男性吸烟烟龄和吸烟量与骨密度关系

目的探讨男性吸烟与骨密度关系。方法用DXA仪测定腰椎及髋部BMD。结果 (1)除腰椎侧位BMD外,吸烟组正位总体、髋部总体、股骨颈及Ward’s区BMD显著低于非吸烟组。(2)校正年龄与BMI后,烟龄与腰椎正位、髋部总体、股骨颈及Ward’s区BMD均呈显著负相关(P0.05)。每日吸烟量与腰椎正位及Ward’s区BMD呈显著负相关(P0.05)。结论男性吸烟者BMD下降;吸烟是骨质疏松症(OP)的一个危险因素;预防OP应提倡戒烟。     

男性吸烟与骨密度及骨生化指标关系

目的探讨男性吸烟与骨密度及骨生化指标关系。方法用DXA仪测定腰椎及髋部骨密（BMD），用ELISA测定389例20～80岁健康男性血清骨特异性碱性磷酸酶（sBAP）和I型胶原氨基末端肽（sNTX）。结果（1）各部位BMD均在20岁～年龄组最高，30岁之后随年龄增加而缓慢下降；40—60岁各年龄组之间的BMD差异无统计学意义。（2）除腰椎侧位BMD外，吸烟组其它各部位BMD显著低于非吸烟组；吸烟组的BAP显著高于非吸烟组，2组之间的sNTX差异无统计学意义。（3）校正年龄与BMI后，烟龄与腰椎正位，髋部总体，股骨颈及ward＇s区BMD均呈负相关（P〈0．05）。每日吸烟量与腰椎正位及Ward＇s区BMD呈负相关（P〈0．05）。结论男性随年龄增长骨量丢失。男性吸烟者骨生化指标与骨转换水平增高，骨量丢失加速。吸烟等生活方式增高骨转换水平，影响骨转换的增龄性变化并加速骨量的丢失。吸烟是骨质疏松的一个危险因素。预防骨质疏松症（OP）应提倡戒烟。     

腰椎和股骨颈骨质疏松症检出率比较分析

目的：探讨测量部位对骨质疏松症诊断的影响。方法：测量50岁以上人群1087人(男性525例,女性562例)腰椎和股骨颈骨密度,以本次流调骨峰值减去2．5标准差为诊断骨质疏松症标准,分别进行统计,并比较不同测量部位骨质疏松检出率;同时摄T4—L4例位片筛选出压缩性骨折患者,比较不同测量部位骨质疏松检出率。结果：两性随年龄增加,两部位BMD逐渐降低,同年龄组女性骨密度低于男性;男性股骨颈骨密度比腰椎骨密度诊断骨质疏松阳性检出率高,女性腰椎BMD诊断骨质疏松症的检出率高于股骨颈BMD的检出率。结论：女性腰椎BMD诊断骨质疏松敏感性优于股骨颈BMD。     

2型糖尿病患者不同部位骨密度变化及骨折情况分析

目的探讨2型糖尿病(T2DM)患者不同部位骨密度(BMD)的特征及骨折情况。方法 2012—2015年青岛市城阳区人民医院内分泌科住院T2DM患者125例为观察组,健康体检者240例为对照组,收集一般临床资料;双能X线吸收法测定腰椎(L)后前位1-4椎体和左侧股骨近端各部位(股骨颈、股骨干、大粗隆、Ward's三角和全髋部)的BMD。结果男性DM腰椎(L2)的BMD低于非糖尿病(NDM)组,差异有统计学意义(P<0.05);女性DM的Ward's三角区和股骨颈BMD低于NDM组,差异有统计学意义(P<0.05)。骨质疏松(OP)患病率,女性DM(55.20%)和NDM(29.16%)均高于男性DM(28.80%)和NDM(21.66%),差异有统计学意义(P<0.05);男性DM患者(28.80%)高于NDM患者(21.66%),其中L2和L1-4(5.40%和16.00%)高于NDM患者(1.66%和9.58%),差异有统计学意义(P<0.05);女性DM患者(55.20%)高于NDM患者(29.16%),其中Ward's三角、股骨颈和股骨全部(20.00%、12.80%和42.40%)高于NDM患者(3.33%、5.00%和17.91%),差异有统计学意义(P<0.05)。男性和女性DM患者骨折人数最多部位为腰椎。结论 T2DM患者易伴发OP,其中L2和Ward's三角区可分别作为男性和女性患者早期诊断OP的首选检查部位。     

饮食及生活习惯对中老年男性骨密度影响

目的 确定几种常见生活因子对中老年男性骨密度(BMD)的影响,以便指导骨质疏松症的防治工作。方法 对在武汉同济医院高干病房进行体检的286例50～79岁的汉族中老年男性采用问卷方法进行生活饮食习惯等情况调查;用双能量X线骨密度测量仪(DEXA)测定腰椎及股骨颈BMD值,并进行统计分析。结果 (1)将平均每天摄钙量按从低至高分A、B、C₃组,其中年龄在60～69岁的C组腰椎及股骨颈BMD明显高于A组(P<0.01),与B组比较其股骨颈BMD差异也有统计学意义(P<0.05);70～79岁年龄的C组腰椎及股骨颈BMD与A、B组比较均有很大差距,差异有统计学意义(P<0.05)。(2)不同的蛋白质摄入量及饮酒对骨密度的影响不明显。(3)吸烟对骨密度有较大影响,吸烟组股骨颈BMD低于非吸烟组(P<0.05)。(4)运动对骨密度有较大影响,运动组股骨颈BMD高于非运动组(P<0.05)。结论 增加钙的摄入有助骨密度的提高;蛋白质的摄入情况以及饮酒对骨密度影响不大;吸烟促进骨密度的降低;运动有助于骨密度的提高。     

386例健康男性骨密度与吸烟的关系

目的：研究吸烟对骨密度的影响，方法：采用现况研究法，对386例（吸烟157例、非吸烟229例）中国北方汉族男性人群进行骨密度测量和问卷调查，逐步回归方法分析主要影响因素，用方差分析和协方差分析法了解吸烟对骨密度的影响。结果：各部位骨密度值随吸烟量的增及吸烟年限的延长而下降。日吸烟量超过15支、腰椎、股骨颈、Ward三角区和全身骨密度值为1．127、0．952、0．8744和1．148g/cm^2均显低于日吸烟量未超过15支（1．179、1．002、0．907和1．219g/cm^2)，其中股骨颈和Ward三角区骨密度也分别显低于非吸烟（0．998和0．896g/cm^2)；修正体重等混杂因素后，这种差异在腰椎和全身部位仍然显。同时吸烟15年以上，其骨密度值比日吸烟量少于15支且吸烟不足15年低4．6％－6．7％。     

南昌地区成年男性骨密度现状及与吸烟关系的研究

目的 调查南昌地区健康成年男性骨密度,探讨吸烟与骨密度的关系.方法 采用法国MEDILINK公司生产的型号为OSTEOCORE2双能X线骨密度仪测量548例南昌地区健康成年男性正位腰椎(L2～L4)、左侧股骨颈及左前臂BMD,分析不同年龄组BMD及骨质疏松患病率变化.并根据吸烟指数进行分组,分析BMD与吸烟指数关系.结果 正位腰椎、股骨颈、前臂BMD峰值均出现在30～39岁年龄段,而后随年龄增加而下降,50岁以后降低更明显,骨质疏松患病率均随年龄增加而增加.吸烟指数与正位腰椎BMD呈负相关(r=-0.472,P＜0.01),与股骨颈、前臂BMD呈弱负相关(r值分别为-0.163和-0.135,P均＜0.05).结论 南昌地区男性BMD峰值出现在30～39岁年龄段,而后随年龄增加BMD下降,骨质疏松患病率增加.吸烟是骨质疏松的危险因素,为预防骨质疏松应尽早戒烟.     

吸烟、酗酒对深圳地区成年人骨密度的影响

[目的]研究吸烟、酗酒对骨密度的影响.[方法]对来我院健康检查的成年人,角双能X线骨密度仪测量腰椎、左股骨上端骨密度;采用问卷调查方法,确定其吸烟、酗酒状况;用方差分析和协方差分析法,分析吸烟和酗酒对骨密度的影响.[结果]受检男性日吸烟量超过10支者,腰椎、股骨颈、Ward三角区骨密度值,均低于日吸烟量未超过10支者,其中殷骨颈和Ward三角区骨密度也分别显著低于非吸烟者;修正体重等混杂因素后,这种差异在腰椎仍然显著.吸烟年限≥15年,日吸烟量≥10支者;其骨密度值比日吸烟量<10支且吸烟<15年者低46%～67%.受检妇女吸烟年限≥15年,日吸烟量≥10支者,其骨密度值比日吸烟量<10支且吸烟<15年者低32%～35%.酗酒男性和女性骨密度与对照组比较,除30～39岁男性组,其余各组差异无统计学意义.[结论]研究初步显示:无论男女,吸烟可导致骨密度较低.其影响与吸烟年限及吸烟量有关.     

北京市海淀区健康人骨密度生理值的调查研究

目的为了解北京市不同年龄、不同性别健康人腰椎、股骨上端骨密度(BMD)生理值.方法随机对北京市海淀区20岁以上的2 193名健康人进行腰椎及股骨的BMD测定.结果腰椎峰值BMD年龄;女性见于30～39岁,男性见于20～29岁;股骨上端(Neck、Ward's、Troch)峰值BMD年龄;男女两性均见于20～29岁.BMD丢失率女性比男性高40%～120%.结论建立不同性别、不同部位、不同年龄BMD生理值为骨质疏松症的诊断提供科学依据.     

2型糖尿病老年男性患者骨密度变化研究

目的研究2型糖尿病老年男性患者的骨矿面密度（bone mineral density,BMD）变化,探讨影响其骨密度的可能因素。方法应用双能x线骨密度仪测定60例老年男性2型糖尿病患者的腰椎和股骨颈骨密度,并检测血清和尿液中骨代谢及血糖相关的生化指标,分析影响患者骨密度的可能因素。结果依据患者腰椎或股骨颈的骨密度值,骨质疏松的检出率为20％,骨量减少的检出率为53．3％。相关分析显示,年龄、体重、HbAlc均是与腰椎或股骨的BMD相关的变量,其中体重与腰椎的BMD相关性最高（r=0．254,P〈0．01）,HbAlc与股骨的BMD相关性最好（r=-0．224,P〈0．01）。结论老年男性2型糖尿病患者的BMD与年龄、体重、HbAlc相关。     

Bone mineral density in adults in Taiwan: results of the Nutrition and Health Survey in Taiwan 2005-2008 (NAHSIT 2005-2008)

Osteoporosis is one of the most prevalent global health problems in the elderly. A nationwide representative sample of 1121 adult subjects, aged 19 years and older, were scanned by a dual-energy X-ray absorptiometry in the third survey year of Nutrition and Health Survey in Taiwan 2005-2008. There was an apparent gender difference in the trend of bone mineral density (BMD) with age. In males, the decrease in BMD with age at lumbar spine and at femoral neck were statistically significant in those younger than 50 years, whereas the decrease in BMD at forearm was significant only in those aged 50 years and older (β= -0.005, p<0.0001). In females there was a significant negative correlation between BMD at femoral neck and age (β= -0.004, p<0.0001). In the 236 subjects aged 50 years and older, the prevalence rates of osteoporosis were 4.3% at lumbar spine, 12.0% at femoral neck, and 11.6% at forearm in males, and 12.6% at lumbar spine, 18.1% at femoral neck, and 25.0% at forearm in females, respectively. The prevalence rates of osteoporosis at any site were 23.9% in males and 38.3% in females, respectively. The prevalence rates of low bone mass at lumbar spine, femoral neck, and forearm were 28.8%, 57.5%, and 22.7% in males and 34.7%, 45.9%, and 26.1% in females, respectively. Effective measures to maintain bone health and/or to reduce excessive bone loss may be important in the prevention of osteoporotic fractures in Taiwanese adults.     

Cigarette smoking and bone mineral density in the elderly.

OBJECTIVE: To test the hypothesis that cigarette smoking is associated with reduced bone mineral density in elderly men and women. DESIGN: Cross sectional study. SUBJECTS: These comprised 224 men and 186 women aged 61-73 years, born and resident in East Hertfordshire. MEASUREMENTS: Lumbar spine and femoral neck bone mineral density (BMD) were determined by dual energy x ray absorptiometry. RESULTS: After adjusting for potential confounding variables, men who were current smokers were found to have a lumbar spine BMD that was 7.3% (95% CI 0.4, 14.2) lower than men who had never smoked. Similarly, women who were current smokers had a BMD value that was 7.7% (95% CI 0.3, 15.6) lower than in women who had never smoked. The difference at the femoral neck was smaller and not statistically significant. For both men and women, each decade of smoking was associated with a reduction of 0.015 g/cm2 in BMD at the lumbar spine (95% CI: men 0.002, 0.027; women 0.003, 0.028). At the femoral neck the reduction in BMD was 0.011 g/cm2 (95% CI 0.003, 0.020) for men and 0.004 g/cm2 (95% CI -0.003, 0.012) for women with each decade of smoking. CONCLUSIONS: The results show an adverse effect of smoking on BMD which was most noticeable at the lumbar spine, and seemed stronger in men than women. This effect could not be explained by differences in life style between smokers and nonsmokers.     

复方口服避孕药对青春期女性骨矿物质密度的影响

目的:观察16～18岁女性应用妈富隆和炔雌醇醋酸环丙孕酮对骨矿物质密度(BMD)的影响。方法:选择376例16～18岁青春期女性,其中127例女性应用妈富隆,134例应用炔雌醇醋酸环丙孕酮,115例应用非激素避孕(对照组),应用双能X线吸收法测量腰椎和股骨颈BMD,比较口服复方避孕药者与对照组女性BMD的改变。结果:用药24个月,应用妈富隆的女性腰椎、股骨颈BMD与基础值相比轻度降低,但差异无统计学意义(P>0.05);而应用炔雌醇醋酸环丙孕酮的女性腰椎和股骨颈BMD与基础值相比轻度增高,差异无统计学意义(P>0.05);与对照组相比,腰椎和股骨颈BMD增加幅度减小。应用妈富隆和炔雌醇醋酸环丙孕酮者与对照组女性相比,腰椎和股骨颈BMD没有明显差异(P>0.05)。结论:16～18岁青春期女性应用妈富隆或炔雌醇醋酸环丙孕酮2年对BMD没有不利影响,但是继续应用是否影响BMD峰值的获得有待进一步研究。     

Calcium Intake, Vitamin D and Bone Health Status of Post-menopausal Chinese Women in Kuala Lumpur

Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide β cross link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high levels of CTX- β. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as < 50 nmol/l). Mean total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p< 0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p< 0.001) and femoral neck (r=0.295, p< 0.001). CTX-β was negatively correlated with BMD at the spine (r= -0.235, p< 0.001), whereas P1NP (r=-0.215, p< 0.001) and osteocalcin (r=-0.265, p< 0.001) were both negatively correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion, this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status and low bone mass and elevated biochemical markers of bone turnover.     

Effect of two kinds of different combined oral contraceptives use on bone mineral density in adolescent women

BackgroundSteroid hormonal contraceptives are highly effective and widely used. Most studies have shown a negative effect of combined oral contraceptives (COCs) on the bone mineral density (BMD) of adolescents. The study was conducted to compare BMD among users of ethinylestradiol/desogestrel, users of ethinylestradiol/cyproterone acetate and nonhormonal control subjects in women aged 16–18 years.Study DesignThe study included 450 women 16–18 years of age. One hundred fifty women were using ethinylestradiol/desogestrel, 150 women were using ethinylestradiol/cyproterone acetate, and 150 women were using nonhormonal contraception as control subjects. BMD ofthe lumbar spine and femoral neck was obtained using dual-energy X-ray absorptiometry, and mean BMD changes in COCs users and nonusers were compared.ResultsAt 24 months of treatment, lumbar spine and femoral neck mean BMD values in women (n=127) who used ethinylestradiol/desogestrel were slightly lower compared with baseline, but these effects did not reach statistical significance (p=.837 and p=.630, respectively). The mean lumbar spine and femoral neck BMD values in women (n=134) who used ethinylestradiol/cyproterone acetate were slightly higher compared with baseline, but there was no statistical significance (p=.789 and p=.756, respectively). The increases in mean percent change in lumbar spine and femoral neck BMD in the ethinylestradiol/cyproterone acetate group were less than those in the control group (1.88% vs. 0.30% and 0.98% vs. 0.49%, respectively). There were no significant differences in mean BMD of the lumbar spine and femoral neck between the users of ethinylestradiol/desogestrel or ethinylestradiol/cyproterone acetate and nonusers (p>.05).ConclusionOur study indicates that 2 years of COCs therapy had no significant effect on bone density in adolescents, but it remains unknown whether therapy longer than 2 years has a significant adverse effect on the attainment of peak bone mass.     

Reduced spinal and femoral bone mass and deranged bone mineral metabolism in chronic alcoholics.

Prevalence and factors which may influence the development of osteoporosis have been assessed in 32 chronic alcoholic males by measuring the bone mineral density (BMD) of the lumbar spine and femoral neck by dual photon absorptiometry. Serum bone Gla-protein, as an index of bone formation, 25-hydroxyvitamin D, testosterone and cortisol levels were also measured. Eleven patients (34%) had osteoporosis. In seven the lumbar BMD was below the fracture threshold. Lumbar and femoral neck age-matched BMD were below mean normal values in 20 and in 23 patients, respectively. Moreover, the age-matched BMD was significantly lower in the femoral neck (91.7 +/- 14.4%) than in the lumbar spine (100.1 +/- 17.1%) (P < 0.001). Duration of alcoholism was significantly higher in patients with age-matched BMD below 100% than in those with age-matched BMD above 100%. Bone GLA-protein and 25- hydroxyvitamin D were below normal levels in 67% and 56% of patients, respectively. Serum testosterone was normal in all but two patients, and cortisol was within normal values in all patients tested. In addition a direct correlation was found between the days of abstinence before the study and serum levels of bone GLA-protein (r = 0.64, P < 0.001). In conclusion, chronic alcoholics frequently have bone loss of the lumbar spine and femoral neck related with the duration of alcohol intake. The correlation between bone-GLA protein levels and the days of abstinence suggests that alcohol directly depresses bone formation. Likewise, the low levels of vitamin D also support that this deficiency may contribute to the development of osteopenia in chronic alcoholism.     

降钙素受体基因多态性与广州地区绝经后妇女骨密度关系研究

目的探讨降钙素受体基因多态性与绝经后妇女人群骨密度相互关系。方法选取年龄≥42岁的广州地区汉族绝经后妇女(自然绝经≥2年)231例,采用双能X线吸收法(DEXA)测定其全身、腰椎2~4(L2~4)、股骨颈(neck)、粗隆间(inter)、Ward’三角和大转子(troch)区等部位的骨密度(BMD)值,并采用聚合酶链反应限制性片段长度多态性(PCR-RFLP)技术检测外周血白细胞基因组降钙素基因多态性。结果231例受试对象中,CTR基因型分别为CC型194例(占84.0%),CT型33例(占14.3%),TT型4例(占1.7%),基因型分布符合Hardy-weinberg定律。分析三种基因型与骨密度的关系显示,它们各自所代表的骨密度值之间差异并无统计学意义。结论降钙素基因C1377T多态性不能作为预测广州地区汉族绝经后妇女发生骨质疏松危险性的遗传标志。     

Bone Mass, Depressive, and Anxiety Symptoms in Adolescent Girls: Variation by Smoking and Alcohol Use

Purpose

The purpose of the study was to examine (a) the association between depressive and anxiety symptoms with bone health, (b) the association of smoking or alcohol use with bone health, and, in turn (c) whether the association between depressive and anxiety symptoms with bone health varied by smoking or alcohol use individually or by combined use. Bone health included total body bone mineral content (TB BMC) and bone mineral density (BMD) of the lumbar spine, total hip, and femoral neck. Previously published data have not examined these issues in adolescence, a period when more than 50% of bone mass is accrued.

Methods

An observational study enrolled 262 healthy adolescent girls by age cohort (11, 13, 15, and 17 years). Participants completed questionnaires and interviews on substance use, depressive symptoms, and anxiety. BMC and BMD were measured by dual-energy X-ray absorptiometry.

Results

Higher depressive symptoms were associated with lower TB BMC and BMD (total hip, femoral neck). Those with the lowest level of smoking had higher BMD of the hip and femoral neck, whereas no main effect differences were noted by alcohol use. Regular users of both cigarettes and alcohol demonstrated a stronger negative association between depressive symptoms and TB BMC as compared with nonusers/experimental users and regular alcohol users. Findings were parallel for anxiety symptoms.

Conclusion

Depressive and anxiety symptoms may negatively influence bone health in adolescent girls. Consideration of multiple substances, rather than cigarettes or alcohol separately, may be particularly informative with respect to the association of depression with bone health.     

口服复方避孕药对青春期女性骨密度的影响

目的:观察复方口服避孕药(COCs)妈富隆(去氧孕烯/炔雌醇)对青春期女性骨矿物质密度(BMD)的影响。方法:接纳150例年龄16～18岁女性应用COCs避孕为观察组,用药24个月;接纳150例年龄16～18岁从未应用激素避孕药女性做对照组;应用双能X-线吸收法测量腰椎和股骨颈BMD。结果:观察组用药2年后腰椎和股骨颈BMD从基础值1.010±0.107g/cm3和0.818±0.089g/cm3降低到1.007±0.108g/cm3和0.813±0.090g/cm3,分别降低了0.29%和0.61%;而对照组则从基础值1.008±0.109g/cm3和0.816±0.087g/cm3增高至1.027±0.106g/cm3和0.824±0.089g/cm3,分别增高了1.88%和0.98%;用药2年后,观察组与对照组相比BMD无明显差异(P>0.05)。结论:青春期女性应用COCs避孕2年对BMD无明显影响。