上海地区绝经后妇女骨质疏松危险因素分析

目的 探讨上海地区绝经后妇女骨质疏松的危险因素.方法 2008年6月至2008年9月从上海城市社区中年龄在45～80岁的绝经后妇女中随机抽取曾经双能X线骨密度测量仪测定并经临床医生确诊为骨质疏松者250人作为患者组,随机抽取非骨质疏松者250人作为对照组进行病例-对照研究.结果 单因素Logistic回归分析结果显示,年龄、文化程度、职业、绝经年限、体质指数(BMI)、是否经常摄入高钙食物及晒太阳、既往有非外伤性骨折、经常跌倒、糖尿病、慢性胃病、胃肠切除和腹泻与骨质疏松有关.多元Logistic回归模型进行分析显示,年龄、绝经年限、营养状态与骨质疏松关系最密切.结论 上海地区绝经后妇女发生骨质疏松与多种因素有关,早绝经、BMI低及老年妇女尤其要注意骨质疏松的防治.     

北京社区绝经后女性骨质疏松性骨折相关危险因素和防治现况

目的了解北京社区绝经后女性骨质疏松性骨折相关危险因素和防治现况。方法选取2016年3月至2017年11月就诊于北京两个社区卫生服务中心的绝经后女性2 990例,在取得书面知情同意后,由医生询问、受访者回答填写自行设计的骨质疏松症危险因素及防治情况的调查问卷,回收有效问卷2 866份。对问卷内容进行统计分析,将无骨质疏松性骨折史者作为对照组,有骨质疏松性骨折患者作为骨折组,分析骨质疏松性骨折相关危险因素和防治情况。结果受试者中有明确骨质疏松性骨折史170例,占5. 9%。骨折组比对照组年龄更大[(67±7) vs.(62±7)岁,P<0. 000 1],绝经年限更长[(16. 9±7. 5) vs.(12. 2±7. 8)年,P<0. 000 1],身高下降≥4 cm的比例更大(30. 6%vs. 16. 4%,P<0. 000 1)。两组规律服用钙剂的比例均不足30%,均很少补充维生素D。无受试者规律应用双膦酸盐类药物抗骨质疏松治疗。结论年龄、绝经年限、身高下降是否超过4 cm是绝经后女性是否发生骨质疏松性骨折的重要危险因素。即使是已发生骨质疏松性骨折的社区绝经后女性,骨质疏松症的基础措施和抗骨质疏松药物治疗仍极不充分。     

绝经后妇女骨折后再骨折的危险因素分析

目的探讨绝经后妇女骨折后再骨折的危险因素。方法选择2010年5月至2012年5月在该院住院治疗的581例绝经后骨折妇女为研究对象,根据绝经后骨折妇女有无再次发生骨折分为对照组和观察组,采用自编问卷、焦虑自评量表、抑郁自评量表和匹兹堡睡眠质量指数问卷对两组患者进行测评。结果本研究入组的581例绝经后骨折妇女中,有100例再次出现骨折,骨折再发生率为17.21%,而多因素Logistic回归分析结果显示骨质疏松、跌倒、骨折史和抑郁是绝经后骨折妇女再次发生骨折的危险因素。结论绝经后骨折妇女骨折再发生率较高,在临床医疗过程中,应该制定针对性的干预措施减少患者骨折的再次发生,进而改善该类患者的预后。     

绝经后妇女冠心病

绝经后妇女冠心病具有不同于男性的特点，值得引起临床的重视。１危险因素主要有以下五个发病因素：①高血压：５０岁以上女性患高血压多于男性，且血压上升较为急剧，７５岁以上女性约８０％有高血压。Ｊｏｈａｎｓｏｎ等通过流行病学调查发现，高血压是女性冠心病重要的...     

上海地区绝经后妇女骨质疏松症危险因素流行病学研究

目的通过绝经后骨质疏松症的分布特征和易发因素相关性分析,探讨绝经后骨质疏松症的病因机理和危险因素。方法选取社区50～69岁绝经1年以上妇女,以问卷调查,结合DXA测量BMD值,以及血清1α,25（OH）2D3等骨代谢指标测定,分析与骨丢失的相关性。结果骨质疏松症的发生率随增龄和绝经年限的延长而上升,绝经年龄早、生育胎数多、哺乳时间长是低骨量的重要危险因素,而使用雌激素、长期饮用牛奶、维持一定体重对骨量值有保护作用。此外,绝经后OP妇女的血清1α,25（OH）2D3和25（OH）D3含量均明显低于非OP妇女,血清1α,25（OH）2D3含量与BMD值呈高度相关（r=0．693,P〈0．01）。骨代谢相关指标分析表明,绝经后OP表现为高骨转换型,维生素D与PTH状态,以及DPD／Cr等均是评价绝经后OP患者的重要指标。结论妇女绝经后有一个快速的骨丢失过程,而血清1α,25（OH）2D3水平的低下是绝经后骨量丢失的一个重要原因。为维护骨骼健康,应维持其底物25（OH）D3在正常范围内。     

上海地区绝经后妇女骨质疏松症危险因素流行病学研究

目的 通过绝经后骨质疏松症的分布特征和易发因素相关性分析,探讨绝经后骨质疏松症的病因机理和危险因素.方法 选取社区50～69岁绝经1年以上妇女,以问卷调查,结合DXA测量BMD值,以及血清1α,25(OH)2D3等骨代谢指标测定,分析与骨丢失的相关性.结果 骨质疏松症的发生率随增龄和绝经年限的延长而上升,绝经年龄早、生育胎数多、哺乳时间长是低骨量的重要危险因素,而使用雌激素、长期饮用牛奶、维持一定体重对骨量值有保护作用.此外,绝经后OP妇女的血清1α,25(OH)2D3和25(OH)D3含量均明显低于非OP妇女,血清1α,25(OH)2D3含量与BMD值呈高度相关(r=0.693,P<0.01).骨代谢相关指标分析表明,绝经后OP表现为高骨转换型,维生素D与PTH状态,以及DPD/Cr等均是评价绝经后OP患者的重要指标.结论 妇女绝经后有一个快速的骨丢失过程,而血清1α,25(OH)2D3水平的低下是绝经后骨量丢失的一个重要原因.为维护骨骼健康,应维持其底物25(OH)D3在正常范围内.     

影响绝经后妇女骨量的相关因素分析

目的 探讨影响绝经后妇女骨量的相关因素。方法 记录142名健康绝经后妇女年龄、体重、身高、体重指数、初潮年龄、绝经年龄、初产年龄、分娩次数，采用放免法测定血清雌二醇（E2）、睾酮（T）、总三碘甲状腺原氨酸(TT3)、总甲状腺素（TT4）、甲状旁腺素全段（PTH－SP）、降钙素（CT）。双能X光骨密度仪测量腰椎、髋部、前臀骨密度值（BMD）。各项指标与骨密度值进行直线相关分析和逐步回归分析。结果 在一般状况的各项指标中，影响骨量的主要因素为年龄、绝经年龄和体重；骨量随E2、T、CT、TT3、TT4水平的下降而减少，随PTH水平的减少而增高，影响骨量的调钙激素为E2、TT4、PTH。结论 绝经后妇女随增龄和血PTH水平上调骨量丢失增加，血雌激素、甲状腺素水平及体重对维持骨量有重要作用。     

绝经后妇女骨质疏松症与心血管病危险因素的相关性研究

目的探讨绝经后妇女骨密度与冠心病危险因素的相关性研究。方法选取2007年10月—2011年10月航空总医院心内科门诊及住院的绝经后妇女460例,分为骨质疏松组和非骨质疏松组,记录其存在的心血管病危险因素。结果骨质疏松组中,吸烟、高血脂、糖尿病、冠心病所占的比例高于非骨质疏松组,两组比较差异有统计学意义(P<0.05)。多因素logistic回归分析显示,糖尿病,高脂血症是绝经后妇女骨质疏松患者的主要危险因素。雌激素水平与绝经后妇女骨密度呈负相关,绝经后妇女体内雌激素水平明显下降。结论老年人骨质疏松是一个全身性疾病,与高脂血症等心血管疾病的危险因素密切相关,治疗时应采取系统全身性措施,绝经后妇女骨质疏松患者更应采取积极的预防和治疗措施。     

上海地区绝经后女性患者脆性骨折危险因素的回顾性病例研究

目的 调查绝经后女性患者在就诊后10年期间的脆性骨折的发生率,并分析其危险因素.方法 以2008年11月-2010年11月就诊于华东医院的947例45 ～84岁绝经后女性为研究对象,于基线水平调查研究对象的一般情况、骨折史、慢性疾病史等,并用双能X射线(DXA)检测患者腰椎、股骨颈、髋部的骨密度.于2019年11月对患...     

雌激素替代治疗预防绝经后骨质疏松

绝经后骨质疏松的防治是目前老年医学领域研究的一个重要课题。本文就雌激素替代治疗预防绝经后骨质疏松的作用、作用机制、实施方法、安全性等问题进行了阐述。认为在绝经后3年内甚至围绝经期即开始长期雌激素替代治疗,能安全、有效地预防骨质疏松。     

上海市北蔡镇老年人骨质疏松危险因素分析

目的 探讨上海市北蔡地区老年人骨质疏松的危险因素,为骨质疏松的预防提供依据.方法 随机抽取上海市北蔡镇3个居委会1个行政村共608名60～79岁的老年人进行骨密度测定,同时进行问卷调查,使用美国GE公司的Lunar Prodigy Advance PA+300164型双能X线骨密度仪对老年人正位腰椎和左股骨近端进行骨密度测定.结果男性骨质疏松率23%,女性61%;60～64岁、65～69岁、70～74岁、75～79岁4组骨质疏松率分别为40%、44%、53%、66%;体力劳动组骨质疏松率52%,非体力劳动组骨质疏松率42%;25岁时低体质量组、正常体质量组和超重组骨质疏松症率分别为56%、41%、58%;男性现体质量＜60 kg、60～70 kg、70～80 kg、＞80 kg 4组骨质疏松率分别为54%、19%、15%、23%;女性现体质量＜50 kg、50～60 kg、60～70 kg、＞70 kg 4组骨质疏松率分别为76%、67%、63%、30%;现体质指数BMI正常体质量组和超质量组骨质疏松率分别为61%、43%;无骨折史、1次骨折史、2次及以上骨折史三组骨质疏松率分别为41%、67%、74%;有生母驼背史和无生母驼背史组骨质疏松率分别为60%、47%.Logistic回归模型多因素分析显示:性别、年龄、骨折史、生母驼背史及内分泌和代谢性疾病史与骨质疏松发病关系密切,且有统计学意义(P＜0.05).结论 上海市北蔡镇老年人骨质疏松与多种因素有关,尤其是高龄女性,患有内分泌和代谢性疾病,既往有骨折史及生母有驼背史者应注意防治.     

Risk factors for postmenopausal osteoporosis

Fifty-eight women with postmenopausal osteoporosis (crush fracture of the spine) were compared with 58 age-matched normal women. The osteoporotic women had lower total-body calcium levels and bone mineral content of the radius, had undergone an earlier menopause, smoked cigarettes more, and had breast-fed less often. They also had lower levels of estrone, estradiol, and testosterone and reduced levels of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D. These findings suggest the presence of changeable risk factors for the development of osteoporosis. Smoking should be discouraged. An adequate intake of calcium and vitamin D should be ensured. It is the opinion of the authors that those women who have had an early menopause or who have a low bone mass at the time of menopause should be given the choice of medically supervised replacement therapy with estrogen and progesterone.     

Risk factor analysis for metaplastic gastritis in Koreans

AIM: To conduct a retrospective study to determine the risk factors for development of metaplastic gastritis in Korean population. METHODS: The database of 113449 subjects who underwent a gastroscopy for the purpose of a regular check-up at center for health promotion, Samsung medical center during 5 years was collected and retrospectively analyzed. Among them, 5847 subjects who had endoscopically diagnosed as a metaplastic gastritis or 10076 normal as well as answered to questionnaire were included for present study. The subjects were divided into 2 groups; GroupⅠ, normal and GroupⅡ, metaplastic gastritis. Age, gender, Helicobacter pylori (H pylori) seropositivity, body mass index (BMI), family history of cancer, smoking, alcohol consumption, total daily calories, folate and salt intake and dietary habit (out-eating, overeating, irregular eating) were retrieved from questionnaire or electronic medical record and compared between groupⅠand groupⅡ. RESULTS: The prevalence of groupⅡwas 11% (13578/113449) increasing its prevalence with age (P=0.000). But, there was no significant association between 2 groups in BMI, family history of cancer, alcohol consumption, total daily calories, folate and salt intake and dietary habit (out-eating, overeating, irregular eating). Old age (P=0.000), male gender (P=0.000), H pylori seropositivity (P=0.010) and current smoker (P=0.000) were significantly more common in groupⅡat multiple logistic regression model. CONCLUSION: Our data suggested that old age, male gender, H pylori seropositivity and smoking were risk factors for metaplastic gastritis, precancerous lesion of gastric cancer.     

老年慢性阻塞性肺疾病患者发生骨质疏松的危险因素

Objective To explore the risk factors of osteoporosis and the relation with pulmonary dysfunction in elderly patients with chronic obstructive lung disease (COPD). Methods One hundred and eighty patients (82 females and 98 males) with acute exacerbation of chronic obstructive lung disease (AECOPD) from March 2006 to June 2008 were selected in the study. The bone mineral density (BMD) of lumbar vertebrae and hip joint were determined by dual energy X-ray absorptiometry(DEXA). All the patients were divided into two COPD groups with and without osteoporsis. The smoking history, incidence of vertebral fractures, glucocorticosteroid using condition and so on were recorded. The pulmonary function, 6-minute walk distance(6MWD), body mass index (BMI) and serum albumin concentration were evaluated. Results The mean age of all patients was (72±7)years, and the average smoking amount was (59±27)pack years. The ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) was(36.46±9.8)%, and 30% of the patients had inhaled or oral glucocorticoids for more than 3 months. The BMD measurement results showed that BMD of 95% patients(171 cases) was lower than the normal level, and 119 cases (66%) had osteoporosis, including 61 males and 58 females (62%vs. 70%, x2 = 1.435, P=0.33), and 52 cases had (29%) osteopenia. Linear correlation analysis showed that BMI, 6MWD, RV% and FVC% had positive correlation with osteoporosis (r=0.362, 0.635, 0.688, 0.973;all P<0.05).Conclusions The prevalence of osteoporosis is high in elderly patients with moderate or severe COPD, and enough attention and active intervention shoule be paid.     

Estrogen therapy for postmenopausal osteoporosis

Osteoporosis is a worldwide problem that results in fractures that lead to disability and high costs to society. Estrogen therapy is frequently utilized for postmenopausal symptoms, but also has proven protective effects on the skeleton. The main action of estrogen at the cellular level is to inhibit the osteoclast by increasing levels of osteoprotegerin (OPG). OPG binds to the receptor activator of NFkB and prevents osteoclast differentiation, activity and survival. Numerous trials have demonstrated the positive effect estrogen has on the improvement of bone mineral density, and lower doses have also proven efficacious with fewer side effects. Both observational and randomized clinical trials have demonstrated the ability of estrogen treatment to prevent fractures. Topics that remain controversial include the appropriate length of estrogen treatment for postmenopausal women and the appropriate follow-up after treatment discontinuation.     

Combination therapy for postmenopausal osteoporosis

A number of agents have been shown to reduce the risk of fractures in patients with postmenopausal osteoporosis. However, the additional benefits of combination therapy as opposed to monotherapy are uncertain. We performed a MEDLINE search and reviewed the published randomized trials of agents used in combination. Combination therapy results in greater gains in bone mineral density than monotherapy and possibly greater effects on bone turnover. However, none of these studies are large enough or of sufficient duration to determine whether a greater reduction in fracture is achieved. Combination therapy has important cost implications and is likely to be associated with an increased prevalence of adverse events, reduced tolerability and a reduction in adherence. Furthermore, over-suppression of bone turnover as a result of combination antiresorptive therapy might have adverse effects on bone strength, particularly with long-term treatment. Thus, the use of combination therapy for treatment of osteoporosis cannot be recommended on the basis of currently available evidence.