跟骨定量超声法评价正常女性骨丢失和骨质疏松患病率

目的　评价正常女性跟骨超声随增龄骨量丢失及骨质疏松患病率。方法　用定量超声法测定了 2 72例正常女性右跟骨宽带超声衰减 (BUA) ,超声声速 (SOS)及骨硬度指数 (STI)。结果女性跟骨峰值骨量出现在 30～ 39岁。 5 0～ 84岁 3组与峰值组以及两两之间比较 ,差异均有显著性(P <0 0 1)。老年组骨质丢失率和骨质疏松患病率分别为 2 6 %～ 37%和 4 2 %～ 6 9%。在各个年龄组中 ,STI丢失率最高 ;STI和BUA骨质疏松检出率相近 ,均大于SOS。结论　跟骨超声的 3项指标均可用于区分绝经前、后的妇女 ;STI检测骨量丢失和OP患病率最敏感     

甲亢合并骨质疏松患者生长激素变化的研究

目的：了解甲亢合并骨质疏松病人血清生长激素水平的变化，同时探讨甲状腺激素水平，年龄、病程等相关因素对骨量丢失的影响。方法：选择未经治疗的甲亢病人146例为研究对象，排除其他疾病，药物，绝经，高龄等影响因素，依骨密度（BMD）结果分为三组，即BMD正常组，骨量减少组，骨质疏松组，以直线相关分析法检验上述各变量间的相关性，结果：GH、ALP与BMD之间有非常显负相关，GH与年龄、病程、T3、T4等指标之间无显相关性。Neck,Wark'S,Troch三部位的BMD与T3、T4及病程之间呈显负相关，而L2－4的BMD与上述三指标无显相关性，却与年龄呈负相关。结论：甲亢合并骨质疏松病人血清GH水平随着BMD的减少而升高，GH在此可能起到了促进骨形成，减少骨量丢失的代偿作用，GH测定可作为甲亢合并骨症疏松患观察指标之一。此外，甲亢病人以骨骨上端的BMD减低为主，腰椎的BMD受T3、T4及甲亢病程的影响较小，而与年龄增长有密切关系。     

糖尿病患者定量超声骨量分布的研究

本文对１６７例糖尿病（ＤＭ）患者进行了定量超声骨量（ＱＵＳ）研究。结果表明，ＤＭ患者ＳＯＳ、ＳＤ值均显著低于健康对照组（ｐ＜０．０１），且ＩＤＤＭ患者的ＳＯＳ峰值比ＮＩＤＤＭ患者的ＳＯＳ峰值低（ｐ＜０．０５），表明ＤＭ患者伴有不同程度骨钙、磷代谢异常，最终导致骨质疏松症（ＯＰ）。结果还显示，女性ＤＭ患者低于男性患者ＳＯＳ、ＳＤ（ｐ＜０．０５），表明女性ＤＭ患者更易受多种因素的影响，导致骨矿含量明显降低。因此对ＤＭ患者应同时服用治疗ＯＰ的药物。     

中老年2型糖尿病患者骨代谢特点及骨量丢失危险因素分析

目的 探讨中老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者骨代谢特点及骨量丢失危险因素.方法 选择中老年T2DM患者612例(男296例,女316例),根据骨密度(bone mineral density,BMD)水平分为骨量正常组(108例)、骨量减少组(281例)、骨质疏松组(22...     

健康和骨质疏松女性胫骨定量超声及骨折阈值的价值

目的 用太原地区健康女性胫骨定量超声骨量（ＱＵＳ）的健康参考值,探讨诊断骨质疏松症的诊断标准及骨折阈值。方法 对太原地区的健康女性１７３６例（９￣８３岁）和骨质疏松女性１８７例（４２￣８０岁）;其中骨折患６７例,测定胫骨定量超声骨量值。结果 健康女性３０岁以前胫骨ＳＯＳ值年龄的增加而升高;３０￣４０岁达到峰值,４０岁以后胫骨ＳＯＳ值开始下降;绝经后胫骨ＳＯＳ值明显降低,与绝经时间呈负相关（ｒ＝０     

哈尔滨地区379例女性跟骨超声骨量的研究

目的 调查哈尔滨地区部分成年女性跟骨骨密度,为该地区正常骨密度参考标准的建立及数据积累提供资料.方法 应用法国Osteospace MEDI LINK骨密度仪,利用定量超声法测量379例人群跟骨超声骨量.结果 统计出不同年龄组超声速度(SOS)、骨硬度指数(STI)、低骨量(LBM)及骨质疏松(OP)比例.结论 哈尔滨地区成年女性SOS峰值在35～岁年龄组,至50～岁年龄组明显下降;STI峰值在35～岁年龄组,以后随着年龄的增长而降低,至55～岁年龄组明显下降;50～岁年龄组低骨量和骨质疏松比例明显增加,且随年龄增长比例呈现继续增长趋势.     

老年女性2型糖尿病患者骨量变化与骨代谢生化指标的观察分析

目的研究老年女性2型糖尿病患者骨量及骨代谢生化指标的变化。方法运用QCT测定42例正常老年女性以及31例确诊为2型糖尿病的老年女性患者的腰椎松质骨密度,检测糖化血红蛋白(糖尿病组)、胰岛素及C肽(空腹及餐后2h)、性激素、血钙、磷、总碱性磷酸酶、骨钙素及尿脱氧吡啶啉、尿钙、磷。结果①老年女性2型糖尿病组骨密度与年龄相匹配的对照组比较无显著差异(P>0.05);②老年女性糖尿病组Dpd及BGP水平均高于对照组(P<0.05),而雌二醇水平低于对照组(P<0.05)。结论老年女性2型糖尿病患者与正常老年女性相比骨密度无明显差异;血BGP及尿Dpd是老年女性2型糖尿病患者骨代谢紊乱的敏感指标。     

高原藏族居民跟骨定量超声测定分析

[目的]测定生活在海拔3000m高原的藏族居民的跟骨定量超声参数，了解藏族的骨量变化规律和高原环境对其的影响。[方法]采用UBIS3000型定量超声仪，对夏河县596名藏族居民跟骨定量超声参数进行测定。[结果]超声振幅衰减（BUA）、刚度（STI）、超声声速（SOS）的峰值男性为30～39岁，女性为40-49岁，达到峰值后男女性随年龄增长各项指标快速下降，绝经后女性最为明显。[结论]高原藏族居民峰值骨量高，老年后骨量丢失迅速，发生骨质疏松的危险性增加。     

骨折患者胫骨定量超声骨量及骨折阈值的测定

目的确定太原地区健康人群胫骨定量超声骨量（ＱＵＳ）的正常参考值范围,探讨用ＱＵＳ诊断骨质疏松的诊断标准及骨折阈值的界限。方法：对２６７２例７～９２岁居住在太原地区的健康人群和１０５例４６～９１岁的骨折患者,采用定量超声骨量分析仪测定胫骨ＱＵＳ值。结果：健康人群胫骨ＱＵＳ值在３０岁以前随年龄的增加而增加;峰值在３０～３９岁,男性５０岁以后胫骨ＱＵＳ值均匀下降;女性４０岁以后胫骨ＱＵＳ值开始下降,胫骨ＱＵＳ值与绝经时间呈负相关性（Ｐ＜０．０１）;以２０～４０岁男性及女性胫骨ＱＵＳ均值减２．０及２．５标准差,分别得出各自的界限值（３６９４．８３７ｍ／ｓ和３６６７．２４３ｍ／ｓ）,６３例女性骨折患者中５９例（９３．７％）及４２例男性骨折患者中４０例（９０．５％）胫骨ＱＵＳ低于此界限值。结论：２．０标准差胫骨ＱＵＳ界限值可作为男性和女性骨质疏松症的诊断标准;２．５标准差ＱＵＳ界限值可作为男性和女性骨质疏松症的骨折危险阈值。     

The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease

A reduced bone mineral density has been reported in patients with untreated celiac disease (CD) as well as in patients with poorly controlled type 1 diabetes mellitus (T1DM). The aim of this study was to evaluate the bone mineral status by phalangeal quantitative ultrasound in 52 children and adolescents with both diseases (mean age 13.3+/-4.9 years). As a control group 50 patients with T1DM and no CD (age 12.2+/-4.0 years) were studied. The following bone parameters, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were considered and expressed as z score. Compliance to gluten free diet and long term glycemic control (mean of four determinations of HbA1c in the last year) were also assessed. The lowest mean AD-SoS z score values were found in patients with T1DM and CD, who reported transgressions to gluten free diet and exhibited positivity for serum anti-tissue transglutaminase antibodies (tTG) and/or endomysial antibodies (EmA), compared with patients with occasional transgressions but negative for anti-tTG and/or -EmA, patients strictly adherent to the diet, and patients who suffered only from diabetes (ANOVA p=0.021). No difference was found between patients with diabetes alone and patients with both diseases strictly adherent to gluten free diet. Prevalence of osteopenia (z AD-SoS values <-2 SD) was higher in patients with T1DM and CD and poor compliance to the diet (45.5%) compared with patients with T1DM (8%) or patients with both diseases strictly compliant to diet (12.9%) (p=0.015). A negative correlation between Ad-SoS z score and HbA1c (r -0.236, p=0.036) was found when patients with T1DM and patients with T1DM and CD, who strictly adhere to the diet, were pooled. In conclusion the quality of bone as assessed by phalangeal ultrasound in patients with T1DM and CD, who strictly adhere to gluten free diet, is similar to that found in T1DM patients. A higher prevalence of osteopenia is present in patients with both diseases who reported habitual transgressions to gluten free diet. The gluten free diet, as well as the optimization of glycemic control, plays an important role in preventing the osteopenic status caused by the clustering of these two chronic diseases.     

昆山地区336例青年人胫骨定量超声骨量研究

目的　为昆山地区胫骨定量超声骨量峰值的建立提供标准化方法并积累数据。　方法以社区 2 4～ 43岁青年健康志愿者 3 3 6例为研究对象 ,用QUA测定胫骨定量超声骨量值。结果　昆山地区男、女性人群的定量超声骨量峰值均出现在 3 2～ 3 5岁年龄段 ,其值分别为 (40 42 6± 76 6)m/s(男性 )和 (40 3 4 8± 70 2 )m/s(女性 )。 40岁以前 ,SOS值无明显性别差异 ,40岁以后 ,女性SOS值明显低于男性。结论　胫骨定量超声骨量峰值无明显性别差异 ,建立的峰值骨量值可作为临床和流行病学研究诊断骨质疏松症的基础参考值     

超声靶向破坏微泡在糖尿病基因治疗中的应用

糖尿病是以高血糖为特征的代谢性疾病,常伴有各种组织,特别是眼、肾、心脏、血管、神经慢性损害和功能障碍,为治疗带来困难。近年来,糖尿病的基因治疗成为热点。超声靶向破坏微泡(UTMD)安全性高、重复性好,组织靶向高,已经成为基因潜在传递方法。本文就UTMD技术及其在糖尿病基因治疗中的研究进展进行综述。     

Quantitative ultrasound of lower leg and foot muscles: Feasibility and reference values

Background

Ultrasound is a non-invasive method to quantitatively measure various muscle parameters. Purpose of this study was to assess the feasibility of ultrasound of lower leg and foot muscles and to obtain reference values for muscle thickness (MT) and echo intensity (EI).

Methods

Ultrasound measurements of leg and foot muscles were performed in 60 healthy adults. MT and EI were quantitatively determined for the abductor hallucis (AH), extensor digitorum brevis (EDB), extensor hallucis longus (EHL) and peroneus longus (PER) muscles. Influence of age, height, weight and sex was determined using a multiple linear regression analysis.

Results

All muscles except the AH could easily be visualized with ultrasound. EI tended to be increased above 60 years and MT was significantly higher in men compared to women, necessitating age- and sex-dependent reference values.

Conclusions

This study shows that muscle ultrasound is capable of visualizing lower leg and foot muscles and reference values for MT and EI can be obtained. Future research will focus on the use of these reference values to evaluate muscle abnormalities caused by neuromuscular disorders like hereditary motor and sensory neuropathy.     

糖尿病性阴茎勃起功能障碍大鼠模型海绵体超微结构的研究

目的　探讨糖尿病（ＤＭ） 性阴茎勃起功能障碍（ＥＤ） 的发病机理。　方法　ＳＤ 大鼠注射链脲佐菌素制造ＤＭ 动物模型后,注射阿朴吗啡观察６ 周、８ 周及１２ 周大鼠阴茎勃起情况,筛选ＤＭ 性ＥＤ 大鼠模型,观察其阴茎海绵体组织超微结构的改变。　结果　ＤＭ 性ＥＤ 大鼠模型阴茎海绵体内皮细胞及平滑肌细胞超微结构均有明显的病理改变：线粒体退变、内质网扩张,糖原颗粒、吞饮小泡及微丝减少。此外,还可见大量间质组织增生及微血管腔闭塞。随ＤＭ 病程不同,其改变程度不同,８ 周时以内皮细胞损害为明显,１２ 周时以平滑肌细胞损害为明显。　结论　ＤＭ 严重影响阴茎勃起功能,海绵体组织超微结构的病理改变可能是ＤＭ 性ＥＤ 发病机理之一。     

Characteristics of calcaneus quantitative ultrasound normative data in Chinese mainland men and women

Introduction Quantitative ultrasound (QUS) assessment at the calcaneus, as a safe and reliable method for evaluating skeletal status, is rapidly gaining in popularity. Assessment by QUS provides three parameters of skeletal status: broadband ultrasound attenuation (BUA), speed of sound (SOS) and derived data-stiffness index (STI). The objective of the present study was firstly to determine the normative QUS data on healthy Chinese mainland men and women and secondly to investigate the effects of sex, age and body size on these three QUS parameters.Methods A study cohort consisting of 725 healthy Chinese women and 568 men aged 10–83 years participated in this investigation. The three QUS parameters all exhibited a characteristic mild rise-then-fall pattern with increasing age in both sexes. Younger men and women had similar QUS values, while older women had lower values than older men. Age-related differences were more pronounced among females. Pearson’s correlation and regression analysis showed that weight was a major determinant of QUS in both sexes, along with age.Results There were some discrepancies between our data and results from other populations, even when the same type of QUS instrument was used, probably as a result of various factors, including ethnic, life-style environment and diet, among others.Conclusions These normative data will be useful for comparing the results of individual studies, predicting fracture risk of Chinese men and women and determining diagnostic criteria of osteoporosis by QUS.     

Body mass index, calcium intake, and physical activity affect calcaneal ultrasound in healthy Greek males in an age-dependent and parameter-specific manner

Quantitative ultrasound (QUS) is a peripheral bone densitometry technique that is rapidly gaining in popularity for the assessment of skeletal status. This study was carried out to examine the effect of anthropometric, dietary, physical activity, and other lifestyle factors on QUS parameters in healthy Greek males of various ages, including children (n = 192), adults (n = 106), and elderly (n = 86) subjects. Calcaneal QUS measurements were performed with the Sahara device (Hologic), which measures broadband ultrasound attenuation (BUA) and speed of sound (SOS) through the os calcis. A composite parameter, the quantitative ultrasound index (QUI), and an estimate of heel bone mineral density (eBMD) were also derived. BUA correlated positively with height, weight, and body mass index, as well as waist and hip circumferences (P < 0.001), but this was not the case for SOS. QUI and eBMD were inconsistently related with anthropometric characteristics. Overweight and obese males had significantly higher BUA than normal-weight subjects (P < 0.05), but similar SOS, QUI, and eBMD; this held true for all age groups. Boys participating in organized physical activities had significantly higher SOS, QUI, and eBMD than those who did not (P < 0.05), although BUA was similar in the two groups; no differences according to organized physical activity were detected in adults and the elderly. On the other hand, adult men devoting at least some time to non-organized physical activities had significantly higher QUS values than their non-exercising peers (P < 0.05); no such effects, however, were seen in children and the elderly. Adult men with calcium intakes above 800mg/day had significantly higher SOS, QUI, and eBMD than those consuming less calcium (P < 0.05), and also tended towards higher BUA (P = 0.079); no such differences were observed among children and elderly men. The effects of physical activity and calcium intake on heel QUS persisted even after controlling for body size. Overall, body weight was the sole significant positive determinant of BUA ( = 0.373; t = 6.589; P < 0.001), explaining approximately 14% of the total variance, while age was the sole significant negative determinant of SOS ( = –0.198; t = –3.321; P = 0.001), albeit explaining only less than 4% of the total variance. In conclusion, body size, dietary calcium intake, and physical activity patterns seem to inconsistently and age-dependently influence heel QUS among healthy Greek males in a parameter-specific manner.     

中老年骨折妇女超声骨质测量中参数分析

目的　用定量超声骨质测量仪对中老年妇女骨折病人检测 ,探讨其参数的意义 ,为骨质疏松性骨折的诊断、防治提供科学依据。方法　用法国DMS公司UBIS 50 0 0型超声骨密度 /骨质量测量仪测量 74例 41岁以上中老年妇女骨折病人的骨质 ,并与 2 1 8例同龄健康妇女作对照。结果　 61岁以前 2组宽波段超声衰减平均值 (BUA)比较差异无显著意义 (P >0 0 5)、而 61岁以后则有显著意义 (P <0 0 1 ) ;51岁以前 2组超声传播速度 (SOS)值比较差异无显著意义 (P >0 0 5)、而 51岁以后则有显著意义 (P <0 0 1 ) ;在绝经后早期 (51～ 60岁 ) 2组比较 ,BUA值差异无显著意义 (P >0 0 5)而SOS值则已有显著意义 (P <0 0 1 )。结论　定量超声骨质测量仪不仅可以提供骨量的指标 ,而且可以对骨结构进行评估 ,无辐射、成本低廉、操作方便 ,在骨质疏松性骨折的早期预测、早期诊断和及时防治中具有重要意义     

Lifestyle factors affecting heel ultrasound in Greek females across different life stages

The use of quantitative ultrasound (QUS) of the bone is rapidly gaining in popularity, and QUS is widely used worldwide for the assessment of skeletal status. Although much has been learned about the influence of various factors on ultrasonic parameters in various populations, similar information at the local level is not available. This study was carried out to examine the effects of anthropometric, dietary, physical activity, reproductive, and other lifestyle factors on QUS parameters in healthy Greek women, including children (n=217), adults (n=235), and elderly (n=369) subjects. Calcaneal QUS measurements were performed with the SAHARA device, which measures broadband ultrasound attenuation (BUA) and speed of sound (SOS) through the os calcis; a composite parameter, the quantitative ultrasound index (QUI), and an estimate of heel bone mineral density (eBMD) were also derived. All QUS indices were higher in adult women than in girls or elderly women (P<0.05). The latter had a similar BUA to girls, but lower SOS, QUI, and eBMD (P<0.05). Most QUS parameters correlated positively with height, weight, body mass index (BMI), hip circumference, organized physical activity, and activity promoting bone mass, but negatively with the time devoted to sedentary activities and absolute carbohydrate intake (P<0.05). Age of menarche and years since menopause were negatively associated with QUS in the adult and elderly women, respectively (P<0.05). The latter relationship, however, was due to the confounding effect of advancing age. Overweight and obese females had significantly higher BUA and eBMD than normal-weight subjects (P<0.05), but similar SOS and QUI; this held true for all age groups. Likewise, in all ages, individuals spending more than 2 h/week on organized activities had significantly higher QUS indices than those spending less time on exercise (P<0.05). Further, postmenarchial girls had significantly higher age-adjusted BUA, SOS, QUI, and eBMD than premenarchial ones (P<0.05). Similarly, all QUS parameters were significantly higher in adult women with an early onset of menarche (<14 years old) than in those with a late onset (P<0.05), but no effects of menarche were detected among the elderly. No significant effects of calcium intake (which was generally adequate), smoking or alcohol drinking (which were generally low) on QUS indices were observed, in either age group. Available independent variables could explain approximately 16%–24% of the total variance in BUA, SOS, QUI and eBMD. The most important positive predictors of QUS were adulthood, time devoted to organized activities, and weight or BMI, while age and carbohydrate intake per se contributed negatively. In conclusion, age, body size, physical activity, and some aspects of reproductive history and diet appear to variably affect calcaneal QUS indices among otherwise healthy Greek women at different life stages.