Effects of alendronate and risedronate on bone mineral density and bone turnover markers in late postmenopausal women with osteoporosis

This study was undertaken to compare the effects of alendronate and risedronate on bone mineral density (BMD) and bone turnover markers (BTMs) in late postmenopausal women with osteoporosis. Thirty women older than 60 y of age were randomly assigned to receive alendronate 10 mg (n=16) or risedronate 5 mg (n=14) on a daily basis. The patients were followed every 3 mo for 12 mo. BMD measurements were taken at baseline and at the end of the study, and BTMs were measured at 3-mo intervals. By the end of the study, there were statistically significant increases in BMD in both groups at all sites at which they were measured (P < .001). However, these differences were not statistically significant between groups. By the end of the study, all BTMs had decreased significantly and to a similar extent in both groups. The most significant change was observed in the third month of the study. A negative correlation was noted between percentage change in bonespecific alkaline phosphatase and femoral neck BMD (r=-0.467). This study reported no difference between the 2 drugs in their effects on BMD and BTMs.     

Relation between homocysteine and biochemical bone turnover markers and bone mineral density in peri- and post-menopausal women.

Background: Recently, increased plasma homocysteine (Hcy) has been suggested as an independent risk factor for osteoporotic fractures. Therefore, it is tempting to speculate that Hcy adversely affects bone metabolism. This study aimed to analyze the relation between Hcy and biochemical markers of bone metabolism and bone mineral density (BMD). Materials and methods: We investigated 143 peri- and post-menopausal women [median age (25th-75th percentile), 67 (57-75) years]. All subjects underwent a detailed medical examination, measurement of bone mineral density at lumbar spine (BMD-LS) and total hip (BMD-HIP), and fasting venous blood and urine sampling. Osteocalcin (OC), serum calcium (Ca), urinary desoxypyridinoline cross-links (DPD), osteoprotegerin (OPG) and soluble receptor activator of NF-kappaB ligand (sRANKL) were studied. Results: According to BMD subjects were classified as normal (n=24), osteopenic (n=51) or osteoporotic (n=68). Median Hcy did not differ between normal, osteopenic and osteoporotic subjects (p=0.647). Partial correlation analysis, controlling for the major confounders, age, creatinine, menopause and previous fractures, revealed significant correlations between Hcy and DPD (r=0.193, p=0.022), as well as between Hcy and Ca (r=0.170, p=0.045). After adjustment for the same confounders, subsequent regression analysis confirmed significant associations of Hcy with DPD and Ca. No significant relations could be observed between Hcy and BMD-LS, BMD-HIP, OC, OPG or sRANKL. Conclusion: Our results demonstrate weak, but significant, relations between Hcy and markers of organic and inorganic bone resorption, suggesting a mechanistic role of Hcy in bone metabolism. The relation between Hcy and bone resorption was not dependent on OPG or sRANKL.     

辛伐他汀对糖尿病性骨质疏松患者骨密度和骨转换的影响

INTRODUCrION Many basic and clinical experiments showed that drugs of statinsmight stimulate proliferation and differentiation of osteoblast andmight be used as an effective drug to treat osteoporosis. We usedsimvastatin (one kind of drugs of statins) to treat cases with dia-betic osteoporosis for 3 months, observed and compared each indexbefore and after treatment in order to observe its effects on boneformation.     

Utility of biochemical markers of bone turnover and bone mineral density in management of osteoporosis

Biochemical markers of bone turnover (bone-turnover markers) are released during bone formation or resorption and can be measured in blood and/or urine. The concentration of bone-turnover markers in serum or urine reflect bone remodeling activity and can potentially be used as surrogate markers of the rate of bone formation or bone resorption. While the diagnosis of osteoporosis is based on bone mineral density (BMD), the absolute fracture risk for a particular BMD measurement varies several fold depending on age and is also influenced by other clinical risk factors. The measurement of bone-turnover markers may be of additional value to BMD and clinical risk factors in fracture risk assessment by improving the sensitivity and specificity of prediction of future fractures. In clinical practice, bone-turnover markers may help make cost-effective treatment decisions in patients with borderline absolute risk. BMD changes following treatment cannot be detected with confidence for 12-24 months due to measurement imprecision. Bone-turnover markers, which show an early response following treatment, may be useful for monitoring therapy, identifying non-compliance and non-responders, and predicting early response to therapy. This review concludes by identifying the need for internationally agreed-upon standards for bone resorption and formation.     

阿仑膦酸钠对中老年骨质疏松症患者骨密度的影响

背景阿仑膦酸钠是近来所采用的一种试图通过抑制破骨细胞来治疗骨质疏松症的药物,其效果与单纯补钙有何差异,尚待进一步观察.目的观察口服阿仑膦酸钠片对中老年骨质疏松症症状及骨密度的影响,并与葡萄糖酸钙口服液的干预效果比较.设计随机分组,采用自身对照及同期实验对照.单位北京大学深圳医院骨科.对象病例来源于1999-07/2001-07在北京大学深圳医院骨科门诊就诊的中老年骨质疏松症患者68例,选择年龄45岁以上,并排除继发性骨质疏松症患者,有62例患者纳入本次实验,用随机数字法随机分为治疗组(口服阿仑膦酸钠片)32例和对照组(口服葡萄糖酸钙口服液)30例.干预在综合治疗的基础上,治疗组每天给予阿仑膦酸钠片10 mg,对照组给予葡萄糖酸钙口服液,2支/次(每支约含葡萄糖酸钙100 mg,相当于钙9 mg),3次/d,两组疗程均为3个月.根据躯体疼痛改善情况、有无新的骨折发生及骨密度改善情况,分3级进行判定.主要观察指标①两组治疗前后骨密度值比较.②两组疗效比较.③两组不良反应和副作用比较.结果治疗组30例和对照组26例的观察结果纳入分析.①两组治疗前后骨密度值比较治疗组用药3个月,患者的骨密度明显上升,治疗前后比较,差异有显著性意义[(0.667±0.083)和(0.716±0.082)g/cm2;t=2.473,P＜0.01];对照组骨密度治疗前后比较,差异无显著性意义[(0.671±0.081)和(0.680±0.073)g/cm2;t=1.812,P＞0.05];两组治疗后比较,差异有显著性意义(t=2.384,P＜0.01).②两组疗效比较治疗组有效率高于对照组,差异有显著性意义(X2=14.9,P=0.005).③两组不良反应和副作用比较治疗组服药期间有7例患者轻度腹部不适,对照组无任何不良反应.结论阿仑膦酸钠片不仅能抑制骨的吸收,还能促进骨质恢复,增加骨量,可协助治疗中老年骨质疏松症,其疗效较单纯的葡萄糖酸钙口服液好.     

阿仑膦酸钠对中老年骨质疏松症患者骨密度的影响

背景：阿仑膦酸钠是近来所采用的一种试图通过抑制破骨细胞来治疗骨质疏松症的药物,其效果与单纯补钙有何差异,尚待进一步观察.目的：观察口服阿仑膦酸钠片对中老年骨质疏松症症状及骨密度的影响,并与葡萄糖酸钙口服液的干预效果比较.设计：随机分组,采用自身对照及同期实验对照.单位：北京大学深圳医院骨科.对象：病例来源于1999-07/2001-07在北京大学深圳医院骨科门诊就诊的中老年骨质疏松症患者68例,选择年龄45岁以上,并排除继发性骨质疏松症患者,有62例患者纳入本次实验,用随机数字法随机分为治疗组（口服阿仑膦酸钠片）32例和对照组（口服葡萄糖酸钙口服液）30例.干预：在综合治疗的基础上,治疗组每天给予阿仑膦酸钠片10 mg,对照组给予葡萄糖酸钙口服液,2支/次（每支约含葡萄糖酸钙100 mg,相当于钙9 mg）,3次/d,两组疗程均为3个月.根据躯体疼痛改善情况、有无新的骨折发生及骨密度改善情况,分3级进行判定.主要观察指标：①两组治疗前后骨密度值比较.②两组疗效比较.③两组不良反应和副作用比较.结果：治疗组30例和对照组26例的观察结果纳入分析.①两组治疗前后骨密度值比较：治疗组用药3个月,患者的骨密度明显上升,治疗前后比较,差异有显著性意义[（0.667&;#177;0.083）和（0.716&;#177;0.082）g/cm^2;t=2.473,P＜0.01];对照组骨密度治疗前后比较,差异无显著性意义[（0.671&;#177;0.081）和（0.680&;#177;0.073）g/cm^2;t=1.812,P＞0.05];两组治疗后比较,差异有显著性意义（t=2.384,P＜0.01）.②两组疗效比较：治疗组有效率高于对照组,差异有显著性意义（X^2=14.9,P=0.005）.③两组不良反应和副作用比较：治疗组服药期间有7例患者轻度腹部不适,对照组无任何不良反应.结论：阿仑膦酸钠片不仅能抑制骨的吸收,还能促进骨质恢复,增加骨量,可协助治疗中老年骨质疏松症,其疗效较单纯的葡萄糖酸钙口服液好.     

Biomarkers of bone turnover and bone mineral density in hyperprolactinemic amenorrheic women.

We tested the hypothesis that biomarkers of bone resorption are increased in hyperprolactinemic amenorrheic patients with estrogen (E) deficiency, augmenting the possible risk of developing osteoporosis. Fifty hyperprolactinemic patients with amenorrhea of more than 12 months and with low serum E2, as well as 30 healthy fertile women (controls), matched for age and body mass index, participated in this study. Bromocriptine was administered orally to hyperprolactinemic patients and blood and urine samples were collected before and 12 weeks after treatment. Serum osteocalcin (OC) and bone-specific alkaline phosphatase (B-ALP), reflecting bone formation, and urinary deoxypridinoline (D-Pyr) and N-telopeptide of type 1 collagen (NTX) excretion, reflecting bone resorption, were measured using direct immunoassays. Hyperprolactinemic patients had higher (p < 0.0005) levels of all the biomarkers compared to control values: (OC, 22+/-1.2 [SE] vs. 14+/-.99 ng/ml (+57 %); B-ALP, 14.2+/-0.7 vs. 7.5+/-0.8 ng/ml (+89 %); D-Pyr, 8.8+/-0.6 vs. 3.2+/-0.3 nmol/mmol creatinine (+175%) and NTX, 65+/-5.1 vs. 25+/-3.2 nmol bone collagen equivalent (BCE)/mmol creatinine (+160%)). These results were associated with significantly decreased lumbar spine bone mineral density (LS-BMD), measured by dual energy X-ray absorptiometry (DEXA). Treatment of hyperprolactinemia with bromocriptine restored normal values of bone formation and resorption markers. In conclusion, hyperprolactinemia with estrogen deficiency exhibits a significant increase of bone resorption which is associated with a significant decrease of LS-BMD. These changes may subject the patient to the possible risk of developing osteoporosis.     

Effect of alendronate on bone mineral density and biochemical markers of bone turnover in type 2 diabetic women: the fracture intervention trial

OBJECTIVE: Alendronate sodium (ALN) increases bone mineral density (BMD) in heterogeneous populations of postmenopausal women, but its effect is unknown in women with type 2 diabetes. The objective of this project was to compare changes in BMD during 3 years of ALN treatment versus placebo in diabetic women. RESEARCH DESIGN AND METHODS: We used data from the Fracture Intervention Trial, a randomized blinded placebo-controlled trial conducted at 11 centers in which 6458 women aged 54-81 years with a femoral neck BMD of or=200 mg/dl. RESULTS: In diabetic women, 3 years of ALN treatment was associated with increased BMD at all sites studied, including 6.6% at the lumbar spine and 2.4% at the hip, whereas women in the placebo group experienced a decrease in BMD at all sites except the lumbar spine. The safety/tolerability of ALN was similar to placebo, except for abdominal pain, which was more likely in the ALN group. CONCLUSIONS: ALN increased BMD relative to placebo in older women with type 2 diabetes and was generally well tolerated as a treatment for osteoporosis. Increases in BMD with ALN therapy compared with placebo were similar between women with and without diabetes.     

Serum osteopontin levels in relation to bone mineral density and bone turnover markers in postmenopausal women

Osteopontin (OPN) is an extracellular matrix protein that is expressed in bone cells such as osteoblast and osteocytes and associated with bone turnover and bone mineral density (BMD) in postmenopausal women. Here, we aimed to investigate the relationship between circulating OPN levels and BMD in postmenopausal women in Southern China. A total of 362 postmenopausal women were consecutively recruited into this study from 2011–2013. Serum levels of OPN, receptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL), and bone turnover markers were analyzed. BMD was measured by dual energy X-ray absorptiometry. Osteoporosis and osteopenia were diagnosed according to the World Health Organization criteria. Serum OPN levels were remarkably higher in the osteoporotic group than those in the osteopenic and normal groups (all p?r?=??0.25, p?=?0.004; r?=??0.66, p?r?=??0.28, p?=?0.001; respectively) and positively associated with type I procollagen amino-terminal propeptide (PINP), carboxy-terminal cross-linking telopeptide of type I collagen (CTX), and RANKL (r?=?0.20, p?=?0.020; r?=?0.17, p?=?0.036; r?=?0.19, p?=?0.028, respectively) in the osteoporotic group. In multiple regression analyses, lumbar spine BMD, PTH and RANKL were the predictors for serum OPN levels. In conclusion, OPN serum levels are negatively related to BMD and positively correlated with bone turnover levels in this group of Chinese postmenopausal women.     

骨转换指标和骨密度预测骨折危险性的可行性

背景:骨密度虽然可以诊断骨质疏松,但不能及时反映受试者正在发生的骨代谢情况:骨转换指标虽然不能诊断骨质疏松,但它可以及时反映受试个体正在发生的骨转换速率.目的:概述骨转换指标和骨密度预测骨质疏松症的骨折危险性,从理论上分析,骨折术后愈合与否的预测方法的可行性.方法:以bone tunrnover,biochemical marker,osteoporosis为检索词,检索Pubmed数据库(1999-01/2009-01);以骨转换,骨代谢,生化标志物,骨密度,骨质疏松,骨折为检索词,检索CNKI数据库(1999-01/2009-01).文献检索语种限制为英文和中文.纳入与骨转换指标和骨密度预测骨折危险性的研究紧密相关的文章;排除重复文献.结果与结论:计算机初检得到631篇文献,根据纳入排除标准,对其中31篇文献进行分析.骨质疏松症是老年人发病及死亡的主要原因之一,早期预测骨质疏松症的骨折危险性意义重大.文章介绍了长期制动后的骨代谢机制、骨生化标志物种类、骨密度测量、多细胞基本单位和OPG-RANKL-RANK系统在骨重建中的作用;重点介绍了国内外学者运用骨转换指标和骨密度预测骨质疏松症和长期制动后的骨折危险性,从理论上分析骨折术后愈合与否的预测方法的可行性.     

2型糖尿病女性患者骨密度与骨转换率的相关性

目的探讨2型糖尿病(T2DM)女性患者骨密度与骨转换及骨重建的相关性。方法回顾性分析纳入在南方医科大学第三附属医院内分泌科住院的201例T2DM女性患者住院期间的临床数据,采用双能X线骨密度仪,测量骨密度,包括腰椎、左侧股骨颈和髋部总体,将纳入对象分为骨量正常组85例(T>-1)、骨量减少组87例(-2.5 < T < -1)和骨质疏松组29例(T < -2.5),检测骨钙素N端中分子片段和β-Ⅰ型胶原C-末端交联分别评估骨形成和骨吸收。根据骨形成和骨吸收的T值分别计算骨转换率和骨重建率,比较T2DM患者骨质疏松组和骨量正常组患者的的骨转换率T值以及骨重建率T值的差异,并评估T2DM女性患者骨转换率T值和骨重建率T值与骨密度之间的相关性。结果T2DM女性患者骨质疏松组的骨转换率T值与T2DM女性患者骨量正常组的骨转换率T值差异有统计学意义(P=0.041),T2DM女性患者骨转换率T值与髋部骨密度负相关(r=-0.14,P =0.049)。校正糖化血红蛋白后,T2DM女性患者骨转换T值与髋部仍呈骨密度负相关(r=-0.144,P=0.043)。结论在T2DM女性患者中,随着骨转换率的增高,患者骨密度越低,并发低创伤性骨折的风险也会随之增高。     

Bone mineral density and bone turnover in postmenopausal women treated for breast cancer

Chemotherapy and endocrine treatments for breast cancer are believed to increase risk of osteoporosis by causing early menopause in premenopausal women and by further depleting estrogen levels in postmenopausal women. Multivariate analyses were used to evaluate the contributions of 7 predictors (age, body mass index [BMI], family history of osteoporosis, months since menopause, past use of chemotherapy, and current use of tamoxifen or aromatase inhibitors) in explaining variability in bone mineral density (BMD) at the hip and the spine and bone turnover in 249 postmenopausal women who are breast cancer survivors. This report was an analysis of baseline data from a federally funded (1 R01 NR07743-01A1) intervention study on osteoporosis prevention. Mean age of the women was 58.5 years, and average BMI was 26.7 kg/m; 98% were white. All had measurable bone loss, 167 had chemotherapy, 76 were on tamoxifen, and 21 were on aromatase inhibitors. Women with higher BMI had higher BMD at the hip (P < .001) and the spine (P = .004). Women on tamoxifen had lower measures of bone formation (Alkphase B) (P < .001), suggesting less bone turnover, and higher BMD at the hip (P = .035). There was a trend for women who had received chemotherapy to have lower BMD at the spine (P = .06). The implications of these findings are discussed in the article.     

Pamidronate increases bone mineral density in women with postmenopausal or steroid-induced osteoporosis

INTRODUCTION: We aimed to determine the efficacy and safety of a cyclic intravenous therapy with pamidronate in patients with postmenopausal or glucocorticoid-induced osteoporosis. METHODS: We enrolled 86 Austrian female patients with postmenopausal (n = 69, mean age 68.13 +/- 1.14) or glucocorticoid-induced (n = 17, mean age 66.89 +/- 2.03) osteoporosis defined as a T-score of < -2.5 for bone mineral density (BMD) of the lumbar spine L1-L4. Patients received a single intravenous dose of 30 mg pamidronate at 3 months intervals. The per cent change in BMD was primary, whereas the safety and the biological response were secondary endpoints. RESULTS: Seventy-six female patients (88%) completed study. Sixty patients received pamidronate therapy for the treatment of late postmenopausal osteoporosis and 16 patients received the same treatment for glucocorticoid-induced osteoporosis. At the end of the trial, lumbar spine (L1-L4) BMD increased significantly in patients with postmenopausal osteoporosis (P = 0.000067), whereas in patients with glucocorticoid-induced osteoporosis no significant change was observed (P = 0.724). The increase in the Ward's triangle BMD did not reach significance level in postmenopausal women receiving pamidronate (P = 0.0740). However, pamidronate treatment for glucocorticoid-induced osteoporosis resulted in a significant increase in Ward's triangle BMD (P = 0.0029). The efficacy of pamidronate treatment for postmenopausal osteoporosis was also reflected in a decrease in circulating biochemical markers for bone formation, including alkaline phosphatase and osteocalcin. In addition, pamidronate was well tolerated with no incidence of severe gastrointestinal events. CONCLUSION: Cyclic intravenous administration of pamidronate is well-tolerated therapy in postmenopausal osteoporosis, and increases spinal BMD. Randomized controlled studies with adequate number of patients are needed to test the efficacy of the compound in the treatment of glucocorticoid-induced osteoporosis.     

Comparison of clinical efficacy and safety between denosumab and alendronate in postmenopausal women with osteoporosis: a meta-analysis

The aim of this study was to perform a head-to-head comparison of efficacy and safety profile between 60 mg denosumab (Den) subcutaneously (SC) per 6 months (Q6M) and 70 mg alendronate (Aln) orally per week (QW) for postmenopausal women with low bone mineral density. We searched electronic databases comparing efficacy and safety of Den SC Q6M and Aln QW in postmenopausal women. The primary outcomes of efficacy evaluation in included trials were incidence of clinical fracture in both groups and bone mineral density (BMD) at different skeletal sites. And adverse events (AEs), including incidence of neoplasms and infections, were considered as secondary outcomes. Following the instructions of 'Cochrane Handbook for systematic Reviews of Interventions 5.0.2', we identified eligible studies, evaluated the methodological quality and abstracted relevant data. Four heterogeneous randomised controlled trials (RCTs) involving 1942 women were identified. The results of review showed low evidence quality that supported the hypothesis the denosumab vs. alendronate could reduce risk of fracture [OR (95% CI) 1.42 (0.84 to 2.40), 11 more women per 1000 (from 4 fewer to 36 more), p = 0.19] but the moderate to high quality evidence suggesting treatment with 60 mg Den SC Q6M was more effective for postmenopausal women in increasing BMD [at distal radius (DR), total hip (TH), lumbar spine (LS), and femoral neck (FN)]. Hazards of neoplasms [OR (95% CI) 1.10 (0.65 to 1.86), 3 more per 1000 (from 10 fewer to 24 more), p = 0.62] or infections [OR (95% CI) 0.95 (0.79 to 1.15), 12 fewer per 1000 (from 53 fewer to 33 more,), p = 0.62] were appeared to be similar.Our review suggested within 1 year 60 mg Den SC Q6M treatment was more effective in increasing bone mass but could not reduce the fracture risk to a greater extent than 70 mg Aln QW therapy. Also the Den SC Q6M therapy did not increase the risks of neoplasms and infections compared with Aln QW.     

A comparison of the effect of alendronate and risedronate on bone mineral density in postmenopausal women with osteoporosis: 24-month results from FACTS-International

Objectives: To compare alendronate 70 mg once weekly (OW) with risedronate 35 mg OW with respect to change in bone mineral density (BMD), biochemical markers and upper gastrointestinal (UGI) tolerability over 24 months. Methods: This was a 12‐month extension to the Fosamax^® Actonel^® Comparison Trial international study (FACTS). Postmenopausal women with osteoporosis randomly assigned to either alendronate 70 mg OW or risedronate 35 mg OW for the 12‐month base study continued taking the same double‐blind study medication. Efficacy measurements were BMD at the hip trochanter, lumbar spine, total hip, and femoral neck and levels of four bone turnover markers at 24 months. The primary hypothesis was that alendronate would produce a greater mean per cent increase from baseline in hip trochanter BMD at 24 months. Results: Trochanter BMD increased significantly from baseline to month 24 in both groups, with a significantly larger increase with alendronate: adjusted mean treatment difference of 1.50% (95% confidence interval: 0.74%, 2.26%; p < 0.001). Similar results were seen at all BMD sites. Significant geometric mean per cent decreases (p < 0.001) from baseline were seen for all four bone turnover markers in both groups, with significantly larger decreases (p < 0.001) with alendronate: adjusted mean treatment differences ranged from 8.9% to 25.3%. No significant differences were seen in incidence of UGI or other adverse events. Conclusions: Alendronate 70 mg OW yielded significantly greater BMD gains and larger decreases in bone turnover marker levels than risedronate 35 mg OW over 24 months, with no difference in UGI tolerability.     

The effect of different doses of calcitonin on bone mineral density and fracture risk in postmenopausal osteoporosis

A total of 107 patients were included in the study to determine the effects of different doses of intranasal calcitonin on bone mineral density and fracture risk in postmenopausal osteoporosis. Patients were randomly divided into three groups. All three groups were given 1000 mg/day calcium and vitamin D in adequate doses. Two of the groups, the exception being the placebo group, were also given either 50 IU or 100 IU of calcitonin. The data of 81 patients who completed the 24 months of regular study treatment and controls were evaluated. When compared, both of the calcitonin groups were superior to the placebo group regarding increase in bone mineral density and decrease in fracture rate.     

The roles of bone mineral density, bone turnover, and other properties in reducing fracture risk during antiresorptive therapy

Osteoporosis is a skeletal disorder characterized by compromised bone strength and increased risk of fracture. Properties related to bone strength include rate of bone turnover, bone mineral density, geometry, microarchitecture, and mean degree of mineralization. These properties (with or without bone density) are sometimes collectively referred to as bone quality. Antiresorptive agents may reduce fracture risk by several separate but interrelated effects on these individual properties. For example, antiresorptive agents have been reported to reduce bone turnover, stabilize or increase bone density, preserve or improve microarchitecture, reduce the number or size of resorption sites, and improve mineralization. Although changes in bone architecture and mineralization are not currently measurable in clinical practice, bone turnover is assessed easily in vivo and affects the other bone properties. Moreover, antiresorptive therapies that produce larger decreases in bone turnover markers together with larger increases in bone mineral density are associated with greater reductions in fracture risk, especially at sites primarily composed of cortical bone such as the hip. Reductions in fracture risk are the most convincing evidence of good bone quality. Data from well-designed randomized clinical trials with up to 10 years of continuous antiresorptive therapy have shown that certain antiresorptive agents effectively reduce fracture risk and (together with extensive preclinical data) suggest no deleterious effects on bone quality.     

长沙地区女性促卵泡刺激素水平与骨密度和骨质疏松患病率的关系

目的:调查中国女性年龄相关的血清促卵泡刺激素浓度及其与骨密度和骨质疏松症患病率之间的关系.方法:于2007-06/2008-06选择自长沙和附近地区20～82岁699名健康的中国女性,排除患有影响骨代谢疾病、服用影响骨代谢药物的个体.其中绝经前妇女464名和绝经后妇女235名,绝经年龄为41～59岁.受试者均知情同意并签定了书面协议书.抽空腹静脉血测定血清卵泡刺激素和黄体生成素浓度.用DXA仪测定腰椎、总髋部、前臂超远端骨密度,评价血清促卵泡刺激素与年龄、骨密度和患骨质疏松症风险的关系.结果:促卵泡刺激素约从40岁起随增龄而增加,到60岁又随增龄而下降.促卵泡刺激素与不同部位骨骼的骨密度呈显著负相关.在腰椎、总髋部、前臂超远端,促卵泡刺激素四分位数的骨质疏松症平均患病率分别为0.57%,0.43%,27.1%,30.9%.与一分位数和二分位数比较,四分位数的妇女骨质疏松症患病率和患病风险显著增加;与三分位数比较,处于四分位数的妇女骨质疏松症患病率和患病风险也显著增加,特别是在腰椎.结论:血清促卵泡刺激素水平与骨密度的变化呈负相关,和骨质疏松症的发生呈正相关.