老年女性骨密度与左心室肥厚的相关性

背景：老年女性心血管事件发生率增加与骨量减少相关,左心室肥厚是明确的心血管事件独立危险因素,这两者在发病机制上可能相关。 目的：探讨老年女性骨量与左心室质量指数的相关关系。 方法：选取老年女性受试者157例,按照骨密度分组,分为骨量正常组、骨量减少和骨质疏松组。进行病史询问及临床检查,测定生化指标,完成股骨骨密度和腰椎骨密度测定,进行超声心动图检查,计算得出左室质量指数。进行单因素方差分析和多因素多元线性回归分析。 结果与结论：随着骨量减少,左室质量指数逐渐增大,左心室肥厚发生率上升,差异有显著性意义(P < 0.05)。以左室质量指数为因变量,多元线性回归分析显示,年龄、收缩压、高血压病程、腰椎骨密度或股骨骨密度与左室质量指数独立相关。结果提示在老年女性人群中,骨密度可能是影响左室质量指数的独立危险因素。     

Farnesyl diphosphate synthase: a novel genotype association with bone mineral density in elderly women

OBJECTIVE: We evaluated the association between a single nucleotide polymorphism in the farnesyl diphosphate synthase gene (FDPS), BMD and bone turnover markers. METHODS: Two hundred and eighty-three community-dwelling Caucasian women aged 65 or older were screened from the greater Boston area. A validated FDPS SNP (rs2297480, A/C) was genotyped and evaluated for effect on bone mineral density (spine, hip, forearm) and bone turnover markers (urine N-telopeptide cross-linked collagen type 1, osteocalcin and bone-specific alkaline phosphatase). RESULTS: BMD was lower at all sites measured in women with the C/C or C/A genotypes. Statistically significant differences (p<0.05) were found at the PA spine, trochanter, distal radius, and proximal ulna after adjustment for age and BMI. No significant differences were found in bone turnover markers. CONCLUSION: These findings suggest that a single nucleotide polymorphism in the FDPS gene (rs2297480) may be a genetic marker for lower BMD in postmenopausal Caucasian women.     

雌激素受体基因多态性与老年妇女的骨密度

背景：雌激素受体α基因多态性与骨质疏松的发生相关有一定的关系,但是对于危险基因型的研究还存在商榷余地。 目的：分析雌激素受体基因多态性与老年妇女骨密度的相关性。 方法：选择检查的老年健康妇女120例,提取全血基因组DNA,选择限制性内切酶PvuⅡ和XbaⅠ进行酶切,分析基因型的分布与频率。同时选择双能X射线骨密度仪测股骨颈、大转子及Ward三角处的骨密度值。 结果与结论：XbaⅠ酶切基因型XX 6例,Xx 78例,xx 36例;PvuⅡ酶切PP 32例,Pp 50例,pp 38例。不同基因型老年妇女的年龄、绝经年龄与体质量指数值对比差异无显著性意义(P > 0.05)。PvuⅡ酶切PP基因型妇女的大转子与ward三角处的骨密度值明显大于Pp及pp妇女(P < 0.05);而XbaⅠ酶切基因多态性在老年妇女中股骨颈、大转子与Ward三角的骨密度均无显著差异(P > 0.05)。说明雌激素受体基因多态性与老年妇女骨密度有一定的相关性,P等位基因对老年妇女大转子与Ward三角处的骨密度的维持有一定作用。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

Relationship of head lean mass to regional bone mineral density in elderly postmenopausal women

OBJECTIVES: This study investigated the relationship of head lean mass to bone mineral density (BMD). METHOD: Subjects were 102 elderly women (> or =65-years-old) and 123 middle-aged postmenopausal women (<65-years-old) with right-side dominance. Age, height, weight, and years since menopause (YSM) were recorded. Lean mass of the head, arm, trunk, leg, and total body were measured by dual-energy X-ray absorptiometry (DEXA). BMD of the same regions were measured by DEXA. RESULTS: In elderly women, head lean mass was positively correlated with BMD of the head (r=0.389, P<0.01), left arm (r=0.235, P<0.05), right arm (r=0.280, P<0.05), lumbar spine (L2-4) (r=0.411, P<0.001), pelvis (r=0.490, P<0.001), left leg (r=0.572, P<0.001), right leg (r=0.558, P<0.001), and total body (r=0.529, P<0.001). These relationships remained significant after adjusting for age, height, and YSM. In addition, the strength of correlation of head lean mass with BMD was higher than those of other regional lean mass with respective BMD. In middle-aged women, strength of correlation of head lean mass with BMD was loose (r< or =0.238), while regional lean mass was more correlated with respective regional BMD. CONCLUSION: Factors related to lifestyle associated with higher (lower) head lean mass may contribute to higher (lower) BMD in elderly postmenopausal women.     

Safety of denosumab in postmenopausal women with osteoporosis or low bone mineral density: a meta-analysis

Purpose: The aim of this meta-analysis was to assess the safety of denosumab in postmenopausal women with osteoporosis or low bone mineral density (BMD). Methods: Safety of denosumab was compared with placebo or bisphosphonates. A systematic literature search without language restriction was conducted up to January, 2014. The RevMan 5.1 software was used for statistical analysis. Results: A total of 11 English literatures were eventually identified. The pooled data in the overall analysis revealed that there was no significant difference when compared denosumab with placebo or bisphosphonates in any adverse events (AAE) (RR=0.99, 95% CI=0.98-1.01, p=0.29), serious adverse event (SAE) (RR=1.05, 95% CI=0.98-1.13, p=0.18), neoplasm/cancer (RR=1.14, 95% CI=0.95-1.37, p=0.16) and deaths (RR=0.77, 95% CI=0.57-1.04, p=0.09). However, significant differences were found when compared denosumab with placebo or bisphosphonates in SAE related to infection (RR=1.23, 95% CI=1.00-1.52, p=0.05) and non-vertebral fracture (RR=0.86, 95% CI=0.74-1.00, p=0.05). Subgroup analysis was performed by the type of drugs which was used in the control group. The results of subgroup analysis did not demonstrate the differences between denosumab and bisphosphonates in SAE related to infection (RR=1.13, 95% CI=0.63-2.03) and non-vertebral fracture (RR=1.31, 95% CI=0.87-1.98). Conclusions: Compared to placebo, denosumab treatment significantly decreased the risk of non-vertebral fracture but increased the risk of SAE related to infection in the postmenopausal women with osteoporosis or low BMD. However, no difference between the safety of denosumab and bisphosphonates was found.     

IGF-1 bioavailability is increased by resistance training in older women with low bone mineral density

We investigated if long-term resistance training would increase insulin-like growth factor-1 (IGF-1) bioavailabilty at rest in older women (68+/-1 years) with low bone mineral density. IGF-1 levels were significantly lower (P<0.05), and insulin-like growth factor binding proteins -1 and -3 (IGFBP-1 and IGFBP-3) significantly higher than an age-matched healthy normal group. Resistance training resulted in significant (P<0.05) increases in repetition maximums across all exercises (range 41-78%). Resting IGF-1 levels were significantly (P<0.05) elevated (70%) by the resistance training whereas no significant changes occurred in IGFBP-1 and IGFBP-3 levels. IGFBP-1/IGF-1 and IGFBP-3/IGF-1 ratios were significantly decreased (approximately - 50%) as a result of resistance training (P<0.05). Thus, IGF-1 bioavailability was increased as a result of resistance training induced increases in IGF-1 levels in older women with low bone mineral density. These alterations in the IGF-1 system may be contributing to the significant strength gain observed with the resistance training in this population.     

Effect of dietary supplementation with collagen hydrolysates on bone metabolism of postmenopausal women with low mineral density

Collagen hydrolysates (CH), obtained by an enzymatic hydrolysis process of gelatins, have potential application as oral supplements. Objective: To evaluate the effects of diet supplementation with collagen hydrolysates on bone metabolism markers in postmenopausal women with low bone mineral density. Methods: A randomized double-blind clinical assay with postmenopausal women with osteopenia was planned. The volunteers ingested 10 g/day of CH or a placebo for a period of 24 weeks. The bone resorption markers (carboxyl-terminal collagen crosslinks—CTX) and bone formation markers (osteocalcin—OSCAL and bone-specific alkaline phosphatase—BAP) were determined at baseline and at 12 and 24 weeks of treatment. Results: The sample consisted of 35 placebo and 36 treated subjects (aged 57.3 ± 4.8 years and BMI of 27.4 ± 4.5 kg/m²). BAP levels showed no significant changes over the time. CTX levels showed a significant increase during the 24 weeks of treatment from 0.40 to 0.48 ng/mL in CH group and 0.47 to 0.57 ng/mL in placebo group (p < 0.0001). OSCAL levels also showed a increase during the 24 weeks from 24.8 to 29.0 ng/mL in CH group and 28.1 to 31.8 ng/mL in placebo group (p < 0.001). A comparison of levels of bone markers between CH and placebo group demonstrated no differences. Analysis of variance revealed no significant effect of dietary supplementation with collagen hydrolysates on biochemical bone markers. Conclusions: CH consumption did not produce any effects on bone metabolism as measured by biochemical indices of bone remodeling in postmenopausal women. The majority of patients exhibited inadequate calcium intake, as well as excess body weight.     

Comparison of effect of treatment with etidronate and alendronate on lumbar bone mineral density in elderly women with osteoporosis

The purpose of this open-labeled prospective study was to compare the treatment effects of cyclical etidronate and alendronate on the lumbar bone mineral density (BMD), bone resorption, and back pain in elderly women with osteoporosis. Fifty postmenopausal women with osteoporosis, age ranging from 55 to 86 years (mean: 70.7 years), were randomly divided into two groups with 25 patients in each group: the cyclical etidronate group (etidronate 200 mg daily for 2 weeks every 3 months) and the alendronate group (5 mg daily). The BMD of the lumbar spine (L1-L4) measured by DXA, the urinary cross-linked N-terminal telopeptides of type I collagen (NTX) level measured by the enzyme-linked immunosorbent assay, and back pain evaluated by the face scale score were assessed at baseline, 6 months, and 12 months. There were no significant differences in baseline characteristics including age, body mass index, years since menopause, lumbar BMD, urinary NTX level, and face scale score between the two treatment groups. Etidronate treatment sustained the lumbar BMD following a reduction in the urinary NTX level and improved back pain, while alendronate treatment reduced the urinary NTX level more significantly, resulting in an increase in the lumbar BMD, and similarly improved back pain. No serious adverse events were observed in either group. This study confirmed that alendronate treatment had a greater efficacy than etidronate treatment in increasing the lumbar BMD through the reduction of bone resorption in elderly women with osteoporosis.     

Determinants of one-year response of lumbar bone mineral density to alendronate treatment in elderly Japanese women with osteoporosis

The purpose of this study was to determine factors that could predict the one-year response of the lumbar bone mineral density (BMD) to alendronate treatment in elderly Japanese women with osteoporosis. Eighty-five postmenopausal women with osteoporosis, all of whom were between 55-88 years of age, were treated with alendronate (5 mg daily) for 12 months. Serum calcium, phosphorus, and alkaline phosphatase (ALP) and urinary NTX levels were measured at the baseline and 6 months, and lumbar (L1-L4) BMD was measured by dual energy X-ray absorptiometry at the baseline and 12 months. Multiple regression analysis was used to determine factors that were correlated with the percent change in lumbar BMD at 12 months. Lumbar BMD increased by 8.1 % at 12 months with a reduction in the urinary NTX level by 51.0 % at 6 months. Baseline lumbar BMD (R2=0.226, p < 0.0001) and percent changes in serum ALP and urinary NTX levels (R2=0.044, p < 0.05 and R2=0.103, p < 0.001, respectively) had a negative correlation with the percent change in lumbar BMD at month 12, while the baseline number of prevalent vertebral fractures (R2=0.163, p < 0.001), serum ALP level, and urinary NTX level (R2=0.074, p < 0.05 and R2=0.160, p < 0.001, respectively) had a positive correlation with it. However, baseline age, height, body weight, body mass index, years since menopause, serum calcium and phosphorus levels, and percent changes in serum calcium and phosphorus levels at 6 months did not have any significant correlation with the percent change in lumbar BMD at 12 months. These results suggest that lumbar BMD was more responsive to one-year of alendronate treatment in elderly osteoporotic Japanese women with lower lumbar BMD, more prevalent vertebral fractures, and higher bone turnover, who showed a greater decrease in bone turnover at 6 months, regardless of age, years since menopause, and physique. Alendronate may be efficacious in elderly Japanese women with evident osteoporosis that is associated with high bone turnover, and the percent changes in serum ALP and urinary NTX levels at 6 months could predict the one-year response of lumbar BMD to alendronate treatment.     

Bone metabolism and bone mineral density in premenopausal women with mild depression

This study was undertaken to investigate the bone metabolism and bone mineral density (BMD) in female patients suffering from depression. Forty-two female patients diagnosed with depression and 42 healthy women, all in the premenopausal age, were enrolled. A clinical evaluation, measurements of the biochemical markers of bone metabolism and BMD measurements were performed. The BMD values were found to be similar in all measured sites. It was concluded that a low BMD was not a prominent feature of premenopausal women with mild depression, even though an increase in bone resorption was found.     

Low handgrip strength is associated with low bone mineral density and fragility fractures in postmenopausal healthy Korean women

Osteoporosis is a widely recognized health problem in postmenopausal women. Osteoporotic fractures reduce independency, limit daily living activities, and increase the mortality rate. Epidemiological studies have demonstrated that low handgrip strength is a risk factor for functional limitations and disabilities, and all-cause mortality. We investigated the relationship between handgrip strength and bone mineral density (BMD) of the spine, femur neck, and total hip, as well the relationship between handgrip strength and previous fragility fractures in 337 healthy postmenopausal Korean women (mean age of 59.5 ± 6.8 yr) who were free of diseases or medications affecting bone metabolism. Age and handgrip strength were associated with BMD of the spine, femur neck, and total hip in multiple regression models. Low handgrip strength (odds ratio [OR], 0.925; range, 0.877 to 0.975; P = 0.004) and low femur neck BMD (OR, 0.019; range, 0.001 to 0.354; P = 0.008) were independent predictors of previous fragility fractures in a multiple regression model. Our results demonstrate that low handgrip strength is associated with low BMD of the spine, femur neck, and total hip, and with increased risk of previous fragility fractures.     

VDR polymorphisms are associated with bone mineral density in post-menopausal Mayan-Mestizo women

Background: Osteoporosis is characterized by low bone mineral density (BMD), which is determined by an interaction of genetic, metabolic and environmental factors.

Aim: To analyse the association between two polymorphisms of VDR as well as their haplotypes with BMD in post-menopausal Maya-Mestizo women.

Subjects and methods: This study comprised 600 post-menopausal Maya-Mestizo women. A structured questionnaire for risk factors was applied and BMD was assessed at the lumbar spine (LS) and total hip (TH) by dual-energy X-ray absorptiometry. DNA was extracted from blood leukocytes. Two single-nucleotide polymorphisms of VDR (rs731236 and rs2228570) were studied using real-time PCR allelic discrimination for genotyping. Differences between the means of the BMDs according to the genotype were analysed with covariance. Haplotype analysis was conducted.

Results: TT genotype of rs731236 of VDR had higher BMD at total hip and femoral neck (FN), and one haplotype formed by the two polymorphisms was associated with only TH-BMD variations. This difference was statistically significant after adjustment for confounders. The genotype of rs2228570 of VDR analysis showed no significant differences with BMD variations.

Conclusion: The results showed that the TT genotype of rs731236 of VDR and one haplotype formed by rs731236 and rs2228570 polymorphisms were associated with higher BMD at TH and FN.     

Magnesium intake and bone mineral density in young adult women

The purpose of this study was to determine a possible association between magnesium intake and bone mass in young adult women. Subjects consisted of 106 female university students aged 19-25 years. Calcium and magnesium intakes were evaluated using the duplicate sampling method on three weekdays. Spinal and femoral bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. Mean magnesium intake was 139 mg/day (median 127, SD 54). The correlation between magnesium intake and BMD was of borderline significance (r = 0.175, p = 0.073) for the femoral neck, and was insignificant (r = 0.084, p = 0.391) for the lumbar spine. However, the partial correlation between magnesium intake and BMD of the femoral neck (r = -0.027, p = 0.788), adjusted for calcium intake, was not significant. In conclusion, we did not find an association between magnesium intake and bone mass in young women, and calcium intake needs to be included as an important, potential confounding factor when exploring such an association.     

Kinematics of the lumbar spine in elderly subjects with decreased bone mineral density

Lumbar spine kinematics was studied in subjects with normal bone mineral density, osteopenia and osteoporosis to determine the effect of bone mineral density and morphology on the flexion–extension movement patterns of the lumbar spine. Lateral radiographs and skin-mounted electromagnetic motion tracking sensors were employed to study lumbar spine kinematics using a Bayesian Belief Network model. The predicted angular displacement of the vertebrae had a high correlation (r = 0.91, p < 0.001) with the actual movements. The overall mean error was −0.51° ± 3.11°. Intervertebral angular displacement and velocity consistently increased from L1/L2 to L5/S1. Differences were observed in the movement pattern between normal subjects and those with decreased bone density. In normal subjects, vertebral angular acceleration consistently decreased from the upper to the lower vertebrae but the same consistent predictable pattern was not observed in the subjects with decreased bone mineral density. It is possible that these changes in kinematic behaviours are related to morphological changes as well as altered neuromuscular functions.     

Serum leptin levels,bone mineral density and osteoblast alkaline phosphatase activity in elderly men and women

Although primarily secreted by adipose cells, leptin, a polypeptide hormone that influences body weight, satiety and lipid metabolism, and its receptor are also expressed in human osteoblasts. Leptin plays a role in the central, hypothalamic modulation of bone formation, as well as locally within the skeleton by enhancing differentiation of bone marrow stroma into osteoblasts and inhibiting its differentiation into osteoclasts and adipocytes. The purpose of this investigation was to compare serum leptin values in 100 postmenopausal women (age 62-97) and 31 men (age 72-92) to bone mineral density (BMD) measurements made by dual X-ray absorptiometry and additionally to biochemical markers of bone resorption and formation, including crosslinked collagen N-telopeptides (NTx), aminoterminal extension procollagen propeptides (PINP) and bone-specific alkaline phosphatase (bAP). The circulating level of leptin directly correlated with body mass index (BMI) (r=0.61-0.78, P<0.001) and was modestly, but significantly and positively associated with bAP activity (r=0.24-0.33, P<0.01) in the sera of men and women after adjustment for BMD, age and BMI. The association of circulating leptin levels with bAP, a specific marker of osteoblast activity suggests that leptin levels influence osteoblast activity in vivo in elderly women and men.