氟、锶与骨质疏松症

氟、锶骨有特殊的亲和力,对骨代谢有特殊的影响。小剂量的氟制剂能中度增加骨量,用氟治疗6个月BMD就可有统计学意义。在治疗用剂量下锶盐具有拆耦联作用,在保持骨形成的同时抑制骨吸收,是非常有前景的治疗骨质疏松的药物。     

饮水中锶的健康效应和安全水平

含锶矿泉水是天然矿泉水的主导类型之一.锶与钙一样具有趋骨特性,适宜的锶摄入可以促进钙的吸收从而有益于骨骼健康,但过量的锶摄入尤其伴随钙摄入较低时,可能会导致骨钙减少,增加佝偻病发生风险.含量适宜时,锶对糖和脂类代谢可能具有益处,但锶对于心血管系统的影响尚不明确.据目前资料分析,每日饮用2 L的生活饮用水,其中锶含量不超...     

大豆异黄酮对大鼠骨代谢生化指标的影响

目的：探讨植物雌激素－－大豆异黄酮对大鼠骨代谢生化指标的影响。方法：Wistar大鼠随机分组后，给予不同剂量的大豆异黄酮，喂养3个月后，对血清中骨形成生化指标碱性酸酶（AKP），骨钙素（BGP）和骨吸收生化指标抗酒石酸酸性磷酸酶（STrACD)及雌二醇进行检测，结果：具有弱雌激素样作用的大豆异黄酮对实验大鼠的子宫、卵巢无刺激作用。与对照组相比，大豆异黄酮可影响骨代谢生化指标，高剂量的大豆异黄酮（41．6mg/k.bw)具有同时抑骨形成和骨吸收的作用，使骨转化率降低，但对骨吸收的作用大于骨形成。结论：大豆异黄酮对骨代谢生化指标有一定的调节作用，能够抑制骨吸收，预防骨质疏松的发生。     

雷尼酸锶:改善骨质的生理学探讨

体外研究表明,雷尼酸锶能够增强成骨细胞的增殖,进而增加其成骨活性。同时,雷尼酸锶能剂量依赖性地降低破骨细胞的活性。体内研究显示,雷尼酸锶能降低骨再吸收,维持骨形成保持在一个较高水平,并且防止骨丢失,而且可将骨形成和骨再吸收有效地解偶联,使处于生长期动物的骨增长、骨几何学形状和微观结构得到改善。雷尼酸锶处理未经阉割的雌性大鼠2年后,发现椎骨和中段股骨的骨机械性能得到显著增强。所有骨强度的决定因素如骨量、尺寸、微观结构以及骨质明显受到影响。骨机械性能增加的特征是最大负荷的增加以及抗损伤能力的显著改善,本质是其塑性的增加,这与骨质自身修复过程是相一致的。实验结果表明,在雷尼酸锶处理下形成的新骨在骨折前能够承受更剧烈的变形应力。此外,雷尼酸锶的处理能够防止卵巢切除术对骨强度的有害影响。动物模型经过1年时间雷尼酸锶处理,能有效地阻止椎骨机械性能的改变,并部分保留骨小梁的微观结构:剂量依赖性影响骨体积/小梁体积的比率、小梁数目和厚度。     

异黄酮和骨质疏松

异黄酮是主要存在于大豆及大豆制品中的一类植物雌激素。近年来，大量的细胞培养、组织培养以及动物实验表明，异黄酮能对骨代谢产生明显影响，促进骨形成，抑制骨吸收，有效地预防骨质疏松的发生。流行病学研究也提示它可能对骨质疏松症的发生有一定预防作用。     

084 氟和骨形态发生蛋白对骨代谢的影响

氟和骨形态发生蛋白(BMPs)均为影响骨生长的因素。为探讨氟对BMPs产生及活性的作用以及二者共同对骨代谢的影响，本文分别从骨形成、骨细胞、骨矿物质代谢、信号转导及骨疾患等5个方面将关于氟和BMPs对骨代谢影响的研究进行了综述。氟和BMPs均具有诱导骨形成的作用；影响骨细胞的活性和增殖以及钙磷等骨矿物质代谢；并且二者信号转导均与MAPK途径有关；与氟骨症、骨质疏松等骨疾患有着直接或间接的关系。系统研究氟和BMPs间的关系以及它们在骨代谢中的作用特点，对氟骨症等代谢性骨疾患的预防和治疗有重要意义。     

骨形成标志物测定及其在儿科的临床应用现状

骨由细胞和基质构成,是一种代谢活跃的组织,处于持续不断的骨形成(bone form ation)和骨吸收(bone resorption)的动态平衡之中。成骨细胞和破骨细胞是骨代谢的功能细胞,分别介导骨形成和骨吸收。二者在骨代谢过程中分别产生一些特异性酶和其它代谢产物,这些产物以一定的比例进入血循环,其血清水平与骨代谢活动密切相关,称为骨代谢的特异性标志物。骨形成标志物是成骨细胞在不同分化阶段的产物,亦称成骨细胞表型标志物。近年来测定方法的进步使其在儿科基础和临床领域的应用越来越广泛。本文对骨形成标志物测定及其在儿科的临床应用作一综述…     

氟和骨形态发生蛋白对骨代谢的影响

氟和骨形态发生蛋白（BMPs）均为影响骨生长的因素，探讨为探讨氟对BMPs产生及活性的作用以及二者同对骨代谢的影响。本文分别从骨形成，骨细胞，骨矿物质代谢，信号转导及骨疾患者5个方面将在于氟和BMPs对骨代谢影响的研究进行了综述，氟和BMPs产具有诱导骨形成的作用，影响骨细胞的活性和增殖以及钙磷等骨矿物质代谢；并且二者信号转导均与MAPK途径有关；与氟骨症，骨质疏松等疾患有着直接或间接的关系，系统研究氟和BMPs间的关系以及它们在骨代谢中的作用特点，对氟骨症等代谢性骨疾患的预防和治疗有重要意义。     

氟作用下骨代谢信号通路的研究进展

氟作为人体必需的微量元素对骨的影响主要为骨形成与吸收。目前已发现多条信号通路参与骨的代谢,其中骨代谢通路中转化生长因子(TGF)/骨形态发生蛋白(BMP)/Smads、Wnt(wingless-type MMTV integration site family members)/β-连环蛋白(β-catenin)、破骨细胞抑制因子(OPG)/核因子κB受体活化因子配体(RANKL)/核因子κB受体活化因子(RANK)信号通路等研究较为广泛,而氟在其代谢通路中的影响仍需大量的试验研究证实。本文则主要通过对已经试验研究证实的结论做出归纳,简要综述氟对以上三个骨代谢信号通路的影响。     

Determinants of bone mass in menopause

Osteoporosis, one of the most prevalent diseases of the aged, is characterized by a reduced bone mass which increases the risk for skeletal fracture. The current research was designed to examine determinants of bone mass in 59 postmenopausal women. Information was obtained at baseline concerning anthropometric, nutritional, and physical activity factors. Bone mass in the arm and leg was measured by a computerized tomography (CT) scanner at baseline and 8 months later. The study revealed that the CT scanner is an effective, precise instrument for measuring bone mass, and significant bone loss was found over the 8-month period. The cross-sectional results indicated that the primary determinants of bone mass were age and physical activity.     

钦水锶对大鼠骼生长发育影响的实验研究

研究了高锶饮水对大鼠骨骼生长发育的影响。结果表明，饮水中锶浓度为５－５００ｍｇ／Ｌ达１２周可引起Ｗｉｓｔａｒ大鼠血清、尿、股骨、颌骨和牙齿中锶含量增高，呈明显的剂量－反应关系。同时，锶还可使骨骼钙含量降低，牙齿钙含量和骨骼的骨密度增主同，以及除第１２周生大鼠外血清钙水平下降。     

饮水锶对大鼠骨骼生长发育影响的实验研究

研究了高锶饮水对大鼠骨骼生长发育的影响。结果表明，饮水中锶浓度为５～５００ｍｇ／Ｌ达１２周可引起Ｗｉｓｔａｒ大鼠血清、尿、股骨、颌骨和牙齿中锶含量增高，呈明显的剂量－反应关系。同时，锶还可使骨骼钙含量降低，牙齿钙含量和骨骼的骨密度增高，以及除第１２周雌性大鼠外血清钙水平下降。尚未发现锶对动物体重、体长、血清ＡＫＰ活性、尿钙水平以及股骨弯曲断裂载荷的影响。然而，锶对动物骨骼生长发育影响性别之间存在差异，如在第１２周染锶组雄性大鼠血清钙含量降低，而雌性大鼠升高；在第４周和第８周时，仅雄性大鼠尿Ｈｏｐ／Ｃｒ比值增高，而雌性大鼠维持于正常水平；Ｓｒ２＋还使雄性大鼠颌骨骨密度增加，而雌性大鼠股骨骨密度增加。上述改变提示可能是动物性别之间在内分泌调节和代谢过程上不同的结果。     

肌力和体力活动与骨密度关系研究进展

骨质疏松症是一种以低骨量和骨骼微结构退化为特征的骨骼疾病 ,会导致骨骼脆性增加、骨折危险性加大 ,严重威胁人类健康 ,近年来许多研究者从不同方面探索其致病因素 ,寻求预防和治疗骨质疏松症的途径。低骨密度是骨质疏松症重要的临床特征 ,本文就近年来肌力和体力活动与骨密度关系的研究状况作一综述     

饮水中的锶对学龄儿童发育的影响

就高锶饮水对学龄儿童的形体发育、骨龄发育、龋齿和氟斑牙患病率的影响进行了流行病学调查。调查结果表明，饮水中含锶量在１０ｍ ｇ／ Ｌ时对学龄儿童的骨龄发育，尤其是对女童骨龄发育有一定促进作用，对学龄儿童的形体发育没有明显的影响。饮水锶与儿童龋齿率的关系在调查结果中不十分明确，但锶的防龋齿作用有必要做进一步的流行病学调查来证实。     

Osteoporose – sind Prävention und Therapie durch Sport möglich?

Osteoporosis is a systemic disease of the skeleton with reduced bone mass and structural deterioration of the bone tissue, resulting in higher incidence of fractures. Effective prevention of osteoporosis can be expected through improved nutrition as well as increased physical activity. Weight-stressing physical activity is an essential prerequisite for healthy bones. Bone structure and bone tissue metabolism are determined by the individual genetic predisposition and the influence of endocrine and mechanical factors. It is so far unknown, which kind of stress has the strongest anabolic effects on bones in humans- increased intensity, frequency or duration of stress? According to experimental studies in animals it can be concluded, that stress should be dynamic, as intense, as frequent and as comprehensive as possible. Bone adjustment due to training is only possible, if endocrine factors and nutrition dependent parameters are in the normal range, and training is performed under consideration of individual capacity and of scientific principles. Regular physical activity has been established as an important part of therapeutic strategies. However, it is not yet proven, that bone mass can be increased by this. But therapeutic physical activity has additional positive effects which not only improve the quality of life, but also provide some protection against further fractures.     

An audit of current clinical practice in the management of osteoporosis in Nottingham

BACKGROUND: Osteoporosis is now recognized by the World Health Organization and the Department of Health as a major public health problem. In 1994, the Advisory Group on Osteoporosis (AGO), set up by the Department of Health, recommended that Health Authorities and general practitioner fundholders should purchase bone densitometry services for the management of osteoporosis. The aims of this study were to assess the criteria for requests for bone densitometry from primary care in comparison with the AGO recommendations and to compare the numbers of patients referred with a low-trauma osteoporotic fracture with the expected number of fractures in the Nottingham area. METHODS: Patient referral data and requests for bone densitometry were collected by case note review of all new patients referred to the Nottingham Osteoporosis Clinic over a 12 month period and then compared with the AGO recommendations. The patients referred with a history of a low-trauma fracture were then compared with the expected incidence of fractures, calculated using age-sex-specific fracture incidence data applied to the Nottingham population Census statistics. RESULTS: A total of 413 patients were referred to the Osteoporosis Clinic for bone densitometry. Almost two-thirds of the patients had no clinical indicators for requests for scanning, in comparison with the AGO recommendations. Seventy-seven patients were referred with vertebral fracture, 12 hip, 20 colles and 26 other fractures. Using age-sex-specific fracture incidence data applied to the Nottingham population Census statistics, it was estimated that the expected incidence of hip fractures would be 812, distal forearm fractures 514 and vertebral fractures presenting to clinical attention 625. This represents 1.5 per cent of the total hip fractures, 3.9 per cent distal forearm and 12.3 per cent vertebral actually presenting to the Osteoporosis Clinic. CONCLUSION: Bone densitometry was requested in up to 60 per cent of the patients with no clinical risk factors to warrant bone densitometry. Osteoporosis-related fractures remain unrecognized in clinical practice. The majority of patients do not receive specialist assessment despite being at high risk of future fracture. Further steps are necessary to educate health care professionals in primary and secondary care, but more importantly, to direct services more proactively in those at high risk of future fracture.     

Vitamin D and bone health: potential mechanisms

Osteoporosis is associated with increased morbidity, mortality and significant economic and health costs. Vitamin D is a secosteriod hormone essential for calcium absorption and bone mineralization which is positively associated with bone mineral density [BMD]. It is well-established that prolonged and severe vitamin D deficiency leads to rickets in children and osteomalacia in adults. Sub-optimal vitamin D status has been reported in many populations but it is a particular concern in older people; thus there is clearly a need for effective strategies to optimise bone health. A number of recent studies have suggested that the role of vitamin D in preventing fractures may be via its mediating effects on muscle function (a defect in muscle function is one of the classical signs of rickets) and inflammation. Studies have demonstrated that vitamin D supplementation can improve muscle strength which in turn contributes to a decrease in incidence of falls, one of the largest contributors to fracture incidence. Osteoporosis is often considered to be an inflammatory condition and pro-inflammatory cytokines have been associated with increased bone metabolism. The immunoregulatory mechanisms of vitamin D may thus modulate the effect of these cytokines on bone health and subsequent fracture risk. Vitamin D, therefore, may influence fracture risk via a number of different mechanisms.     

The silent thief: osteoporosis and women's health care across the life span

Osteoporosis is a skeletal disease characterized by loss of bone mass and density, which results in an increased risk of fractures. The disease is referred to as the "silent thief," because it is often not until a person falls and breaks a bone that patients and their physicians become aware of weakening bones. An estimated 1.5 million bone fractures occur each year in the United States and cost nearly dollar 17 billion in health care costs and lost productivity. The perception that osteoporosis is an older person's disease is an erroneous one. Osteoporosis does not discriminate by age; in fact, it is a geriatric disease with an adolescent onset. Social workers in health care and other practice settings working with female clients across the life span are in prime positions to influence patient outcomes and reduce health care costs by raising awareness of the risk factors and complex biopsychosocial aspects of this debilitating disease. This article presents social work interventions within the conceptual framework of primary, secondary, and tertiary disease prevention.     

骨质疏松症患者社区健康管理开展现状

骨质疏松症(Osteoporosis,OP)是一种以骨量减少、骨组织微观结构退化为基本特征的慢性非传染代谢性疾病。随着老龄化的不断加剧,骨质疏松症逐渐发展成为主要的健康问题之一。骨质疏松与人们的日常行为习惯、饮食营养结构等密切相关,将骨质疏松的预防和患者管理纳入社区健康管理的基本流程中来,是预防及管理骨质疏松的有效手段。本研究通过对国外中老年骨质疏松社区健康管理开展情况进行整理分析,对我国骨质疏松社区健康管理的主要内容及常见模式综述研究,以期为我国骨质疏松社区健康管理的进一步发展和完善提供理论依据和参考。