Bone loss at the proximal femur and reduced lean mass following liver transplantation: a longitudinal study.

The longevity of recipients of liver transplant may be compromised by spinal osteoporosis and vertebral fractures. However, femoral neck fractures are associated with a higher morbidity and mortality than spine fractures. As there is little information on bone loss at this clinically important site of fracture, the aim of this study was to determine whether accelerated bone loss occurs at the proximal femur following transplantation. Bone mineral density and body composition were measured at the femoral neck, lumbar spine and total body, using dual x-ray absorptiometry in 22 men and 19 women, age 46 +/- 1.4 y (mean +/- SEM) before and at a mean of 19 mo after surgery (range 3-44). Results were expressed in absolute terms (g/cm2) and as a z score. Before transplantation, z scores for bone mineral density were reduced at the femoral neck (-0.47 +/- 0.21 SD), trochanter (-0.56 +/- 0.19 SD), Ward's triangle (-0.35 +/- 0.14 SD), lumbar spine (-0.76 +/- 0.13 SD), and total body (-0.78 +/- 0.15 SD) (all P < 0.01 to < 0.001). Following transplantation, bone mineral density decreased by 8.0 +/- 1.7% at the femoral neck (P < or = 0.01) and by 2.0 +/- 1.2% at the lumbar spine (P < or = 0.05). Total weight increased by 12.2 +/- 2.3%, lean mass decreased by 5.7 +/- 1.4%, while fat mass increased from 24.1 +/- 2.0% to 35.1 +/- 1.8% (all P < or = 0.001). Patients with end-stage liver disease have reduced bone mineral density. Liver transplantation is associated with a rapid decrease in bone mineral density at the proximal femur, further increasing fracture risk and a reduction in lean (muscle) mass, which may also predispose to falls. Prophylactic therapy to prevent further bone loss should be considered in patients after liver transplantation.     

Modifiable predictors of bone loss in older men: a prospective study

BACKGROUND: The determinants of change in bone mineral density (BMD) have been well characterized in women but not in men. This prospective study describes the patterns of BMD change at the hip and spine, incidence of osteoporosis, and modifiable predictors of bone loss in 507 ambulatory community-dwelling men aged 45 to 92 years. METHODS: Bone mineral density was assessed at the hip and lumbar spine by dual-energy x-ray absorptiometry (DEXA) between 1988 and 1992 and again 4 years later. BMD change was examined both as a continuous and a dichotomous (BMD loss vs no change/gain) variable. Incidence of osteoporosis was evaluated based on t -scores. Data were analyzed in 2002. RESULTS: Annual BMD loss averaged 0.47% at the total hip and 0.34% at the femoral neck with an annual average of 0.22% gain at the spine. The rate of BMD loss at the hip and incidence of osteoporosis increased significantly with age. The main predictors of BMD loss were age >/=75 years, baseline BMI <24 kg/m(2), 4-year weight loss of >/=5%, current smoking, and physical inactivity. Moderate alcohol consumption showed some bone-sparing effect. Diuretic and calcium supplement use were not associated with bone loss. CONCLUSIONS: Relatively healthy community-dwelling men lose bone with age, and men aged >/=75 years are particularly vulnerable. Potentially modifiable characteristics such as low body mass, weight loss, smoking, and physical inactivity were important predictors of bone loss and should be considered for the prevention of osteoporosis in men.     

A high body mass index protects against femoral neck osteoporosis in healthy elderly subjects

OBJECTIVE: In a large sample of elderly subjects, we assessed the possible protective effect of obesity on the development of osteoporosis. METHODS: Healthy subjects 70 y or older and of low socioeconomic level were studied. Bone mineral density was measured in the femoral neck by using a Lunar Prodigy double beam densitometer and compared measurements with appropriate standards. Osteoporosis was defined according to criteria of the World Health Organization (WHO). Body weight and height were recorded simultaneously, and body mass index (BMI) was calculated as weight (kg) divided by height (m2). Age-adjusted odds ratios for femoral osteoporosis were calculated for WHO-proposed BMI ranges in women and men, with an odds of one for a BMI below 25 kg/m2. RESULTS: Eight hundred forty-five subjects (615 women and 230 men; mean age, 75 +/- 4.4 y) were studied. Mean BMI was 28.1 +/- 4.7 kg/m2. Twenty five percent of women and 11% of men had osteoporosis (P < 0.001). Forward stepwise multiple regression analysis showed BMI to be the best independent predictor of bone mineral density in women and men. The age-adjusted odds ratios for femoral osteoporosis were 0.34 (95% confidence interval [CI], 0.21 to 0.55) and 0.13 (95% CI, 0.04 to 0.43) for women and men with a BMI between 25 and 30 kg/m2, respectively. The odds ratios for women and men with a BMI between 30 and 35 kg/m2 were 0.21 (95% CI, 0.11 to 0.39) and 0.09 (95% CI, 0.01 to 0.67), respectively CONCLUSIONS: This study confirms the protective effect of a high BMI on femoral neck bone mineral density among elderly subjects. The risk for osteoporosis among men and women with a BMI above 30 kg/m2 was approximately 33% compared with subjects with a normal BMI.     

Assessment of loss of height in elderly women

Loss of height with advancing years in women most commonly reflects the development of osteoporosis of the vertebral column. Moreover, height measurement from young adult life is often not available for making this judgement about a particular woman. Unless affected by fracture or Paget's disease of bone, alteration in hip length with age is unlikely. We have therefore examined the relationship between height and hip length in young adult Caucasian Australian women and used this to predict earlier 'maximal height' from hip length in elderly Caucasian Australian women. The equation used was maximal height = a + b hip length (r = 0.65, n = 36, P less than 0.0001) where values for a and b were taken from the sample of young women, (a = 1.096, b = 1.185) and applied to the older women. The difference between 'maximal height' and 'observed height' then provided an estimate of 'loss of height'. For a representative sample of ambulant institutionalized elderly women aged 85 +/- 6.47 years, (mean +/- s.d.) range 70-98 years, the loss of height was 0.15 +/- 0.07 m (mean +/- s.d.), range 0-0.27 m. For such groups of women there should be value in knowing maximal height and loss of height at least in so far as assessment of lean body mass, adiposity (as BMI or weight (kg)/height(m)2) and osteoporosis are concerned.     

Vitamin K intake and bone mineral density in women and men

BACKGROUND: Low dietary vitamin K intake has been associated with an increased risk of hip fracture in men and women. Few data exist on the association between dietary vitamin K intake and bone mineral density (BMD). OBJECTIVE: We studied cross-sectional associations between self-reported dietary vitamin K intake and BMD of the hip and spine in men and women aged 29-86 y. DESIGN: BMD was measured at the hip and spine in 1112 men and 1479 women (macro x +/- SD age: 59 +/- 9 y) who participated in the Framingham Heart Study (1996-2000). Dietary and supplemental intakes of vitamin K were assessed with the use of a food-frequency questionnaire. Additional covariates included age, body mass index, smoking status, alcohol use, physical activity score, and menopause status and current estrogen use among the women. RESULTS: Women in the lowest quartile of vitamin K intake (macro x: 70.2 microg/d) had significantly (P < or = 0.005) lower mean (+/- SEM) BMD at the femoral neck (0.854 +/- 0.006 g/cm(2)) and spine (1.140 +/- 0.010 g/cm(2)) than did those in the highest quartile of vitamin K intake (macro x: 309 microg/d): 0.888 +/- 0.006 and 1.190 +/- 0.010 g/cm(2), respectively. These associations remained after potential confounders were controlled for and after stratification by age or supplement use. No significant association was found between dietary vitamin K intake and BMD in men. CONCLUSIONS: Low dietary vitamin K intake was associated with low BMD in women, consistent with previous reports that low dietary vitamin K intake is associated with an increased risk of hip fracture. In contrast, there was no association between dietary vitamin K intake and BMD in men.     

Lifetime milk consumption and bone mineral density in older women.

This study examined the relationship between lifetime milk consumption both axial and appendicular bone mineral density in 581 postmenopausal White women. Positive significant, graded associations between milk consumption in adulthood and bone mineral density at the spine, total hip, trochanter, intertrochanter, and midradius, but not the ultradistal wrist or femoral neck, were observed. Adolescent milk consumption showed similar, statistically significant associations (spine and midradius). Associations were independent of age, body mass index, years postmenopausal, thiazide, estrogen and alcohol use, smoking, and exercise. Regular milk consumption in youth and adulthood is associated with better bone mineral density at cortical and trabecular sites in elderly women.     

Risk factors for low bone mineral density among a large group of Norwegian women with fractures

The objectives of this study were to determine factors related to fractures and bone mineral density (BMD) in a large group of Norwegian women. In a cross-sectional study, 3803 women aged 50–75, all with a history of fractures, were included in the study. BMD was measured with Dual energy X-ray absorptiometry at both hip (neck) and spine (L1–L4), while information on other factors thought to influence BMD were obtained through a questionnaire. In multivariate analysis, the strongest positive predictor of both hip and spine BMD was current body weight, while weight loss since the age of 25 and number of years since menopause were the strongest inverse predictors. In addition, use of cortisone and maternal history of fractures were associated with lower BMD, as was loss of height since the age of 25. Physical activity was positively correlated with BMD. These results show the complexity of factors involved in the etiology of osteoporosis, with several factors acting in synergism. This points to the need for multifactorial prevention strategies, which most effectively need to be instituted at an early age, before peak bone mass is achieved.     

Intake of fermented soybeans, natto, is associated with reduced bone loss in postmenopausal women: Japanese Population-Based Osteoporosis (JPOS) Study

Japanese fermented soybeans (natto in Japanese), which contain a large amount of menaquinone-7, may help prevent the development of osteoporosis. We assessed the possibility of an association between habitual natto intake and bone mineral density (BMD) and BMD change over time in healthy Japanese women who participated in a large representative cohort study (Japanese Population-based Osteoporosis Study: JPOS study). The BMD was measured at the spine, hip, and forearm in 944 women (20-79 y old) at baseline and at a follow-up conducted 3 y later. Dietary natto intake was assessed by a FFQ on both occasions. Additional covariates including age, height, weight, lifestyle factors, dietary calcium intake, and the intake of other soybean products, were also measured. The total hip BMD at baseline increased (P for trend = 0.0034) with increasing habitual natto intake in the postmenopausal women, although this was not the case at other skeletal sites. There were significant positive associations between natto intake and the rates of changes in BMD at the femoral neck (P < 0.0001) and at the distal third of the radius (P = 0.0002) in the postmenopausal women. The association in the femoral neck persisted even after adjusting for covariates. No significant association was observed between the intake of tofu or other soybean products and the rate of BMD change in the postmenopausal women. Natto intake may help prevent postmenopausal bone loss through the effects of menaquinone 7 or bioavailable isoflavones, which are more abundant in natto than in other soybean products.     

Osteoporosis and the risk of hip fracture

The incidence of cervical and intertrochanteric proximal femur fractures at various levels of cervical and intertrochanteric bone mineral density, respectively, was estimated by using population-based data from ongoing studies of osteoporosis and fractures among women residing in Rochester, Minnesota. Hip fractures were uncommon among women with femoral bone density greater than or equal to 1.0 g/cm2, but their frequency increased as bone density declined below that point at both femoral sites. The incidence of cervical femur fractures was estimated at 8.3 per 1,000 person-years among women with cervical bone density less than 0.6 g/cm2, while the estimated incidence of intertrochanteric femur fractures reached 16.6 per 1,000 person-years among those with intertrochanteric bone density less than 0.6 g/cm2. This new approach to the assessment of fracture risk from bone mineral density measurements indicates that osteoporosis is an important underlying cause of hip fractures.     

Milk intake during childhood and adolescence,adult bone density,and osteoporotic fractures in US women

BACKGROUND: Calcium supplements increase bone mass in children, but the effect does not persist once supplementation is discontinued. OBJECTIVE: The objective of this study was to determine whether milk intake during childhood and adolescence, when controlled for current calcium intake, is associated with adult bone mass (ie, bone mineral content), bone mineral density, and the incidence of osteoporotic fracture. DESIGN: We used data from the third National Health and Nutrition Examination Survey of 3251 non-Hispanic, white women age >or=20 y. Bone density was measured at the hip. History of fracture of the hip, spine, or forearm was classified as a lifetime fracture (occurring after age 13 y) or an osteoporotic fracture (occurring after age 50 y). Subjects reported frequency of milk consumption during childhood (aged 5-12 y) and during adolescence (aged 13-17 y). Regression models controlled for weight, height, age, menopause and use of estrogen, physical activity, smoking, and current calcium intake. RESULTS: Among women aged 20-49 y, bone mineral content was 5.6% lower in those who consumed <1 serving of milk/wk (low intake) than in those who consumed >1 serving/d (high intake) during childhood (P < 0.01). Low milk intake during adolescence was associated with a 3% reduction in hip bone mineral content and bone mineral density (P < 0.02). Among women aged >or=50 y, there was a nonlinear association between milk intake during childhood and adolescence and hip bone mineral content and bone mineral density (P < 0.04). Low milk intake during childhood was associated with a 2-fold greater risk of fracture (P < 0.05). CONCLUSION: Women with low milk intake during childhood and adolescence have less bone mass in adulthood and greater risk of fracture.     

Zinc intakes and plasma concentrations in men with osteoporosis: the Rancho Bernardo Study

BACKGROUND: Low zinc intakes and reduced blood zinc concentrations have been reported to be associated with osteoporosis in women. OBJECTIVE: The objective was to examine the independent association between dietary zinc and plasma zinc and the association of each with bone mineral density (BMD) and 4-y bone loss in community-dwelling older men. DESIGN: Of the original Rancho Bernardo Study subjects, 396 men (age: 45-92 y) completed BMD measurements at baseline in 1988-1992 and 4 y later. Osteoporosis was defined as a BMD > or = 2.5 SDs below the mean for young women (a T-score < or = -2.5). At baseline, dietary intake data were collected by using a standard food-frequency questionnaire, and plasma zinc concentrations were measured by using inductively coupled plasma spectroscopy. RESULTS: The mean dietary zinc intake was 11.2 mg, and the mean plasma zinc concentration was 12.7 micromol/L. Plasma zinc was correlated with total zinc intake (diet plus supplements). Dietary zinc intake and plasma zinc concentrations were lower in men with osteoporosis at the hip and spine than in men without osteoporosis at those locations. BMDs for the hip, spine, and distal wrist were significantly lower in men in the lowest plasma zinc quartile (<11.3 micromol/L) than in men with higher plasma zinc concentrations. The association between plasma zinc and BMD was cross-sectional, longitudinal, and independent of age or body mass index. However, plasma zinc did not predict bone loss during the 4-y interval. CONCLUSION: Dietary zinc intake and plasma zinc each have a positive association with BMD in men.     

Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh

The manufacture of garments is the main industry in Bangladesh and employs 1.6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18-36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36.7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16% of the subjects were found to be vitamin D-deficient (S-25OHD 21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score < -2.5 had a trend of lower values of BMI, waist-hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture.     

Injectable hormone contraception and bone density: results from a prospective study

BACKGROUND: Depot medroxyprogesterone acetate (DMPA) injectable contraception may decrease bone density and increase the risk for osteoporosis in later life. Prospective data are scarce, especially of the effects of DMPA discontinuation on bone. METHODS: Between 1994 and 1999, we conducted a population-based prospective cohort study among women enrollees of a Washington State health maintenance organization. We enrolled 457 nonpregnant women, ages 18-39 years (183 DMPA users and 274 non-users). Bone density was measured by dual-energy x-ray absorptiometry every 6 months for 3 years. RESULTS: Bone density decreased notably among DMPA-exposed women at the spine (adjusted mean bone density was -0.0053 gm/cm for DMPA users compared with +0.0023 gm/cm for non-users for each 6-month interval) and total hip (-0.0060 compared with -0.0002 gm/cm ). This represents an annualized mean rate of change at the spine of -0.87% compared with +0.40% and, at the hip, -1.12% compared with -0.05%. Discontinuers of this method (N = 110) showed sizable increases in bone density over comparison women (for each 6-month interval, adjusted mean spine bone density was +0.0067 gm/cm compared with +0.0023 gm/cm, respectively; adjusted mean hip bone density was +0.0035 compared with -0.0002 gm/cm ). Estimated annualized mean rates of change were +1.41% compared with +0.40% [corrected] at the spine and +1.03% [corrected] compared with -0.05% at the hip. After 30 months, mean bone density for discontinuers was similar to that of non-users. CONCLUSIONS: In this study, DMPA use was strongly associated with bone density loss. Substantial postdiscontinuation recovery of bone provides evidence that the effects may be largely reversible.     

One year of oral calcium supplementation maintains cortical bone density in young adult female distance runners

We conducted a double-blind, placebo-controlled, randomized trial to determine whether 1 year of supplemental calcium intake would augment hip [greater trochanter, GT, femoral neck (FN), total hip (TH)], spine (LS), and femoral mid-shaft (Fmr) BMD in female distance runners. Twenty-three women (age: 23.7 +/- 4.7 yrs, height: 165.6 +/- 6.3 cm, weight: 55.7 +/- 6.1 kg) were randomly assigned to receive either 1000 mg/d of supplemental calcium (N = 13) or placebo tablets (N = 10) for 1 year. BMD was determined by DXA (Hologic 1000-W) and tablet compliance by self-report logs. Compliance averaged 79% and 71% for supplement and placebo groups, respectively. Calcium supplementation did not affect hip or spine BMD, but did prevent loss at the femoral mid-shaft (GT: -0.5% vs. 0.2%, FN: 0.9% vs. 1.1%, TH: -0.3% vs. 0.2%, LS: 0.3% vs. 1.2%, Fmr: 0.1% vs. -1.8%, for calcium vs. placebo, respectively). We conclude that the addition of 800 mg/d of supplemental calcium to the diet of young adult female distance runners with habitual calcium intakes of approximately 1000 mg/d, prevents cortical but not trabecular bone loss.     

甘肃平凉地区中老年骨质疏松症的流行病学调查分析

目的通过流行病学调查甘肃平凉地区中老年骨质疏松症的发病状况与危险因素。方法 2013年9月至2016年5月采用分层随机抽样方式,在甘肃省平凉地区选择1 800名社区居民作为研究对象,调查所有居民的基线资料,同时进行骨质疏松的测定与判定。结果 1 800例中老年居民中共有骨质疏松患者320例,发病率为17.8%,其中男性240例,女性80例;平均年龄(61.93±7.93)岁;平均髋部骨密度为(1.33±0.22)g/cm~2。骨质疏松患者与非骨质疏松居民的性别、年龄、骨质疏松家族史、饮酒、吸烟、体质量指数、腰围等对比有明显差异(P0.05)。偏相关方法显示骨质疏松症患者的年龄、吸烟、体质量指数、腰围和骨质疏松家族史与骨密度均呈正相关(P0.05)。多因素Logistic回归分析显示年龄(OR=3.422)、吸烟(OR=2.671)、体质量指数(OR=2.681)为导致骨质疏松的独立危险因素(P0.05)。结论甘肃平凉地区中老年骨质疏松症的发病率比较高,年龄、吸烟、体质量指数为主要的危险因素,需要积极遵循个体化与整体化防控原则,从而降低骨质疏松症的发生率。     

Impact of CYP3A7*1C polymorphism on bone mineral content in postmenopausal women

INTRODUCTION: CYP3A7*1C polymorphism has been shown to be associated with lower levels of serum dehydroepiandrosterone sulphate in men. The age-related decline of dehydroepiandrosterone sulphate levels is believed to contribute to the development of osteoporosis. We hypothesized that CYP3A7*1C may lead to bone loss through decreased levels of dehydroepiandrosterone sulphate in postmenopausal women. PATIENTS AND METHODS: 319 postmenopausal women were studied and divided into two subgroups: 217 women with osteoporosis and 102 aged-matched women without osteoporosis. The CYP3A7*1C polymorphism was genotyped. Serum dehydroepiandrosterone sulphate levels and bone mineral density were measured. RESULTS: Homozygous CYP3A7*1C carriers had significantly lower bone mineral density at lumbar spine than that of wild type (T-score with CYP3A7*1C mutant type: -3.27 +/- 1.02, T-score with wild type: -1.35 +/- 1.53, p = 0.041) after adjusting for age and DHEAS levels. No association was found between genotypes and dehydroepiandrosterone sulphate levels. CONCLUSION: Our data suggest that CYP3A7 polymorphism might have an influence on bone mass at the lumbar spine independently of serum dehydroepiandrosterone sulphate concentrations.     

Protein consumption and bone mineral density in the elderly : the Rancho Bernardo Study

The role of dietary protein in osteoporosis is unclear, with previous studies having suggested both protection and harm. The associations of total, animal, and vegetable protein with bone mineral density (BMD) and the variations in these associations with calcium intake were studied in a community-dwelling cohort of 572 women and 388 men aged 55-92 years (Rancho Bernardo, California). Multiple linear regression analyses adjusted for standard osteoporosis covariates showed a positive association between animal protein consumption, assessed by food frequency questionnaires in 1988-1992, and BMD, measured 4 years later. This association was statistically significant in women. For every 15-g/day increase in animal protein intake, BMD increased by 0.016 g/cm2 at the hip (p = 0.005), 0.012 g/cm2 at the femoral neck (p = 0.02), 0.015 g/cm2 at the spine (p = 0.08), and 0.010 g/cm2 for the total body (p = 0.04). Conversely, a negative association between vegetable protein and BMD was observed in both sexes. Some suggestion of effect modification by calcium was seen in women, with increasing protein consumption appearing to be more beneficial for women with lower calcium intakes, but evidence for this interaction was not consistently strong. This study supports a protective role for dietary animal protein in the skeletal health of elderly women.     

Bone mineral density and bone markers in patients with a recent low-energy fracture: effect of 1 y of treatment with calcium and vitamin D

BACKGROUND: Low-energy fractures of the hip, forearm, shoulder, and spine are known consequences of osteoporosis. OBJECTIVE: We evaluated the effect of 1 y of treatment with calcium and vitamin D on bone mineral density (BMD) and bone markers in patients with a recent low-energy fracture. DESIGN: In a double-blinded design, patients with fracture of the hip (lower-extremity fracture, or LEF) or upper extremity (UEF) were randomly assigned to receive 3000 mg calcium carbonate + 1400 IU cholecalciferol or placebo (200 IU cholecalciferol). BMD of the hip (HBMD) and lumbar spine (LBMD) were evaluated by dual-energy X-ray absorptiometry, and physical performance was assessed by the timed Up & Go test. Serum concentrations of 25-hydroxycholecalciferol, parathyroid hormone (PTH), telepeptide of type I collagen (ICTP), osteocalcin, and N-terminal propeptide of collagen type I were measured. RESULTS: A total of 122 patients were included (84% women; x +/- SD age: 70 +/- 11 y); 68% completed the study. In an intention-to-treat analysis, LBMD increased in the intervention group and decreased in the placebo group, and the difference between the groups was significant after 12 mo: 0.931 +/- 0.211 compared with 0.848 +/- 0.194 (P<0.05). No significant change was shown for HBMD. The effect of treatment was more pronounced in patients aged <70 y. The intervention decreased bone turnover. PTH was significantly lower in the intervention group (P<0.01) for the LEF patients. ICTP and change in LBMD were significantly related to physical performance. CONCLUSIONS: A 1-y intervention with calcium and vitamin D reduced bone turnover, significantly increased BMD in patients younger than 70 y, and decreased bone loss in older patients. The effect of treatment was related to physical performance.     

膳食钙、磷以及奶制品对绝经后妇女骨密度的影响

目的探讨膳食中钙、磷以及奶制品的摄入量对骨密度及骨盐含量的影响,为研究骨质疏松的预防提供相关线索和依据。方法在广州市越秀区农林街社区发放传单招募调查对象,并采用自编的结构化标准问卷,对320名广州绝经后妇女的膳食习惯进行调查,并测量其全身、股骨全身、股骨颈、股骨干、大粗隆、Ward’s三角以及腰锥1～4的骨密度和骨量,采用多因素逐步回归分析探讨膳食钙、磷及奶制品对骨盐含量及骨密度的影响。结果 320名调查对象平均57.1岁,平均绝经年限7.3年,平均每天摄入钙、磷及奶制品分别为822 mg、949 mg和126 g,平均全身骨密度为1.054 g/cm2,磷与7个部位的骨密度及骨盐含量呈正相关关系（P〈0.05）。随着磷摄入量增加,全身及腰锥1～4骨密度增加,偏回归系数值分别为0.121和0.184 g.（cm2）-1.g-1.d-1。随着奶制品摄入量增加,股骨全身、股骨干骨密度也相应增加,骨密度偏回归系数值分别为0.686、0.841mg.（cm2）-1.g-1.d-1。钙与全身、股骨全身、股骨颈、大粗隆、股骨干和Ward’s三角的BMC具有正相关性,而在钙与BMD关系中,钙只与股骨全身、大粗隆和股骨干呈正相关性,且每日膳食中每增加100 g钙的摄入量,则股骨全身、大粗隆、股骨干的骨密度相应增加5.3、4.8和7.6 g/cm2。结论增加膳食中钙、磷以及奶制品的摄入量有利于绝经后妇女的骨盐含量及骨密度的提高。     

武汉市江岸区中小学教师骨质疏松症患病率调查及相关因素分析

目的了解中小学教师骨质疏松症的患病率和影响因素,为针对性采取预防措施提供参考。方法检测1075例武汉市江岸区中小学教师的骨密度,采用SPSS 16.0软件包进行统计分析。结果男性中小学教师身高、体重、BMI均明显高于女性(P<0.05);40~49年龄组与50岁及以上年龄组男女中小学教师脚跟骨、腰椎总骨密度均明显低于29岁及以下年龄组(P<0.05),50岁及以上年龄组男女中小学教师脚跟骨、腰椎总骨密度明显低于30~39年龄组(P<0.05);随着男女中小学教师年龄逐渐增长,骨量流失和骨质疏松症发生率明显升高(P<0.05),且女性中小学教师骨量流失和骨质疏松症发生率明显高于男性中小学教师(P<0.05);经多因素Logistic回归分析发现,年龄为脚跟骨、腰椎总骨密度的负相关因素,身高、体重、BMI为脚跟骨、腰椎总骨密度的正相关因素。结论随着年龄增长,中小学教师脚跟骨、腰椎总骨密度明显下降,骨量流失和骨质疏松症发生率明显升高,且女性表现尤为明显,建议采取适宜运动锻炼和合理饮食配伍等多方面综合措施,早期防治骨质疏松症的发生。