成都市340名绝经后妇女骨质疏松发病情况调查及影响因素探讨

作者测定了成都市340名绝经后妇女桡骨骨矿物含量及血碱性磷酸酶、血钙、血磷、尿钙、尿磷、尿羟脯氨酸和尿肌酐,并对有关因素进行调查。结果显示:绝经后骨质疏松患病率为25％,患病率随年龄及绝经年限增长而增加。用多元逐步回归分析,从16种有关因素中筛选出血钙、尿钙、血碱性磷酸酶、尿羟脯氨酸、产次、年龄与骨矿物含量相关。用这6种指标进行骨质疏松Fisher判别分析,诊断符合率达75.2％。本文还对这些因素的临床意义进行了讨论。     

甲亢患者骨矿物质含量变化及有关因素的探讨

本文以单光子骨密度仪测定30例甲亢患者的BMC,BMD,并以相应年龄、性别的正常人作对照,同时测定患者的血钙、血磷、AKP、24小时尿钙和尿磷,结果显示男、女性患者均有BMC、BMD的降低,绝经的患者更为明显,BMC与血清钙,BMD与尿钙均呈正相关关系,单光子骨密度仪测定骨矿物质含量对研究甲亢性骨病具有重要意义。     

绝经后骨质疏松与血清OPG及RANKL关系的研究

目的研究血清护骨素（OPG）和核因子-κβ受体活化子配体（RANKL）与绝经后骨质疏松及其引起的骨折、相关骨代谢指标（BTMs）,包括OC,NTX及IGF-1）的关系。方法应用双能X线骨密度仪测量82例绝经后妇女腰椎骨密度（BMD）,按WHO标准,分为无骨质疏松组（NOP）、骨质疏松组（0P1）、骨质疏松伴骨折组（OP2）。测定血清OPG,RANKL及其他骨代谢指标。结果OP1组及OP2组血清OPG水平均低于NOP组（P〈0．05）,OP2组血清RANKL水平低于NOP组（P〈0．01）。校正年龄、绝经年限、体质指数及雌二醇后,血清OPG与BMD呈正相关（P〈0．05）。血清OPG与IGF-1呈正相关（P〈0．001）。Logstic回归分析表明校正年龄、骨转换指标、雌二醇和BMD后,血清OPG及RANKL对骨折有显著影响。结论血清OPG增高可能是对抗绝经后骨吸收加快的一个代偿反应。低水平的血清RANKL可能不利于骨重塑,从而增加了骨折的危险。血清OPG与RANKL是对骨折有显著影响的独立因素,提示它们可望作为更加准确的单独预测骨质疏松骨折的骨代谢标志物。     

北京市房山区绝经前后妇女骨代谢情况报告

测定北京房山区１４４例绝经前后妇女桡骨骨密度值及４３例绝经妇女血清钙、雌激素、降钙素、甲状旁腺素值。结果表明：随着年龄和绝经年限的增加，骨密度值显著下降。血清钙各年龄组变化不大。雌激素、降钙素绝经后逐渐降低，甲状旁腺素明显增加，多因素回归分析提示，年龄、绝经年限、孕次、人工流产次数、服用营养补品、经济水平、雌激素、甲状旁腺素是影响骨密度的主要因素。     

Accuracy study on "Osteorisk": a new osteoporosis screening clinical tool for women over 50 years old.

CONTEXT AND OBJECTIVE: Osteoporosis is the greatest cause of quality-of-life reductions, morbidity and mortality among postmenopausal women, with growing incidence as populations age. Clinical tools like Osteorisk provide an easy-access and low-cost alternative method that helps physicians to reduce the need for dual-energy X-ray absorptiometry (DXA), the expensive gold standard examination for diagnosing osteoporosis. The aim here was to study the accuracy of Osteorisk using heel ultrasonography for bone mineral density (BMD). DESIGN AND SETTING: Cross-sectional study, at Faculdade de Medicina do ABC. METHODS: A structured questionnaire was applied to 615 postmenopausal women, with anthropometric measurements, Osteorisk calculations and quantitative ultrasound on the heel using Sonost 2000 equipment. RESULTS: 461 women were included, with mean age 60 +/- 9 years, weight 67.6 +/- 12.9 kg and body mass index (BMI) 28.8 +/- 5.0 kg/m(2). Their Osteorisk classifications were: 61.0% low-risk, 28.4% medium-risk and 10.6% high-risk. Quantitative ultrasound showed 81.3% low-risk, 10.0% medium-risk and 8.7% high-risk regarding osteoporosis. Statistically significant results were observed (p < 0.001) when Osteorisk was correlated with age, years since menopause and BMI. Correlating these same variables with quantitative ultrasound, statistically significant results were observed for age (p < 0.001), years since menopause (p < 0.001) and BMI (p < 0.006). The sensitivity, specificity, negative predictive value and positive predictive value for Osteorisk were 64%, 6.7%, 89% and 30.6%, respectively. CONCLUSION: Osteorisk is a valid tool for screening for women at low risk of osteoporosis, making it possible for these women not to have to undergo densitometry.     

绝经后女性腰椎骨密度影响因素的研究

目的分析绝经后女性腰椎骨密度的相关影响因素,提高对绝经后女性骨质疏松症的预防,减少骨质疏松症的发生。方法随机抽取2012年1¹2月在武汉大学人民医院进行骨密度测量(采用美国生产的DEXA双能X线骨密度测量仪)的绝经后女性251例。测量记录251例自然绝经女性的年龄、绝经年龄、身高、体质量、第112月在武汉大学人民医院进行骨密度测量(采用美国生产的DEXA双能X线骨密度测量仪)的绝经后女性251例。测量记录251例自然绝经女性的年龄、绝经年龄、身高、体质量、第1⁴腰椎骨密度T值平均值,分析绝经后女性腰椎骨密度的相关影响因素。结果多元逐步回归分析结果显示:体质量和绝经年限为影响绝经后女性腰椎骨密度的主要因素(P<0.05)。绝经后14腰椎骨密度T值平均值,分析绝经后女性腰椎骨密度的相关影响因素。结果多元逐步回归分析结果显示:体质量和绝经年限为影响绝经后女性腰椎骨密度的主要因素(P<0.05)。绝经后1¹0年与绝经后10年以上腰椎骨密度T值比较差异均有统计学意义,绝经10年以后腰椎骨密度明显下降(P<0.05)。不同体质量组腰椎骨密度T值比较差异均有统计学意义(P<0.05),其中低体质量组最低,超体质量组最高,正常体质量组居中。结论女性绝经越早,绝经时间越长,体质量越低,绝经后的腰椎骨密度越低。体质量是腰椎骨密度的保护因素,绝经后女性保持适当的体质量有助于减少骨质疏松症的发生。     

绝经后妇女腰椎骨密度测量及其临床意义

目的 探讨绝经后妇女腰椎骨量的变化规律,找寻低骨量的危险因素。方法 记录２０９例绝经后妇女的年龄、绝经年龄、绝经年限,测量体重和身高,采用Ｈｏｌｏｇｉｃ双能Ｘ线骨密度测量仪检测腰椎正侧位的骨密度。结果 绝经后妇女年龄越大、绝经越早、绝经年限越长、体重指数越小,骨密度越低。结论 绝经和低体重是绝经后骨质疏松症的危险因素,应加强对绝经后妇女尤其是早绝经和低体重的中老年妇女进行骨密度的监测。     

Relation of serum growth hormone and estradiol levels and osteoporosis in postmenopausal women

Serum GH, E2, FSH, LH levels, bone mass, serum alkaline phosphatase (AKP), calcium levels and urinary calcium/creatine ratio in 42 postmenopausal women were compared with those in 30 women of fertile age. In thirteen out of the postmenopausal women we also observed these parameters before and after treatment with diethylstilbestrol (DES). The postmenopausal women had significantly reduced serum GH (P less than 0.01) and E2 levels (P less than 0.001) and increased serum FSH(P less than 0.001), LH levels (P less than 0.001), and had lower bone mass (P less than 0.01). They also had increased serum AKP levels (P less than 0.05) and urinary calcium/creatine ratio(P less than 0.01). There were positive correlations between serum E2 and GH levels, between postmenopausal bone loss and serum E2, GH decline. The postmenopausal bone loss began early as menopause commenced. After treatment with DES in 13 postmenopausal women, we observed that GH significantly increased (P less than 0.01) and FSH, LH decreased (P less than 0.001), AKP decreased by 27.58% and urinary calcium/creatine ratio decreased by 43.94% (compared with that before treatment). Our results indicate that bone turnover increased after menopause and resorption exceeded formation. There is bone loss in early postmenopause. The postmenopausal bone loss is related to serum GH, E2 levels. Estrogen replacement therapy is necessary in postmenopausal women and it should be given as early as possible. After treatment with DES, increased serum GH levels, decreased AKP values (27.58%) and urinary calcium/creatine ratio (43.94%) suggest that estrogen may play a definite role in bone metabolism through increased GH.     

强骨丹对去卵巢大鼠骨质疏松症防治作用的实验研究

[目的]探讨中药强骨丹对绝经后骨质疏松症的防治作用。[方法]运用切除大鼠卵巢方法建立去卵巢骨质疏松症模型,随机分为模型组、强骨丹高低剂量组、西药组,同时设假手术对照组。采用双能X线骨密度测定法、放射免疫分析法和ELISA法等检测各组实验鼠骨密度 (BMD)、骨矿含量 (BMC)、血清雌二醇 (E₂)、骨钙素 (BGP)、抗酒石酸酸性磷酸酶5b(TRACP5b)以及尿脱氧吡啶啉 (Dpol)。[结果]强骨丹可明显升高BMD、BMC,提高血清E₂ 水平,降低TRACP5b和Dpd水平,并降低BGP含量。[结论]强骨丹通过调节机体相关内分泌功能,抑制骨吸收,降低骨的转换率,减少骨丢失,增加骨密度,对绝经后骨质疏松症有防治作用。     

甲状腺功能异常患者的骨密度与骨代谢变化影响因素调查

目的探讨甲状腺功能异常患者的骨密度与骨代谢变化影响因素。方法制定自编问卷来通过问卷调查和临床检测方法收集本院2011～2013年收治的200例甲状腺功能异常患者的临床资料,根据患者有无合并骨质疏松症将患者分为A组和B组,调查研究对象的甲状腺功能、体重指数、骨代谢指标、年龄、绝经情况、饮食生活、治疗史、骨折史、家族史等,并对甲状腺功能与上述多项研究指标之间的关系进行多因素Logistic回归分析。结果女性患病率高于男性。甲状腺功能异常伴骨质疏松患病率随着年龄增长呈增加趋势,尤其绝经后女性发病率显著上升。发病率与年龄、绝经、骨折史、家族史呈正相关,与体重指数等呈负相关。结论甲状腺功能异常患者应密切注意骨含量情况。不健康生活方式、年龄、绝经、骨折史等是其危险因素。