强直性脊柱炎胸腰椎后凸畸形患者全脊柱最大后凸角与骨密度的相关性分析

目的 探讨强直性脊柱炎（AS）胸腰椎后凸畸形患者全脊柱最大后凸角（GK）与骨密度的相关性。方法 横断面研究。纳入2011年4月—2018年11月南京大学医学院附属鼓楼医院脊柱外科AS胸腰椎后凸畸形患者90例,其中男84例、女6例,年龄20~66（37.0±10.6）岁,病程1~38（10.3±8.0）年。测量患者术前GK及L_1~4椎体和股骨颈骨密度T值及Z值,采用Pearson相关分析对GK与L_1~4椎体和股骨颈骨密度T值、Z值的相关性进行分析。结果 患者GK与股骨颈T值、Z值均呈负相关性（r=-0.259、-0.242,P=0.014、0.021）,与L_1~4椎体T值、Z值均无相关性（P值均>0.05）。结论 AS胸腰椎后凸畸形患者的GK与股骨颈骨密度相关。     

骨钙素基因Hind Ⅲ多态性与福州地区汉族绝经后妇女骨密度的相关性

背景：骨质疏松症是一种多基因遗传病,骨钙素受体基因多态性与骨密度关系存在地域和人群的差异。 目的：观察绝经后妇女骨钙素基因型频率分布及其与骨密度的关系,探讨福州地区汉族绝经后妇女骨质疏松症的遗传易感基因。 方法：用聚合酶链式反应限制性片段长度多态性分析201例汉族绝经后妇女骨钙素基因型,用双能X射线吸收法测定腰椎、股骨颈,大转子和Ward’s三角4个部位骨密度值。 结果与结论：福州地区汉族绝经后妇女骨钙素基因型频率分布符合Hardy-Weinberg定律(χ²=2.29,P > 0.05),基因多态性分布依次为HH 5%、hh 46%、Hh 49%,与福州、北京、广州、台湾地区骨钙素基因Hind Ⅲ位点多态性分布频率差异无显著性意义(P  > 0.05)。但是与日本人、白种人差异明显(P  < 0.05)。且HH基因型在大转子骨密度明显高于hh型(P < 0.05),但不同基因型在第2~4腰椎、股骨颈、Ward’s三角区的骨密度差异无显著性意义。提示绝经后妇女骨钙素基因型与大转子骨密度可能存在一定关联。     

退行性腰椎侧凸椎管形态学特征及其与脊柱-骨盆参数的相关性分析

目的 测量退行性腰椎侧凸(degenerative lumbar scoliosis,DLS)患者椎管形态学参数,分析其变化规律及其与脊柱-骨盆参数的相关性。方法 收集DLS患者50例,分别在X线、CT及MRI上测量腰弯Cobb角、腰椎前凸角、顶椎位置、顶椎偏移距离、顶椎旋转度、顶椎侧方和前方滑移距离、骨盆投射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacral slope,SS)、凹侧和凸侧椎间孔高度、宽度和横截面积、硬膜囊横截面积、横径和前后径,分析椎管形态学变化规律及其与脊柱-骨盆参数的相关性。结果DLS患者的顶椎位于L₂～L₃椎体;其椎管相关参数最小处均位于L_4/5节段;椎间孔相关参数最小处均位于L_2/3节段。DLS患者L_2/3水平椎管及椎间孔的形态学参数与年龄、腰弯Cobb角及顶椎偏移距离存在相关性(P<0.05);而L₅/S₁水平椎间孔的形态学参数与PI、...     

基于椎体CT扫描的骨密度HU值分析退变性腰椎侧弯患者骨质疏松的发生率和分布规律

目的 探讨椎体退变性腰椎侧弯(DLS)患者骨质疏松的发生率和分布规律,为骨水泥螺钉的选择性使用提供参考。方法 回顾性分析2015年1月—2019年9月北京大学第三医院骨科接受手术治疗的95例DLS患者的临床和影像学资料,其中男20例、女75例,年龄(63.3±6.5)岁。于脊柱X线全长片上测量患者Cobb角、冠状平衡距离(CBD)值,统计患者冠状位失衡分型例数。选择患者主弯和代偿弯内椎体前缘皮质后方2 mm、椎体中部和椎骨后缘皮质前方2 mm三个层面的CT冠状面重建图像,于椎体松质骨部分选择最大可能的椭圆形区域作为骨密度Hounsfield units(HU)值测量兴趣区,取三个层面测量的平均值作为相应椎体的骨密度HU值,同样方法分别测量椎体凸、凹侧的HU值;以L₁≤110 HU作为骨质疏松的诊断标准,观察患者骨质疏松发生率,并按观察结果将患者分为正常骨密度组和骨质疏松组两组,进而对比两组患者临床基线资料。观察全组患者主弯与代偿弯内椎体HU值,以及主弯和代偿弯内各椎体及其凸凹两侧骨质疏松的发生情况。结果 全组95例患者Cobb角为25.5°±11.1°,CBD为(22.8±18.7)mm,冠状位失衡为A型者74例、B型12例、C型9例。骨密度正常58例(61.1%),骨质疏松37例(38.9%);女性骨质疏松的发生率45.3%(34/75),高于男性的15.0%(3/20),差异有统计学意义(χ²=6.110, P＜0.05)。正常骨密度组和骨质疏松组患者的年龄、体质量指数、Cobb角、CBD、侧弯方向、冠状位失衡分型比较,差异均无统计学意义(P值均＞0.05)。主弯与代偿弯内椎体HU值:L₁为(122.2±45.0)HU、稳定椎为(124.7±44.8)HU、中立椎为(120.9±42.9)HU、上端椎为(124.3±46.1)HU、顶椎(134.4±49.4)HU、下端椎(153.3±63.8)HU、L₅椎(169.8±75.8)HU。主弯内各椎体的骨质疏松发生率分别与L₁椎体比较,差异均无统计学意义(P值均>0.05);而代偿弯内L₅椎体的骨质疏松发生率则低于主弯的L₁椎体,分别为17.9%(17/95)和38.9%(37/95),差异有统计学意义(χ²=10.349,P＜0.05)。L₅椎体、下端椎、顶椎的凸侧骨质疏松发生率高于凹侧,差异均有统计学意义(P值均＜0.01);而上端椎、中立椎、稳定椎凸凹两侧骨质疏松的发生率比较,差异均无统计学意义(P值均＞0.05)。结论 DLS患者中骨质疏松发生率为38.9%,女性患者的发生率更高。代偿弯内椎体骨质疏松发生率低于主弯内椎体,L₅椎、下端椎和顶椎凸侧是骨质疏松的好发部位。     

骨质疏松骨折椎体及相邻椎体骨水泥注入前后的有限元分析

背景：目前有限元构建模型主要是基于医学图像的建模方法,骨水泥注入主要是人为假设的,而文章中治疗前后的数据直接来源于CT扫描,可靠性更高。 目的：构建骨水泥注入前后骨质疏松性腰椎骨折椎体的三维有限元模型,分析治疗前后病椎及邻椎的应力变化。 方法：选取1例75岁骨质疏松性L₂椎体压缩性骨折患者,经双侧椎弓根注入少量骨水泥获得良好疗效,随访2年病椎及邻椎无新发骨折,局部无疼痛。根据其治疗前后的腰椎CT数据,构建三维有限元模型,模拟腰椎屈伸、左右侧屈、旋转等运动,统计分析治疗前后同一运动状态下的应力变化。 结果与结论：建立了腰椎压缩骨折骨水泥注入前后的三维有限元模型,共生成222 727个单元。骨水泥注入增加了L₂椎体(病椎)屈、伸、侧屈各运动时的应力(P < 0.05),对其旋转时的应力无明显影响(P > 0.05);对L₁,L₃椎体(邻椎)在屈、伸、侧屈及旋转时的应力亦无影响(P > 0.05)。提示少量骨水泥注入治疗老年骨质疏松性腰椎骨折可增加病椎强度及应力,但不改变相邻椎体应力。     

注射型磷酸钙人工骨椎体后凸成形固化治疗骨质疏松性胸腰椎压缩骨折

背景：椎体后凸成形目前常用的注射型聚甲基丙烯酸甲酯骨水泥椎体增强剂可达到增加椎体强度、稳定椎体、止痛的目的,但其组织相容性差,无生物降解性,容易造成使临近椎间盘或椎体发生变性、甚至骨折。 目的：观察注射型磷酸钙人工骨椎体后凸成形固化治疗骨质疏松性椎体压缩骨折的效果。 方法：选择2007-12/2010-06哈尔滨医科大学附属第四医院骨外科收治的骨质疏松性胸腰椎压缩性骨折患者20例,均采用经双侧椎弓根球囊扩张注射型磷酸钙人工骨行椎体后凸成形固化治疗。手术前后行疼痛目测类比评分,胸(腰)椎正侧位X射线片及椎体前缘高度、Cobb角检测。 结果与结论：术后病椎前缘椎体平均高度较术前平均高度恢复(3.38±1.44) mm (P < 0.05)。术后Cobb角较术前平均恢复(7.63±2.52)° (P < 0.05),后凸矫正率为(38.90±11.28)%。术后3d及3周目测类比评分均较术前明显降低(P < 0.01)。说明经双侧椎弓根球囊扩张注射型磷酸钙人工骨行椎体后凸成形可以有效增加椎体强度、稳定椎体、明显缓解患者疼痛,是治疗骨质疏松性胸腰椎压缩骨折的有效方法。     

低频脉冲电磁场干预绝经后骨质疏松患者血清护骨素及核因子κB受体 活化子配体的变化

背景：脉冲电磁场能克服传统治疗方法的缺陷,对骨质疏松引起的疼痛、骨量减少、骨密度降低具有肯定的治疗作用。 目的：探讨低频脉冲电磁场治疗绝经后骨质疏松的作用机制。 方法：应用双能X 射线骨密度仪测量150 例绝经后妇女腰椎骨密度,按WHO标准诊断,无骨质疏松患者50例、骨质疏松患者100例。将骨质疏松患者随机分为骨质疏松组和低频脉冲电磁场治疗组,分别给予钙剂口服或钙剂口服+连续14 d的低频脉冲电磁场治疗。 结果与结论：各组患者基线资料具有可比性。与无骨质疏松患者比较,骨质疏松患者腰椎骨密度明显降低(P < 0.01),经低频脉冲电磁场治疗后无明显改变(P > 0.05),但患者血清β-1型胶原C-末端肽明显降低(P < 0.05)、骨钙素明显升高(P < 0.01)。与骨质疏松组比较,其他两组患者血清护骨素明显升高(P < 0.05);低频脉冲电磁场治疗组患者血清核因子κB受体活化子配体明显降低(P < 0.05)。说明低频脉冲电磁场干预14 d对骨质疏松有良好的防治作用。     

新型棘突间撑开融合装置BacFuse修复腰椎退行性病的生物力学特征

背景：近年来，棘突间撑开融合装置BacFuse应用于腰椎退行性疾病的治疗并取得了良好的临床疗效，但目前其相关的生物力学特征暂无相关报道。目的：探索棘突间撑开融合装置BacFuse在腰椎退行性疾病中应用的生物力学特征。方法：构建山羊离体脊柱模型(L₁-L₆)，模拟手术分为4组，分别为对照组、BacFuse固定组(L_3/4)、钉棒固定组(L_3/4)及Topping-off组(L_3/4钉棒固定+L_2/3 BacFuse固定)。搭建山羊腰椎手术模型力学测试系统，采用生物力学机器进行力学加载，模拟腰椎在前屈、后伸、侧屈及旋转时的运动模式(4 Nm的力矩)，采用视觉追踪系统进行定位捕捉，并完成力学及光学校准，通过计算得出L_2/3、L_3/4、L_4/5节段的活动度。结果与结论：(1)相对于对照组，BacFuse组L_3/4固定节段在前屈、后伸、侧屈与旋转方向上活动度分别减少27.27%,...     

骨质疏松性腰椎压缩性骨折的椎间盘和椎旁肌肉MRI变化及意义

目的 研究骨质疏松性腰椎压缩性骨折的椎间盘、椎旁肌肉磁共振成像(MRI)变化及意义。方法 回顾性分析我院85例腰椎压缩性骨折患者的临床资料,将45例存在骨质疏松的患者纳入观察组,40例无骨质疏松的患者纳入对照组。比较2组患者的Pfirrmann分级、L₁～L₅椎旁肌肉的相关指标,包括双侧多裂肌横截面积、双侧竖脊肌横截面积、椎体横截面积、脂肪变性比例。结果 2组Pfirrmann分级比较,差异有统计学意义(P<0.05)。对照组L₁～L₅双侧多裂肌横截面积、双侧竖脊肌横截面积显著大于观察组,L₁～L₅脂肪变性比例显著低于观察组,差异均有统计学意义(P<0.05);2组L₁～L₅椎体横截面积比较,差异无统计学意义(P>0.05)。结论 骨质疏松性腰椎压缩性骨折患者的腰椎间盘退变程度明显高于单纯腰椎压缩性骨折患者,其椎旁肌肉MRI变化主要表现为双侧多裂肌、竖脊肌横截面积减小和脂肪变性比例升高。     

高位腰椎间盘突出症矢状面相关因素分析

背景：高位腰椎间盘突出症相比于常见节段的腰椎间盘突出症少见,但是高位椎管内结构复杂,因而临床表现常较严重且变化多样,分析相关影像学参数可以更深入地了解疾病特点,为早期诊疗及患者术后预防复发提供思路。目的：分析高位腰椎间盘突出症患者矢状面相关影像学参数特点,探讨不同参数对于高位腰椎间盘突出症发病的可能影响。方法：收集2019年1月至2022年1月住院治疗的高位腰椎间盘突出症患者46例作为观察组,其中L₁-L₂节段椎间盘突出9例,L₂-L₃节段10例,L₃-L₄节段27例。按照1∶1比例选取同时期因L₄-L₅节段腰椎间盘突出症就诊的46例患者为对照组。在站立位腰椎正侧位X射线片上测量两组患者的矢状面影像学参数,包括骨盆倾斜角、骨盆入射角、骶骨倾斜角、腰椎前凸角、胸腰椎后凸角、楔形椎骨角度。使用多因素Logistic回归分析判断上述参数与高位腰椎间盘突出症发病的相关性,对有意义的结果进一步纳入ROC曲线分析危险因素的影...     

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：     

绝经后妇女甲状旁腺素基因多态性与骨密度：福州地区的调查

背景：有研究证实,绝经后妇女骨密度与甲状旁腺素基因有密切关系,但在不同地区人群中结果存在差异性。 目的：探讨福州地区绝经后妇女甲状旁腺素基因(PTH)BstBⅠ多态性与骨密度的关系。 方法：用双能X射线骨密度仪检测福州地区150例绝经后妇女的腰椎、股骨颈,大转子和Ward’s三角骨密度,应用PCR-RFLP技术检测甲状旁腺素基因BstBⅠ多态性。 结果与结论：①甲状旁腺素基因型分布频率为BB型 68.8%、Bb型24.1%、bb 型7.1%。等位基因频率为B 81%,b 19%,基因型分布符合Hardy-Weinberg定律。②分析其基因型与骨密度的关系：BB、Bb、bb 3种基因型在股骨颈、大转子、Ward’s三角区4个部位骨密度差异均无显著意义(P > 0.05)。甲状旁腺素基因BstBⅠ位点多态性与骨密度间无关联,尚不能作为预测福州地区绝经后妇女发生骨质疏松危险的遗传标志。 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：     

Association between bone mineral density and LDL receptor-related protein 5 gene polymorphisms in young Korean men

Recently, It has been reported that the LDL receptor-related protein 5 (LRP5) regulates bone formation, and that mutations of the gene cause osteoporosis-pseudoglioma syndrome or high bone mass phenotypes. However, the mutations cannot explain a genetic trait for osteoporosis in the general population because of their rarity. From 219 Korean men aged 20-34 yr, we looked for six known polymorphisms causing amino acid changes in the LRP5 coding region, and investigated their association with bone mineral density (BMD) at the following anatomical sites: lumbar spine (L2-L4) and the left proximal femur (femoral neck, Ward's triangle, trochanter and shaft). We found that the Q89R polymorphism was significantly associated with BMD at the femoral neck and Ward's triangle (p=0.004 and <0.001, respectively). However, after adjusting for age, weight and height, a statistically significant association only occurred at the Ward's triangle (p=0.043), and a marginal association was observed at the femoral neck (p=0.098). No A400V, V667M, R1036Q and A1525V polymorphisms were found, and no statistically significant association was found between the A1330V polymorphism and BMD at any sites. Although we failed to demonstrate a clear association between the LRP5 polymorphism and peak bone mass in young men, the present study suggests that larger-scale studies on the Q89R polymorphism need to be performed.     

白细胞介素6与钙感应性受体基因多态性对青春期女童骨量增长的交互作用

目的 探讨白细胞介素6(interleukin-6,IL-6)与钙感应性受体(calcium sensing receptor,CASR)基因多态性对青春期女童骨量增长的交互作用.方法 选择228名9-11岁半未月经初潮的健康女童进行两年追踪,采用双能X线骨密度仪检测对象追踪前后全身、左侧近端股骨(包括股骨颈、大转子、粗隆间和华氏三角区)和L1-L4腰椎骨矿含量(bone mineral content,BMC)和骨密度(bone mineral density,BMD),采用聚合酶链反应-限制性片段长度多态性技术检测IL-6-634C/G位点多态性,等位基因特异性突变分离扩增-PCR技术检测CASR A986S位点多态性.结果 176名女童完成整个研究.IL-6基因-634C/G和CASR基因A986S位点多态性与青春期女童骨量增长有关联,IL-6基因-634C/G位点CG+GG基因型女童全身和股骨大转子BMD较CC基因型分别低25.7%和20.6%,CASR基因A986S位点AS+SS基因型女童L1.L4腰椎BMC和华氏三角区BMD增长率较AA基因型分别低14.9%和51.3%,差异有统计学意义(P＜0.05).交互作用分析发现,同时具有IL-6基因-634C/G位点G等位基因和CASR基因A986S位点S等位基因的女童,其股骨颈和L1-L4腰椎BMC增长率最低.结论 同时具有IL-6基因-634C/G位点G等位基因和CASR基因A986S位点S等位基因的女童,可能是低骨量增长的危险人群.     

脊髓损伤患者站立活动量与骨密度的变化

背景：脊髓损伤后的骨质疏松,可造成患者持重能力下降,严重影响其生活质量。 目的：分析脊髓损伤后患者的活动情况与骨密度变化的情况。 方法：根据脊髓损伤患者每天的站立活动情况,分为3组：充分活动组每天站立活动1 h以上;限制活动组每天站立活动不足1 h;无活动组无站立活动。 结果与结论：通过双能X射线骨密度仪对患者腰椎及股骨部进行骨密度检查后显示,充分活动组与限制活动组的腰椎(L2~4)、股骨颈、股骨转子和Ward’s三角区骨密度水平高于无活动组(P < 0.05),充分活动组的骨密度水平较限制活动组有显著提高(P < 0.05)。结果证实,相对于脊髓损伤后的相对制动,适当的站立活动在一定程度上有助于减少患者的骨质丢失,缓解骨质疏松的发展,提高骨密度水平。     

护骨素基因T245G多态性与老年人骨密度关系的部位及性别差异

背景：作为骨折发生的重要临床预测因子,骨密度在一定程度上由遗传因素决定。护骨素基因是骨质疏松症发病中的重要候选基因。 目的：探讨护骨素基因T245G多态性与骨密度的相关性。 方法：选取2008-09/2010-04在北京大学人民医院进行常规查体的老年人281名,其中男182名,女99名。应用PCR-RFLP结合DNA测序检测护骨素基因T245G多态性,使用双能X射线骨密度测量仪测定受试者腰椎、髋部标准位置及前臂的骨密度。同时收集受试者的生化指标及临床观察项目。应用ANOVA方法分析护骨素基因T245G多态性与各检测指标的关系。 结果与结论：在老年男性及绝经后女性中,T245G基因T,G等位基因频率分布差异无显著性意义(P > 0.05)。在老年男性中,GG和TG基因型具有较高的腰椎骨密度,而TT基因型的腰椎骨密度较低(P < 0.05),Ward’s三角区及前臂骨密度在各基因型间差异无显著性意义(P > 0.05)。在绝经后女性中,T245G多态性与骨密度无关,说明护骨素基因与老年男性腰椎骨密度有关。     

Bone mineral density in pre-and post-menopausal women with affective disorder treated with long-term L-thyroxine augmentation

BACKGROUND: Augmentation with TSH-suppressive L-thyroxine (T4) has been shown to improve the course of illness in otherwise refractory affective disorders. This collaborative study investigates whether T4 augmentation for a minimum of 12 months decreases bone mineral density (BMD) in 26 pre- and post-menopausal women with affective disorder. METHODS: We measured BMD at the femoral neck, Ward's triangle, trochanter and lumbar vertebrae (L1-L4) in 13 premenopausal and 13 postmenopausal women with affective disorder using dual energy X-ray absorptiometry. BMD was expressed as g/cm(2) and as a Z-score, calculated using bone density data from the international reference population standard. RESULTS: The Z-scores for the pre- and post-menopausal women were within the reference range of the age and sex matched population standard. BMD for the composite group also did not differ either from the population standard. BMD in the lumbar spine and hip did not differ significantly between the pre- and post-menopausal groups. However, there were a relatively high number of postmenopausal patients with BMDs one S.D. lower than the population standard. LIMITATIONS: This is a cross-sectional study with a relatively small sample size. CONCLUSIONS: The study demonstrates that T4 augmentation treatment does not reduce BMD to a clinically significant degree in many women with affective disorder. However, the resilience of bone structure to T4 treatment may vary with site and menopausal status. This study underscores the need for regular assessment of BMD during adjunctive thyroid treatments for affective disorder, especially in postmenopausal women.     

17beta-estradiol (1 mg/day) continuously combined with dydrogesterone (5, 10 or 20 mg/day) increases bone mineral density in postmenopausal women

Although the minimal dose of 17beta-estradiol in hormone replacement regimens was originally considered to be 2 mg/day, it is now increasingly accepted that a lower dose of 1 mg/day is effective in protecting women from the detrimental effects of the menopause. A 1-year, multicentre, double-blind, randomised study was conducted in 214 healthy postmenopausal women in order to assess the effect of 17beta-estradiol (1 mg/day) continuously combined with dydrogesterone (5, 10 or 20 mg/day) in preventing bone loss. Bone mineral density (BMD) was evaluable in 177 women who completed the study. In all women, a statistically significant increase from baseline in lumbar vertebrae (L2-L4) BMD was seen after 6 months ( + 2.4%; p < 0.01); this increase was somewhat greater after 12 months ( + 3.6%; p < 0.01). Similar effects were seen in the hip. After 6 months, BMD in the femoral neck, Ward's triangle and trochanter had increased by 0.20% (not significant [n.s.]), 0.32% (n.s.) and 1.08% (p < 0.01), respectively, compared with baseline. Greater increases were again seen after 12 months ( + 1.16%, + 1.62% and + 2.83%, respectively), all of which were statistically significant (p < 0.01) compared with baseline. The change in BMD from baseline did not differ significantly between the three dydrogesterone dosages for either L2-L4 or hip. All dosages were well-tolerated and amenorrhoea was achieved in over 70%. In conclusion, 17beta-estradiol (1 mg/day) continuously combined with dydrogesterone (5, 10 or 20 mg/day) results in a significant increase in lumbar vertebrae and hip BMD in postmenopausal women. The lower dose of oestrogen and the avoidance of cyclical bleeding make this a particularly suitable regimen for the prevention and treatment of osteoporosis in older women.     

Association of polymorphisms of the osteoprotegerin gene with bone mineral density in Japanese women but not men

Given that osteoprotegerin plays an important role in bone remodeling, the osteoprotegerin gene may be a candidate locus for susceptibility to osteoporosis. The relation of polymorphisms in the promoter of the osteoprotegerin gene to bone mineral density (BMD) was examined in a Japanese population-based prospective cohort study with randomly recruited subjects (1095 women and 1125 men for the 950T --> C polymorphism, 1094 women and 1127 men for the 245T --> G polymorphism). BMD at the radius was measured by peripheral quantitative computed tomography, and that for the total body, lumbar spine, right femoral neck, right trochanter, and right Ward's triangle was measured by dual-energy X-ray absorptiometry. Genotypes were determined with a fluorescence-based allele-specific DNA primer assay system. Among 950T --> C genotypes, BMD for the proximal radius was lower in premenopausal women with the CC genotype than in those with the TT or TC genotype; the difference in BMD between the two groups was 3.9% (P=0.0075). Among 245T --> G genotypes, BMD for the radius, total body, femoral neck, trochanter, and Ward's triangle was lower in postmenopausal women with the GG genotype than in those with the TT or TG genotype, the TT genotype, or the TG genotype; the differences in BMD between the GG genotype and the TT or TG genotype were 19.8% for the distal radius (P=0.0015), 13.1% for the proximal radius (P=0.0095), 11.2% for the total body (P=0.0013), 12.9% for the femoral neck (P=0.0067), 18.7% for the trochanter (P=0.0008), and 27.1% for Ward's triangle (P=0.0038). BMD was not associated with the 950T --> C or 245T --> G genotypes in men. The present results implicate the osteoprotegerin gene as a susceptibility locus for reduced BMD in Japanese women.