Relationship between carotid atherosclerosis and lumbar spine bone mineral density in postmenopausal women

Osteoporosis and increased carotid intima-media thickness (IMT) have been associated with atherosclerosis. We investigated the correlation between carotid IMT and lumbar spine bone mineral density (BMD) in postmenopausal women. We studied the carotid IMT in 175 postmenopausal women, including 43 women (control) with normal spinal BMD, 73 women with osteopenia, and 59 women with osteoporosis. Carotid IMT was assessed by ultrasonography. BMD at the lumbar spine (lumbar 2 to 4 vertebrae) was measured by dual-energy X-ray absorptiometry. Age, years since menopause, and carotid IMT were significantly greater in the osteoporosis group than in the control (all p<0.01) and osteopenia groups (all p<0.01). Estradiol was significantly lower in the osteoporosis group than in the control group (p<0.05). BMD was significantly lower in the osteoporosis group than in the osteopenia or control group (both p<0.01) and in the osteopenia group than in the control group (p<0.01). After adjusting for age, years since menopause, and estradiol, women with osteoporosis had significantly greater carotid IMT than controls (p<0.05). The univariate linear regression analysis revealed that carotid IMT was significantly positively correlated with age, years since menopause, and low-density lipoprotein (LDL) cholesterol (all p<0.05) and was significantly negatively correlated with estradiol and BMD (all p<0.05), but showed no significant association with other clinical variables. In multivariate regression analysis, the carotid IMT was significantly positively correlated with LDL cholesterol (p<0.01) and negatively correlated with BMD (p<0.01), but not with other variables. Carotid atherosclerosis might be associated with lumbar spine bone mass in postmenopausal women, suggesting that postmenopausal women with osteoporosis may have more advanced carotid atherosclerosis than those with a normal bone mass.     

Forearm endothelial function and bone mineral loss in postmenopausal women

It is widely believed that the vasculature plays an important role in bone remodeling. We investigated the relationship between forearm endothelial function and bone mass in the lumbar spine in early postmenopausal women without a history of smoking or diabetes mellitus. We studied the forearm resistance artery endothelial function in 110 Japanese women-52 postmenopausal women with normal spinal bone mineral density (BMD), 36 postmenopausal women with osteopenia, and 22 osteoporotic postmenopausal women. Forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin (NTG) administration was measured by strain-gauge plethysmography. BMD of the lumbar spine (L2-L4) was measured by dual-energy X-ray absorptiometry. After adjustment for age, body mass index, years since the start of menopause, and basal FBF, women with osteoporosis had a lower maximal FBF response to reactive hyperemia (28.4 +/- 3.8 mL/min per 100 mL tissue) than those with normal BMD (39.8 +/- 2.8 mL/min per 100mL tissue) or osteopenia (35.6 +/- 2.5 mL/min per 100mL tissue) (P = 0.029). A significant increase in serum angiotensin-converting enzyme (ACE) activity (P = 0.042) and a significant decrease in the serum concentrations of nitrite/nitrate (P = 0.041) were noted in osteoporotic women compared to women with normal BMD or osteopenia. The present findings suggest that postmenopausal women with low BMD, especially those with osteoporosis, have impaired endothelial function in the forearm resistance arteries.     

绝经后2型糖尿病患者骨密度与颈动脉内膜中膜厚度的关系

目的 探讨绝经后2型糖尿病患者骨密度与颈动脉内膜中膜厚度的关系.方法 选择符合纳入标准的93例绝经后2型糖尿病患者和55例健康对照者,测定其正位腰椎L_(1～4)及左股骨颈骨密度,并根据骨密度将2型糖尿病患者分为并发骨质疏松症组和无骨质疏松症组,同时测定颈动脉内膜中膜厚度,并收集三组患者的年龄、绝经年限、体质指数等资料.结果 骨质疏松症组与无骨质疏松症组比较年龄、绝经年限、病程及体质指数差异有统计学意义(P<0.01);与无骨质疏松症组和对照组比较,骨质疏松症组正位腰椎L_(1～4)、左股骨颈骨密度下降(P<0.01),颈动脉内膜中膜厚度增厚(P<0.01),斑块发生率增高(P<0.05).相关分析显示,2型糖尿病患者正位腰椎L_(1～4)和左股骨颈骨密度与患者年龄、病程、绝经年限及颈动脉内膜中膜厚度呈负相关,与体质指数呈正相关.结论 绝经后2型糖尿病患者骨密度与颈动脉体质指数存在一定的联系,低骨密度绝经后2型糖尿病患者更易发生动脉粥样硬化.     

绝经后妇女脊椎压缩性骨折与骨密度的关系

目的探讨绝经后妇女脊椎压缩性骨折与骨密度（BMD）的关系。方法为病例一对照研究，入选250例有脊椎压缩性骨折的绝经后妇女，另有250名无脊椎压缩性骨折的绝经后妇女作为对照组。两组均有胸腰椎正侧位X线摄片，并应用双能X线吸收仪检测腰椎1～4和左股骨近端各部位BMD。结果脊椎压缩性骨折组身高、体重、腰椎2～4和股骨近端各部位BMD值均显著低于对照组（均P〈0．01）。腰椎2～4BMD是发生脊柱骨折的预报因子（r=-0．416，P〈0．01）。身高和全髋部BMD与骨折次数和骨折椎体数目呈负相关（均P〈0．01）。按股骨颈和全髋部BMD值，骨折组骨质疏松检出率各为50．8％和50．4％；另外剔除在腰椎2～4发生椎体骨折53例，按腰椎2～4BMD检出骨质疏松占64．5％。同时，腰椎2～4、股骨颈或全髋部BMD值低于-2．5s者发生脊柱压缩性骨折的风险分别是BMD正常者的4．76、2．36和3．52倍。结论腰椎呈低骨量是发生脊椎压缩性骨折的重要危险因素。身高的下降和全髋部低BMD值是骨折发生次数和受累椎体数目的危险因子；对绝经后妇女在重视BMD测量的同时，应重视脊柱X线正侧位检查。     

Bone mineral density and frequency of osteoporosis among Vietnamese women with early rheumatoid arthritis

Generalised bone mineral density (BMD) reduction often occurs in established rheumatoid arthritis (RA); however, in early RA, there is a disagreement with regard to BMD in the femoral neck and lumbar spine, and there is no available information for the whole body. Therefore, the aims of this study were to investigate the BMD, frequency of osteoporosis and the risk factors for BMD reduction in Vietnamese women with early RA. BMD in the femoral neck, lumbar spine L1–4 and whole body was measured in 105 women with early RA (disease duration ≤3 years) and 105 age-matched healthy women (26–73 years) using a dual energy X-ray absorptiometry. Femoral neck and whole body BMD in women with RA were lower (p < 0.05) than controls, while lumbar spine BMD was similar between two groups. The frequency of osteoporosis in the femoral neck, lumbar spine and whole body in women with RA aged ≥50 were higher (p < 0.05) than controls: 41.8% versus 29.5%, 42.2% versus 37.7% and 37.1% versus 28%, respectively. There were associations between the frequencies of osteoporosis at all sites with postmenopausal status, glucocorticoid use, rheumatoid factor positivity and disease activity with lumbar spine BMD and disease disability with femoral neck and whole body BMD. In conclusion, women with early RA had significantly lower femoral neck and whole body BMD, but had similar lumbar spine BMD compared with controls. The frequency of osteoporosis at all sites was significantly higher in women with RA than controls, suggesting that assessment of BMD should be considered in women with early RA.     

中老年妇女骨转换生化指标和骨密度的变化

目的 探讨中老年妇女骨转换生化指标与骨密度随绝经的变化.方法 408名符合条件40 ～80岁的女性志愿者,同一时间段留取血清和晨尿,统一用酶免方法 测定血清骨碱性磷酸酶(BAP)、骨钙素和尿I型胶原氨基末端肽(uNTX);用舣能X线骨密度仪测定前后位腰椎1-4(L1-4)、左侧股骨颈的骨密度.结果 (1)BAP、骨钙素和uNTX与年龄、孕次、生育次数和绝经年限呈正相关(均P相似文献   

Early changes in biochemical markers of bone turnover predict bone mineral density response to antiresorptive therapy in Korean postmenopausal women with osteoporosis

Biochemical markers of bone turnover have been suggested to be useful in monitoring the efficacy of antiresorptive therapy. In this study, we investigated the predictive value of bone turnover markers to determine short-term response in bone mineral density (BMD) and to identify nonresponders in 138 postmenopausal women (mean age 58 years) with osteoporosis given with either hormone thearpy (HT) or alendronate. Urinary type I collagen N-telopeptide (NTx) and serum osteocalcin (OC) at baseline, 3, and 6 months after treatment as well as spine and femoral neck BMD at baseline and 12 months were measured. Significant decreases in both NTx and OC were evident in women on treatment with antiresorptive agents as early as 3 months (p<0.01). Percent change of NTx at 3 months correlated with the percent change of spinal BMD at 12 months of treatment. When bone turnover markers were stratified by tertiles, the average rate of lumbar spine BMD gain increased significantly with increasing tertiles of baseline value (p<0.05) and percent change (p<0.05) of urinary NTx at 3 month of treatment. In terms of BMD response, urinary NTx at 3 months decreased significantly more in BMD responders group than in nonresponders group. Logistic regression analysis demonstrated that percent change of NTx at 3 months is an independent predictor to identify BMD nonresponders, defined as those whose BMD gain remained within the precision error range of dual energy X-ray absorptiometer (DXA). We conclude that biochemical markers of bone turnover, especially percent change in urinary NTx levels, can be used to determine BMD response to antiresorptive therapy in Korean postmenopausal women with osteoporosis.     

Knee deformity in rheumatoid arthritis is closely correlated with generalized osteoporosis

To examine the relationship between knee deformity and osteoporosis in women with rheumatoid arthritis (RA), bone mineral density (BMD) in the lumbar spine and distal radius was measured using dual X-ray absorptiometry, and knee deformity (valgus or varus deformity) was measured using plain radiograms in 55 women with RA. Associations between knee deformity and BMD, disease related variables, including RA stage, RA duration, age, cumulative doses of administered glucocorticosteroids, body mass index, or postmenopausal period were evaluated. Cut-off values of the BMD defining RA patients with knee deformity were very close to the BMD value corresponding to 70% of young adult mean in the lumbar spine and distal radius. The femorotibial alignment was significantly correlated with age and deformity of the proximal tibia. Deformity of the proximal tibia was negatively correlated with the radial BMD and lumbar BMD. Deformity of the proximal tibia showed a significant difference between the groups of less than 5 years after menopause and the group of 5–10 years after menopause. We concluded that knee deformity in RA derived from deformity of the proximal tibia, and it was closely correlated with generalized osteoporosis.     

Serum sclerostin levels were positively correlated with fat mass and bone mineral density in central south Chinese postmenopausal women

Objectives To investigate the relationship between serum sclerostin level, body composition, and bone mineral density (BMD) in central south Chinese postmenopausal women. Methods A cross‐sectional study was conducted on 260 healthy central southern Chinese postmenopausal women with vs without osteoporosis, aged 50–76 years old. Dual X‐ray absorptiometry was used to measure the bone mineral content and BMD of the whole body, lumbar spine and left femur, and total body soft tissue composition. Serum sclerostin levels were measured by a quantitative sandwich enzyme‐linked immunosorbent assay. Results Compared with women without osteoporosis, osteoporotic women had a significantly lower level of serum sclerostin (P = 0·001). Serum sclerostin levels were positively correlated with body weight, Ponderal index and fat mass. There was a positive correlation with the BMD of both the whole body and at various sites (P < 0·05), even after controlling for age, age at menopause, height and body weight. Multiple linear stepwise regression analysis showed that serum sclerostin level was the most significant determinant of both whole‐body and lumbar spine BMD, compared with age, age at menopause, fat mass and lean mass. Age had similar impact as serum sclerostin on hip BMD. Conclusions This study showed that in central south Chinese postmenopausal women, serum sclerostin is lower in women with osteoporosis than without. Serum sclerostin is positively correlated with fat mass and BMD for the whole body, lumbar spine and hip.     

Apolipoprotein E 4 allele is associated with low bone density in postmenopausal women

Apolipoprotein E (Apo E) genotypes have been associated with a number of involutional disorders. Recently some studies have examined whether the Apo E 4 allele might play a role in the pathophysiology of postmenopausal osteoporosis. However, association analysis between Apo E genotypes, BMD, bone loss or fracture risk have not brought universal findings. The aim of this study was, therefore, to determine the relationship between the presence or absence of Apo E 4 allele and BMD in postmenopausal women of Caucasian origin. We studied 113 women, age 62.5 +/- 8.9 yr, who underwent measurement of hip and spine BMD by dual-energy absorptiometry (DXA, g/cm2). Apo E genotypes were assessed by PCR amplification and by restriction typing with Cfol enzyme. The Apo E allele frequencies in the study population were as follows: E2 0.084, E3 0.845, E4 0.071. Because the Apo E 4 allele was associated with osteoporosis in previous studies, the probands were dichotomized by the presence or absence of Apo E 4 allele. After adjustment for BMI and years since menopause BMD at the lumbar spine varied significantly by Apo E 4 status. Women with Apo E 4 allele had significantly lower BMD at the lumbar spine than women with no Apo E 4 allele (p<0.003, ANCOVA). In contrast, there were no significant differences in BMD at the hip comparing women with or without the Apo E 4 allele. To conclude, these data may support the importance of Apo E 4 allele in determining postmenopausal spine bone mass.     

Osteoporosis in treated adult coeliac disease.

Forty five women and 10 men with coeliac disease diagnosed in adult life, who were already on a gluten free diet, had serial bone mineral density measurements at the lumbar spine and femoral neck over 12 months. Osteoporosis, defined as a bone mineral density (BMD) < or = 2 SD below the normal peak bone mass was found in 50% of male and 47% of female coeliac patients. Patients with a BMD < or = 2 SD below age and sex matched normal subjects, had a significantly lower body mass index (21.3 kg.m-2 compared with 25.2 kg.m-2, p < 0.02 Wilcoxon rank sum test) and lower average daily calcium intake (860 mg/day compared with 1054 mg/day, p < 0.05 Wilcoxon rank sum test) than patients with normal bone mineral density. In postmenopausal women with coeliac disease there was a strong correlation between the age at menopause and BMD at both the lumbar spine (r = 0.681, p < 0.01, Spearman's rank correlation) and femoral neck (r = 0.632, p < 0.01). No overall loss of bone was shown over the 12 months of follow up, and relative to the reference population there was a significant improvement in BMD at the lumbar spine in women (p < 0.025, paired t test) and at the femoral neck in men (p < 0.05, paired t test). There was a significant negative correlation between the annual percentage change in BMD at the lumbar spine and the duration of gluten free diet (r = -0.429, p<0.01, Spearman's rank correlation), with the largest gain in BMD in patients with most recently diagnosed coeliac disease. Osteoporosis was shown in 47% of patients with treated adult coeliac disease. Recognised risk factors for osteoporosis in the general population including low body mass index, dietary calcium intake, and early menopause are particularly important in coeliac disease. Treatment of coeliac disease with a gluten free diet probably protects against further bone loss, and in the early stages is associated with a gain in bone mineral density.     

Usefulness of bone densitometry in postmenopausal women with clinically diagnosed vertebral fractures

OBJECTIVE: To analyse whether bone mineral density (BMD) assessment is required in postmenopausal women presenting with low trauma vertebral fracture. METHODS: Women with vertebral fracture diagnosed over a 10 year period were recruited from our database. The following were excluded: (a) patients with high energy trauma; (b) patients with malignancies; (c) patients with a metabolic bone disease other than osteoporosis. All postmenopausal women were included in whom BMD had been evaluated at both the lumbar spine and femoral neck by dual energy x ray absorptiometry during the six months after the diagnosis. Patients with a potential cause of osteoporosis other than age and menopause were not considered. A total of 215 patients were identified. RESULTS: The mean (SD) age of the patients was 65.9 (6.9) years. BMD at the lumbar spine was 0.725 (0.128) g/cm(2) and the T score was -2.94 (1.22); BMD at the femoral neck was 0.598 (0.095) g/cm(2) and the T score was -2.22 (0.89). The BMD of the patients was significantly lower than that of the general population at both the lumbar spine and femoral neck. When the lowest value of the two analysed zones was considered, six patients (3%) showed a normal BMD, 51 (23.5%) osteopenia, and 158 (73.5%) osteoporosis. The prevalence of osteoporosis at the femoral neck increased with age; it was 25% in patients under 60, 35% in patients aged 60-70, and 60% in patients over 70. CONCLUSION: These results indicate that bone densitometry is not required in postmenopausal women with clinically diagnosed vertebral fractures if it is performed only to confirm the existence of a low BMD.     

Effects of alendronate on metacarpal and lumbar bone mineral density,bone resorption,and chronic back pain in postmenopausal women with osteoporosis

The purpose of this study was to investigate the effect of alendronate on metacarpal and lumbar bone mineral density (BMD), bone resorption, and chronic back pain in postmenopausal women with osteoporosis. Eighty postmenopausal women with osteoporosis, 59–88 years of age, were divided into two groups of 40 each according to the site of BMD measurement: the metacarpus (M) and the lumbar spine (L). All of them were treated with alendronate (5 mg/day) for 12 months. Metacarpal or lumbar BMD was measured by computed X-ray densitometry or dual-energy X-ray absorptiometry in the M or the L group, respectively, at baseline and every 6 months. Urinary cross-linked N-terminal telopeptides of type I collagen (NTX) were measured by enzyme-linked immunosorbent assay, and chronic back pain was evaluated by face scale score at baseline and every 6 months in both groups. There were no significant differences in baseline characteristics, including age, body mass index, years since menopause, urinary NTX level, face scale score, or number of prevalent vertebral fractures per patient between the two groups. Urinary NTX level was reduced and chronic back pain was improved similarly in both groups. Whereas metacarpal BMD did not significantly change in the M group (0.20% increase), lumbar BMD increased by 8.15% in the L group. These results suggest that although alendronate increases BMD of the lumbar spine, which is rich in cancellous bone, and improves chronic back pain, with suppression of bone resorption in postmenopausal women with osteoporosis, it may fail to increase cortical BMD of the metacarpus, a distal site of the upper extremity.Abbreviations ALP Alkaline phosphatase - BMD Bone mineral density - DXA Dual-energy X-ray absorptiometry - NTX Cross-linked N-terminal telopeptides of type I collagen     

Intravenous ibandronate injections given every three months: a new treatment option to prevent bone loss in postmenopausal women

OBJECTIVE: To investigate the efficacy, safety, and dose response of three doses of ibandronate, given intermittently by intravenous (IV) injection every three months, in preventing postmenopausal osteoporosis. PATIENTS AND METHODS: 629 postmenopausal women, categorised according to time since menopause and baseline lumbar spine (L1-4) bone mineral density (BMD), were enrolled into a multicentre, double blind, placebo controlled trial. They were randomly allocated to receive IV ibandronate 0.5 mg, 1 mg or 2 mg, or placebo every three months. All women received daily calcium supplementation. RESULTS: One year's treatment with intermittent IV ibandronate injections produced a dose dependent gain in mean (SD) lumbar spine BMD from baseline of 2.5 (2.5)%, 1.8 (2.6)%, and 1.0 (2.8)% in the groups receiving 2 mg, 1 mg, and 0.5 mg ibandronate, respectively, compared with a loss of BMD of 0.4 (2.4)% in the women in the placebo group; p=0.0001 for each ibandronate dose v placebo. Highest BMD gains occurred in women with osteopenia receiving 2 mg ibandronate. Similarly, at the hip, all three doses of ibandronate produced significantly better gains in BMD than placebo (p<0.05), with the greatest gains in the women with osteopenia receiving the 2 mg dose. Ibandronate concomitantly and dose dependently suppressed markers of bone turnover in comparison with placebo, and injections were well tolerated. CONCLUSION: IV ibandronate injections, given every three months, may be an effective alternative to oral bisphosphonates and hormonal therapy in the prevention of bone loss in postmenopausal women.     

Clinical significance of 1-year treatment with raloxifene on bone and lipid metabolism in Japanese postmenopausal women with osteoporosis

It has been well established that raloxifene (RLX) has beneficial effects on bone primarily in Caucasian women. However, to date, there is a dearth of data for Japanese postmenopausal women. In this study, we prospectively evaluated the effects of RLX on bone and lipid metabolism in fifty Japanese postmenopausal patients with untreated osteoporosis. We measured bone mineral density (BMD) by dual-energy X-ray absorptiometry at 7 sites including the lumbar spine, femoral neck, and distal radius. BMD was significantly increased at the lumbar spine both at 6 months and at 12 months compared with at baseline (p<0.01 for both), although the possibility could not be completely excluded that this increase may be partly explained by an apparent increase induced by degenerative changes in lumbar vertebrae since we had no control subjects to compare and be more certain of the findings in this study. Both bone-specific alkaline phosphatase (BAP) and serum N-terminal telopeptide of type I collagen (NTx) significantly decreased both at 6 months (p<0.01 for both) and at 12 months (p<0.01 for both) compared with at baseline, but not below the lower limit of the reference value. Total cholesterol and low-density lipoprotein cholesterol were significantly improved while triglycerides and high-density lipoprotein cholesterol were unaltered. Although longer and larger studies with fracture endpoints are needed to draw definite conclusions, our findings suggest the favorable effects of RLX on bone and lipid metabolism in Japanese postmenopausal women with osteoporosis as in Caucasian women.     

Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women

Objectives To elucidate the relationship between body composition and bone mineral density (BMD) and the prevalence of osteoporosis in central south Chinese postmenopausal women. Methods A cross‐sectional study was conducted on 954 healthy central southern Chinese postmenopausal women, aged 50–82. Total body, lumbar spine and left femur BMD and total body soft tissue composition were measured by dual X‐ray absorptiometry. Results Among the study population, 578 (60·5%) subjects were without osteoporosis and 376 (39·4%) subjects were osteoporotic. The osteoporotic women were older, shorter and thinner, had an earlier age at menopause, a lower BMD and bone mineral content (BMC) of the total body and at different sites, and had lower body mass and body mass components than the women without osteoporosis. Both fat mass and lean mass were positively correlated with age at menopause, height, weight, body mass index (BMI) and BMD at all sites. Fat mass and lean mass were also inversely correlated with age and years since menopause (P < 0·05). After controlling for age, age at menopause and height, both fat mass and lean mass were positively correlated with BMD at the lumbar_1–4 spine, the femoral neck and the total hip. Fat mass was the most significant determinant of BMD at the lumbar_1–4 spine with a higher R² change and a partial R² compared with that of lean mass, while lean mass had more impact on the total hip values. Either a fat mass below 18·4 kg or a lean mass below 33·9 kg was correlated with a higher prevalence of osteoporosis at the lumbar spine or total hip. Conclusions In central south Chinese postmenopausal women, both fat mass and lean mass are correlated with BMD at the lumbar spine and hip. Fat mass was the most significant determinant of BMD at the lumbar spine, while lean mass had more impact on the total hip value. Both lower values of fat mass and lean mass are related to a higher prevalence of osteoporosis at either the lumbar spine or the total hip. Thus, it is important to maintain a reasonable body weight to balance bone health and other metabolic disorders.     

健康和骨折女性骨矿密度及其骨折阈值的测定

目的初步确定天津市女性骨矿密度（ＢＭＤ）正常参考值范围，探讨骨质疏松的诊断标准及骨折危险阈值。方法用双能Ｘ线吸收法（ＤＥＸＡ）对４５２例健康女性和５５例绝经后骨折患者ＢＭＤ进行测定。结果腰椎２～４、股骨和全身ＢＭＤ峰值分别在３０～３９、２０～２９和４０～４９岁。ＢＭＤ与年龄、绝经年限呈负相关（均为Ｐ＜０．０１），以绝经后最初５年的降低率最高；ＢＭＤ与身高呈正相关，６０岁以上妇女的体重和脂肪量与各部位ＢＭＤ呈正相关（Ｐ＜０．０５或０．０１）。以２０～４０岁女性腰椎ＢＭＤ均值减２．５标准差（ｓ）为界限值（０．８３ｇ／ｃｍ２），５５例骨折患者中４６例（８３．６％）腰椎ＢＭＤ低于界限值。结论该界限值作为女性骨质疏松诊断标准和脊椎骨折危险阈值可能较为合理。     

Plasma lipids and osteoporosis in postmenopausal women

Many clinical studies have shown that osteoporosis is associated with atherosclerosis and cardiovascular death. Although both high plasma levels of low density lipoprotein cholesterol (LDL-C) and low plasma levels of high density lipoprotein cholesterol (HDL-C) are known to be risk factors for atherosclerosis, it is unclear whether such lipid derangements are also associated with the pathogenesis of osteoporosis. In this study, we evaluated the relationships between plasma levels of total C, LDL-C, HDL-C, or triglyceride (TG) versus bone mineral density (BMD) at the lumbar spine, femoral neck, radius, or total body as well as the presence of vertebral fractures in 214 Japanese postmenopausal women (age range, 47-86 years, mean 62.7). Multiple regression analysis was performed between BMD at each skeletal site versus each lipid level adjusted for age, years after menopause, body mass index (BMI), and %fat. Plasma LDL-C levels were significantly and inversely correlated with the absolute values of both one-third radial (1/3R) and distal radial (UDR) BMD (p<0.01), and tended to be inversely correlated with the absolute values of L-BMD (p=0.051). In contrast, plasma HDL-C levels were significantly and positively correlated with the absolute values of L, 1/3R and UDR BMD (p<0.05). On the other hand, plasma TG levels were significantly lower in women with vertebral fractures than in those without fractures (97.0+/-36.5 vs. 126.4+/-65.8 mg/dl, mean+/-SD, p<0.05). When multivariate logistic regression analysis was performed with the presence of vertebral fractures as a dependent variable and each lipid level adjusted for age, years after menopause, BMI, and %fat as independent variables, TG alone was selected as an index affecting the presence of vertebral fractures (odds ratio: 0.51, 95% confidential interval: 0.29-0.89 per SD increase, p<0.05). Our study showed that plasma LDL-C and HDL-C levels were inversely and positively correlated with both R- and L-BMD values, respectively, while low plasma TG levels were associated with the presence of vertebral fractures in postmenopausal women. Thus, plasma lipids might be related to bone mass and bone fragility, and might be the common factor underlying both osteoporosis and atherosclerosis.     

Relation of plasma total homocysteine, folate and vitamin B12 levels to bone mineral density in Moroccan healthy postmenopausal women

To test whether in Moroccan healthy postmenopausal women, levels of plasma total homocysteine (tHcy), folate, and vitamin B12 are related to BMD. A total of 188 volunteer postmenopausal women were recruited from our blood taking center between April 2008 and December 2008. Each subject completed a standardized questionnaire designed to document putative risk factors of osteoporosis. Bone mineral density was determined by a Lunar Prodigy Vision DXA system, and blood samples for plasma tHcy, folate, vitamin B12, and serum parathyroid hormone (PTH) were taken. Comparison between women with osteoporosis, osteopenia and normal BMD showed that the osteoporotic women were significantly older, had lower weight and height than the women of the other groups. Plasma tHcy was significantly higher in the osteoporotic group. Levels of tHcy were inversely related to BMD at the lumbar spine, at the total hip and plasma vitamin B12 and positively related to age and creatinine. Multiple regression analysis showed that age and BMI were the main predictors of BMD at the lumbar spine, whereas the main predictors of BMD at the total hip were age, BMI, plasma tHcy, and plasma vitamin B₁₂. tHcy and vitamin B12 are independent risk factors for osteoporosis in Moroccan healthy postmenopausal women.     

Plasma leptin concentrations in postmenopausal women with osteoporosis

Osteoporosis is less common in obese individuals with increased bone mineral density (BMD) and plasma leptin concentrations. The aim of this study was to determine the correlation between leptin levels and BMD in postmenopausal women. The study consisted of 90 postmenopausal women with a mean age of 53.45 +/- 0.87 years who visited our outpatient clinic for the evaluation of BMD. Thirty-six post-menopausal women with osteoporosis (mean age: 54.52 +/- 1.41 years and mean body mass index (BMI, kg/m2) 29.33 +/- 0.66), 30 age- and BMI-matched postmenopausal women with normal BMD, and 24 postmenopausal women (mean age: 52.79 +/- 1.48 years and mean BMI: 29.45 +/- 0.89) with osteopenic BMD were included in the study. Plasma concentrations of leptin after an overnight fast were measured by radioimmunoassay. BMD values were measured by dual-energy X-ray absorptiometry (DEXA) at the L2-L4 lumbar spine and femoral neck. The median spine BMD value in the patient group (0.67 +/- 0.08 g/cm2, mean +/- SEM) was significantly lower than that in the control group (1.02 +/- 0.25 g/cm2, mean +/- SEM) and osteopenic group (0.87 +/- 0.05 g/cm2, mean +/- SEM) (p < 0.005). The mean spine BMD value (T score -3.63 +/- 0.25, mean +/- SEM) and the mean femur neck BMD value (T score -2.55 +/- 0.18, mean +/- SEM) of the osteoporosis group were significantly lower than that in the normal BMD group (+ 0.33 +/- 0.14 and + 0.27 +/- 0.18, P < 0.001) and in the osteopenia group (-1.74 +/- 0,1 and -1.18 +/- 0.05, p < 0.005). The mean plasma leptin concentration in the osteoporotic group (17.03 +/- 1.40 ng/ml) was not significantly different from that in the normal BMD group and the osteopenia group (16.55 +/- 1.50 ng/ml; 16.16 +/- 1.60, respectively, p > 0.150). Plasma leptin concentrations were correlated with BMI in three groups (r(s) = 0.450, p = 0.025 in normal BMD group and r(s) = 0.4254, P = 0.009 in the osteoporotic group, and r(s) = 395, p = 0.015 in the osteopenia group. There was no correlation between plasma leptin concentrations and BMD values in three groups (r(s) = -0.89 in normal BMD group, r(s) = -0.124 in osteopenia group, and r(s) = -0.195 in osteoporosis group). From this study we conclude that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.