT3）,游离甲状腺素（FT4）,促甲状腺素（TSH）,血钙（Ca）、血磷（P）、碱性磷酸酶（ALP）,按性别、绝经情况分层,同时纳入与其年龄和性别相匹配的健康志愿者153例（对照组）,比较两组间骨密度及骨代谢指标的差异。结果 亚临床甲减组骨量丢失高于对照组(P<0.005)。亚临床甲减组血钙值均较对照降低,差异有统计学意义（P<0.05）,亚临床甲减组男性血磷、骨密度指标T值、Z值高于对照组,差异有统计学意义（P<0.05）,绝经前妇女Z值高于对照组,差异有统计学意义（P<0.01）,而绝经期前妇女和绝经期后妇女T值、血磷较对照组差异均无统计学意义（P>0.05）。亚临床甲减组ALP较对照组差异均无统计学意义（P>0.05）。多元线性回归分析, 性别(B=0.543,P<0.000 1)与T值正相关,即与男性相比女性的T值更低;T值与绝经(B=-0.274,P=0.001),年龄(B=-0.161,P<0.000 1),TSH(B=-0.108,P<0.000 1)负相关。结论 亚临床甲状腺功能减退患者存在血钙下降,骨密度降低。     

杭州地区围绝经期及绝经后女性代谢综合征的调查研究

目的调查杭州地区40~70岁女性代谢综合征（Mets）的发病情况,了解Mets与年龄、绝经的关系。方法收集1425例40~70岁的女性,按照年龄进行分组,根据中华医学会制定的Mets诊断标准,分析围绝经期女性Mets的患病率及与年龄、绝经的关系。结果研究对象总体平均年龄为（52.38±7.79）岁;各年龄组比较,年龄、身高、体重及BMI均有统计学差异（P＜0.05或0.01）;与40~45岁组相比,其他年龄组的BMI显著上升（均P＜0.01）。研究对象Mets总体患病率为17.89%,随着年龄的增长,患病率呈显著上升趋势（字2=159.1,P＜0.01）;且Mets各组分肥胖、高血糖、高血压、血脂紊乱的发生率均显著升高（字2=59.239、10.707、158.4、143.7,P＜0.05或0.01）。各年龄组SBP、DBP、FBG、TG、TC、LDL-C组间比较均有统计学差异（P＜0.05或0.01）,HDL-C组间比较无统计学差异（P＞0.05）;与40~45岁组比较,其他年龄组的SBP、DBP、TG、TC、LDL-C均显著升高（P＜0.05或0.01）;56~60岁组及60岁以上组FBG显著高于年龄较低的各组（P＜0.05或0.01）。结论Mets的患病率随着年龄的增长呈显著上升趋势,围绝经期和绝经后女性是Mets的高危人群,在围绝经期及绝经早期及时进行个体化生活方式干预、临床激素补充治疗（HRT）,可以显著降低绝经后女性Mets和心血管疾病的发生风险,从而提高围绝经期和绝经后女性的健康水平及生活质量。     

北京地区女性绝经年龄调查与相关因素分析

目的调查目前北京地区女性自然绝经年龄状况,分析影响女性绝经年龄的相关因素.方法 1999年在北京地区18个区(县)采取分层整群概率比率的方法抽取10个样本群,对样本群中的40～65岁围绝经期妇女进行问卷调查.结果平均自然绝经年龄48.41岁.40～54组平均绝经年龄为47.19岁,55～65岁组平均绝经年龄为49.21岁,两组在近20年内平均自然绝经年龄明显提前了2.02岁(P<0.01).结论育龄妇女首孕及初产年龄滞后、孕产次减少、哺乳期缩短,导致近20年内平均自然绝经年龄明显提前,应引起注意.     

血清视黄醇结合蛋白4与绝经后女性非酒精性脂肪性肝病的相关性分析

背景　绝经后女性是非酒精性脂肪性肝病（NAFLD）的危险人群,罹患该病可能导致致死性心血管疾病及其他代谢异常。但NAFLD好发于这一特定生理阶段的机制尚未完全明确。目的　检测绝经后NAFLD女性血清视黄醇结合蛋白4（RBP4）水平,探讨绝经后女性血清RBP4水平与NAFLD的关系。方法　选取2017年5-8月在浙江大学医学院附属杭州市第一人民医院体检中心接受健康体检的37~66岁女性181例。根据是否处于绝经状态和是否符合NAFLD诊断标准分为4组,即绝经前对照组（n=42）、绝经前NAFLD组（n=42）、绝经后对照组（n=36）和绝经后NAFLD组（n=61）。比较各组间血清RBP4水平,应用二分类Logistic回归分析绝经后女性血清RBP4水平与NAFLD的关系,采用受试者工作特征曲线（ROC曲线）及曲线下面积（AUC）分析血清RBP4的诊断价值。结果　绝经后NAFLD组女性血清RBP4水平高于绝经前对照组和绝经后对照组,差异有统计学意义（P<0.05）。校正混杂因素后Logistic回归分析显示,血清RBP4水平升高〔OR=1.155,95%CI（1.059,1.260）,P<0.05〕是绝经后女性NAFLD发生的危险因素。血清RBP4水平预测绝经后NAFLD的ROC曲线的AUC为0.841,95%CI为（0.757,0.924）,最佳截断值为25.1 mg/L,灵敏度为0.78,特异度为0.79（P<0.001）。结论　血清RBP4水平升高与绝经后女性NAFLD发生相关,对绝经后NAFLD的发生具有较好的辅助诊断价值。     

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.     

Reproductive events and family history as risk factors for breast cancer in northern Alberta.

Reproductive events and family history as risk factors for breast cancer in northern Alberta were investigated with the use of data from a computerized population-based registry. Women aged 30 to 79 years attending diagnostic breast clinics at the Cross Cancer Institute from 1971 through 1975 constituted the two study groups; 1232 women had diagnosed breast cancer (malignant disease group) and 602 women were clinically free of all types of breast disease (control group). An increased relative risk of breast cancer was found in women with a family history of breast cancer, those who gave birth to their first term infant at age 30 years or older, those in whom more than 15 years elapsed between menarche and that birth, and those with a late natural menopause. There was a decreased risk, relative to nulliparity, in the postmenopausal women who first gave birth to a term infant 5 years or less after menarche. Artificial menopause (bilateral oophorectomy), parity and age at menarche had no apparent effect on the risk. The pattern of risk factors in northern Alberta differed from that reported for other geographic areas, including other provinces of Canada, thus emphasizing the need for local studies in the planning of screening programs.     

Reproductive period and risk of dementia in postmenopausal women

CONTEXT: Exogenous estrogen use may lower risk of dementia in postmenopausal women. A relationship between long-term exposure to endogenous estrogens and incident dementia has been hypothesized but not studied. OBJECTIVE: To determine whether a longer reproductive period, as an indicator of longer exposure to endogenous estrogens, is associated with lower risk of dementia and Alzheimer disease (AD) in women who have natural menopause. DESIGN AND SETTING: The Rotterdam Study, a population-based prospective cohort study conducted in the Netherlands. PARTICIPANTS: A total of 3601 women aged 55 years or older who did not have dementia at baseline (1990-1993) and had information on age at menarche, age at menopause, and type of menopause. Participants were reexamined in 1993-1994 and 1997-1999 and were continuously monitored for development of dementia. MAIN OUTCOME MEASURES: Incidence of dementia, based on Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria, and AD, based on National Institute of Neurological Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria, compared by quartiles of reproductive period among women with natural menopause. RESULTS: During 21 046 person-years of follow-up (median follow-up, 6.3 years), 199 women developed dementia, including 159 who developed AD. After adjusting for age, dementia was not clearly associated with length of reproductive period. However, after adjusting for multiple covariates, women with natural menopause and more reproductive years had an increased risk of dementia (adjusted rate ratio [RR] for women with >39 reproductive years [highest quartile] compared with <34 reproductive years [lowest quartile], 1.78; 95% confidence interval [CI], 1.12-2.84). The adjusted RR per year of increase was 1.04 (95% CI, 1.01-1.08). For risk of AD, the adjusted RRs were 1.51 (95% CI, 0.91-2.50) and 1.03 (95% CI, 1.00-1.07), respectively. Risk of dementia associated with a longer reproductive period was most pronounced in APOE epsilon4 carriers (adjusted RR for >39 reproductive years compared with <34 reproductive years, 4.20 [95% CI, 1.97-8.92] for dementia and 3.42 [95% CI, 1.51-7.75] for AD), whereas in noncarriers, no clear association with dementia or AD was observed. CONCLUSION: Our findings do not support the hypothesis that a longer reproductive period reduces risk of dementia in women who have natural menopause.     

Opioid overdose mortality in Australia, 1964-1997: birth-cohort trends.

OBJECTIVE: To examine trends in rates of opioid overdose deaths from 1964 to 1997 in different birth cohorts. DESIGN: Age-period-cohort analysis of national data from the Australian Bureau of Statistics. MAIN OUTCOME MEASURES: Annual population rates of death attributed to opioid dependence or accidental opioid poisoning in people aged 15-44 years, by sex and birth cohort (in five-year intervals, 1940-1944 to 1975-1979). RESULTS: The rate of opioid overdose deaths increased 55-fold between 1964 and 1997, from 1.3 to 71.5 per million population aged 15-44 years. The rate of opioid overdose deaths also increased substantially over the eight birth cohorts, with an incidence rate ratio of 20.70 (95% confidence interval, 13.60-31.46) in the 1975-1979 cohort compared with the 1940-1944 cohort. The age at which the cumulative rate of opioid overdose deaths reached 300 per million fell in successive cohorts (for men, from 28 years among those born 1955-1959 to 22 years among those born 1965-1974; for women, from 33 years among those born 1955-1959 to 27 years among those born 1965-1969). CONCLUSIONS: Heroin use in Australia largely began in the early 1970s and rates of heroin use have markedly increased in birth cohorts born since 1950.     

Benefit period using alendronate to increase bone mineral density in women with osteoporosis?

Background Alendronate, a nitrogen-containing bisphosphonate is a specific inhibitor of bone resorption and now in the forefront of treatment of osteoporosis. In this study, we reported a significant increase in bone mineral density (BMD) of the spine and the hip in postmenopausal women taking alendronate at 10mg/d for 1,2 and 3 years. Methods Participants had received daily, oral, 10mg dose of alendronate for one to three years and placed into one of three groups according to alendronate treatment duration: 41 women received alendronate for 1 year (group Ⅰ) , 46 received alendronate for 2 years (group Ⅱ) , and 30 received alendronate tor 3 years (group Ⅲ). Measurements of bone density had been made by dual energy X-ray absorbtiometry once each year.Results The differences in L2-L4,L2, L4, femoral neck and trochanter BMD values before and after treatment for first group were significantly different. In second group, significant differences between initial and after treatment were found at the other sites except at the Ward‘s triangle. In the third group, only a significant increase in the L2-L4, L2, L3, L4, trochanter BMD values between before treatment and at the end of third year was found. Comparisons between groups were performed with Student‘s t test. ANOVA was used to test the age, menopause age, menopause duration and initial BMD values between the three groups. Calculated P values of less than 0.05 were considered statistically significant.Conclusions Alendronate had increased BMD significantly at the spine and hip in postmenopausal women over three years. Increases of BMD in third group were significant during the first and second years. However, continued therapy with alendronate had been required to maintain the gain in BMD over the third year.     

绝经后女性血脂水平与骨密度的相关性研究

目的研究绝经后女性骨密度与血脂水平、体质量指数(BMI)及绝经年限的相关性。方法选择141例绝经后女性作为研究对象,均在骨密度实验室检测骨密度(BMD)水平(主要检测部位为腰椎L_1~4、股骨颈和髋关节,部分病人加做前臂),并根据检测结果(T值为标准)将研究对象分为3组,A组(骨质疏松者,T≤-2.5)、B组(骨量减少者,-2.5 < T < -1.0)和C组(正常骨量病人,T≥-1.0)。同时采集所有研究对象的空腹血,检测其总胆固醇(TC)、低密度脂蛋白(LDL)、三酰甘油(TG) 和高密度脂蛋白(HDL)水平。详细记录病人的身高、体质量、年龄、绝经年龄,计算BMI和绝经年限。结果3组腰椎BMD(LBMD)、股骨颈BMD、全髋关节BMD比较,C组>B组>A组(P < 0.05)。3组HDL、TG、TC水平比较,差异均有统计学意义(P < 0.05~P < 0.01),其中A组HDL水平高于C组(P < 0.05);A组和B组TG水平均低于C组(P < 0.01);C组TC水平低于A组(P < 0.05)。3组LDL水平差异无统计学意义(P < 0.05)。相关性分析显示,年龄和绝经年限与各部位BMD值呈负相关关系(P < 0.05~P < 0.01);身高、体质量及BMI与各部位的BMD呈正相关关系(P < 0.05~P < 0.01)。TG水平与LBMD、股骨颈BMD、全髋关节BMD呈正相关关系(P < 0.01);TC水平与LBMD呈负相关关系(P < 0.05~P < 0.01)。多因素logistic回归分析结果显示,高BMI、高TG者骨质疏松症(OP)发生风险较低,高龄、绝经年限长及高TC者OP发生风险较高。绘制ROC曲线分析TC预测绝经后女性发生OP的价值,计算出AUC为0.636(P < 0.05)。结论绝经后女性不同血脂与不同部位BMD的相关性不同,TC升高与LBMD下降有关,低BMI、高龄、绝经年限长及高TC的绝经后女性更易发生骨质疏松。     

Risks and probabilities of breast cancer: short-term versus lifetime probabilities.

OBJECTIVE: To calculate age-specific short-term and lifetime probabilities of breast cancer among a cohort of Canadian women. DESIGN: Double decrement life table. SETTING: Alberta. SUBJECTS: Women with first invasive breast cancers registered with the Alberta Cancer Registry between 1985 and 1987. MAIN OUTCOME MEASURES: Lifetime probability of breast cancer from birth and for women at various ages; short-term (up to 10 years) probability of breast cancer for women at various ages. RESULTS: The lifetime probability of breast cancer is 10.17% at birth and peaks at 10.34% at age 25 years, after which it decreases owing to a decline in the number of years over which breast cancer risk will be experienced. However, the probability of manifesting breast cancer in the next year increases steadily from the age of 30 onward, reaching 0.36% at 85 years. The probability of manifesting the disease within the next 10 years peaks at 2.97% at age 70 and decreases thereafter, again owing to declining probabilities of surviving the interval. CONCLUSIONS: Given that the incidence of breast cancer among Albertan women during the study period was similar to the national average, we conclude that currently more than 1 in 10 women in Canada can expect to have breast cancer at some point during their life. However, risk varies considerably over a woman's lifetime, with most risk concentrated after age 49. On the basis of the shorter-term age-specific risks that we present, the clinician can put breast cancer risk into perspective for younger women and heighten awareness among women aged 50 years or more.     

Cardiac performance in relation to age of onset of menopause

It is well known that post menopausal women are more prone to cardiovascular diseases, osteoporosis and cancer. This study was done to detect the effect of early onset of menopause on the cardiac performance in postmenopausal women. The cardiac functions were evaluated by the noninvasive technique of measuring systolic time intervals (STI) in the form of total electromechanical systolic time (OS2), left ventricular ejection time (LVET), pre-ejection period (PEP) and PEP/LVET ratio. The study included 50 postmenopausal women with age at the onset of menopause ranging from 29 years to 55 years, divided into three groups I, II and III with mean age at onset of menopause being 36.80 +/- 2.97, 43.97 +/- 2.97 and 52.05 +/- 1.61 years, respectively. In group I, there was a highly significant increase in QS2, PEP and PEP/LVET ratio and in group II, there is a significant decrease in LVET with a highly significant increase in PEP and PEP/LVET ratio. This signifies asymptomatic and subclinical cardiac systolic dysfunction in groups I and II as compared to group III. Early onset of menopause could thus be considered as a risk factor for increased cardiovascular morbidity; hence efforts should be made to timely detect and prevent these diseases in the postmenopausal stage.     

The clinical value of BALP on diagnosis and treatment of osteoporosis in postmenopausal women

Objective： To investigate the changes of bone-specific alkaline phosphatase （BALP） in postmenopausal women, analyze the relationship between BALP and bone mineral density, and study the effects of treatment with risedronate on BALP. Methods ： In this study, 243 women who were all at least 1 year past natural menopause were divided into two groups according to WHO standards. Group Ⅰ was 100 osteopenic patients aged from 43 to 85 （mean age, 61.2 years）. Group Ⅱ was 143 osteoporotic patients aged from 45 to 80（mean age, 62.6 yearsi. Bone mineral density（BMD） was measured by dual-energy X-ray absorptiometry （DEXA） and bone-specific alkaline phosphatase（BALP） was tested among all the patients. All the osteoporotic patients received 1-year Risedronate treatment. BALP was tested again after 3 months treatment of Risedronate for osteoporotic patients and BMD was measured after 1-year treatment. All data were processed by the application of statistical package SAS for windows V.6.12. Results： BALP was greater in the osteoporotic patients as compared with the osteopenic patients （P 〈 0.05）. There was also a significant difference of BALP in the patients before and after treatment of risedronate （P 〈 0.05）. BALP was greater in the patients who were less than 5 years past a natural menopause as compared with those who were more than 5 years past a natural menopause （P 〈 0.05）. There was no significant difference of BALP in the patients who were more than 10 years past a natural menopause. Risedronate decreased serum BALP significantly. Logistic regression analyses showed that 3-month percentage decrease in BALP was profoundly associated with the 1-year percentage increase in BMD（r = 0.696, P 〈 0.01 ）. Conclusion： BALP can predict the response in bone mass during Risedronate treatment in postmenopausal women and identify those noncompliant patients. 3-month percentage change in serum BALP was significantly correlated with the increase of BMD. Serum BALP can play a role in the monitoring of risedronate-treated postmenopausal women with osteoporosis, but it is poor to predict the treatment effects on an individual level.