空勤人员前臂不同部位骨密度的调查

应用单光子骨密度仪（ＳＰＡ）测量１０５名男性空勤人员非优势侧前臂中远１／３，１／６，１／１０部位的骨密度（ＢＭＤ，ｇ／ｃｍ２），并与廊坊男性成人前臂远端相应的各部位骨密度测定值比较。结果表明，空勤人员前臂中远１／３，１／６，１／１０部位骨密度均低于或偏低于廊坊市区健康成人骨密度，其中１／３部位各年龄组桡尺骨骨密度差异具有非常显著性（Ｐ＜０．０１）；１／６部位各年龄组桡骨骨密度和≥３０岁组尺挠骨骨密度差异有显著性（Ｐ＜０．０５）；１／１０部位各年龄组桡尺骨骨密度差异无显著性（Ｐ＞０．０５）。所测空勤人员各部位桡尺骨骨密度随年龄增长，≥３０岁组骨密度略有增高，形成一个不明显的峰值骨量。     

体检人群脂肪性肝病前臂桡骨远端双能X线骨密度分析研究

目的 探讨脂肪肝与骨密度间的变化规律及关系。方法 选自2013年在我院进行B超检查和骨密度测量的体检人群,共计1014例。以B超诊断脂肪肝为标准：脂肪肝组469例,男性370例、女性99例;非脂肪肝组545例,男性282例、女性 263例。以BMI>25kg/m2及BMI <25 kg/m2为标准：肥胖组465例、男345例、女120例;非肥胖组549例,男307例、女242 例。年龄20 ~85岁,平均49. 8岁。按男、女性别,每十岁年龄段分为脂肪肝和非脂肪肝组、肥胖组和非肥胖组,分别计算各组、各年龄段骨密度和BMI。利用SPSS19. 0统计软件对数据进行处理分析,计量资料采用 方式表示,两变量间相关性采 用Pearson乘积-距相关分析,两组数据之间比较用独立样本T检验,P <0. 05为差异有统计学意义。结果 男性40-60岁, 女性40 -70岁脂肪肝组BMD高于非脂肪肝组BMD(P <0.05),脂肪肝组的骨量丢失低于非脂肪肝组;男性20 -70、女性30 -70脂肪肝组BMI高于非脂肪肝组BMI(P < 0. 05),由Pearson乘积-距相关分析,P <0. 0001,脂肪肝与肥胖之间存在的直线相关关系具有统计学意义,两者正相关;男性20 -60岁,女性40、50、70岁年龄段肥胖组BMD高于非肥胖组(P < 0. 05),肥胖组的骨量丢失低于非肥胖组;各组男女峰值骨量在30岁年龄段,40岁开始丢失,男性肥胖组峰值骨量高于非肥胖组(P < 0.05)。有统计学意义的男女各年龄段,脂肪肝组和肥胖组骨量减低发病率明显低于非脂肪肝组和非肥胖组。脂肪肝组和肥胖组发病率接近,非脂肪肝组和非肥胖组的发病率接近。结论 脂肪肝与骨密度间可能通过BMI存在一定的影响关系,BMI 对脂肪肝的影响明确,对骨密度的影响尚不明确,可能存在阈值,有必要进一步深人研究。     

1878例前臂尺桡骨远端骨密度与颈动脉粥样硬化的相关分析

目的探讨骨密度与颈动脉粥样硬化之间的关系。方法选自2013年1月至2016年6月,在我院进行前臂骨密度测量和同时做彩色多普勒颈动脉超声检查的体检人群,共计1878例。根据颈动脉内中膜厚度(intima-media thickness,IMT)超声诊断标准:分为动脉正常组587例,男性330例、女性257例;动脉硬化组1291例,男性912例、女性379例。年龄20~92岁,平均年龄52岁,其中男性53岁,女性49岁。按性别、每十岁年龄段一组,分别计算每一年龄段两组间骨密度进行统计学分析。利用SPSS19.0统计软件对数据进行处理分析,计量资料采用x珋±s方式表示,两组之间进行独立样本T检验,P0.05为差异有统计学意义。结果动脉正常组与动脉硬化组男、女性峰值骨量均出现在30至40岁之间;女性峰值骨量明显低于男性;50岁后女性骨量丢失高于男性;动脉硬化于40岁后明显增加,男性高于女性;男女动脉硬化组与颈动脉正常组之间骨密度值高、低比较均无统计学意义,P0.05。结论动脉硬化与骨质疏松症是与年龄相关的疾病,发病率都随年龄的增长而增加,两者彼此之间的作用机制和发病机理还需深入研究。     

非线性回归拟合正常人群前臂远端骨密度变化

目的采用非线性回归中的最大值函数拟合正常人群前臂远端骨密度（BMD）变化。方法用pDEXA OSTEOMETER DTX-200骨密度仪测量603例5～89岁健康人前臂远端的BMD，对BMD随年龄的变化趋势采用非线性回归模型拟合并与线性回归模型作比较；根据最大值函数回归模型方程，以极大值作为峰值BMD计算出峰值BMD时相应的年龄值以及BMD下降13％和25％时相应的年龄值。结果以方程的决定系数R^2来评价，非线性回归中最大值函数回归模型的拟合效果与线性回归模型中拟合效果最佳的三次回归模型相近。结论在BMD随年龄变化的研究中可试用非线性回归中的最大值函数进行拟合分析。     

长春市24831例前臂远端骨密度影响因素研究

目的研究年龄、性别、体重指数(BMI)、饮食、运动、吸烟、嗜酒、慢性胃炎、糖尿病、高血压、甲状腺机能亢进、父亲骨折病史、母亲骨折病史及女性生育、绝经等因素对骨密度(BMD)的影响。方法双能X线骨密度仪(pDXA)检测前臂远端BMD,用自制的问卷调查表记录受试者生活习惯、慢性病史及女性绝经、生育史等进行统计学分析。结果年龄、性别、体重、运动、饮食、吸烟、嗜酒、慢性胃炎、高血压病、甲状腺机能亢进及母亲骨折病史与BMD检测值相关,具有统计学意义;而父亲骨折病史、Ⅱ型糖尿病病史与BMD无关,女性绝经年限和生育次数与BMD呈明显负相关。结论吸烟、嗜酒、母亲骨折病史、慢性胃炎、甲状腺机能亢进、高血压病史及女性绝经、生育次数是OP的危险因素。运动、喝牛奶、吃海产品、体重指数是OP的可控因素。     

北京密云地区19609例正常人群前臂远端骨密度调查及骨质疏松症发病率研究分析

目的通过密云地区19609例正常人骨密度测量,分析本地峰值骨量、骨密度变化规律及骨质疏松症的发病率。为OP早期预防、诊断、治疗提供依据。方法采用美国Osteometer Medid Tech公司生产的DTX-200型前臂双能X线骨密度仪,检测受试者非受力侧前臂远端桡尺骨三分之一处骨密度(BMD)。将检测结果按性别,十岁为一年龄段分组。结果男女峰值骨量出现在30～39岁,男性0.626±0.078 g/cm2,女性0.507±0.063 g/cm2。男女峰值骨量之间进行独立的样本t检验P<0.05,存在着显著差异,女性明显低于男性峰值骨量,男女在40岁以后随年龄增长BMD逐渐下降,男性70岁,女性60岁以后下降明显,女性早于、快于男性。各年龄段前臂远端1/3处桡骨(RADIUS)BMD要高于尺骨(ULNA)、兴趣区的(ROI)BMD,这种趋势反映了前臂远端以桡骨为主要骨的BMD,与总的前臂远端BMD数据相差不多。各年龄段OP发生率随年龄增加而增加。结论密云地区男女峰值骨量出现在30～39岁,不同年龄,不同性别间骨密度存在显著差异。骨质疏松发生率与年龄的增长呈明显正相关性,患病率从50～59岁开始增加,女性高于男性。     

西安市区正常人群骨密度和峰值骨密度的调查

目的通过调查西安市区正常人群的骨密度(BMD)和峰值骨密度(PBD),从而为西安市区骨质疏松症的预防、诊断和治疗等工作提供一定的理论依据。方法随机选择564名年龄20～80岁的健康西安城市人群。男女性别均以10岁为一个年龄段分为6组,用双能X光骨密度仪(HolgicQDR-2000)测量骨密度。结果男性腰椎和髋部PBD值出现在30～岁,女性腰椎及髋部PBD值也出现在30～岁这一年龄段。结论男女性各部位PBD的形成大部分处于30～岁这个年龄段,并经过进一步的计算得出了西安市骨质疏松症的骨密度诊断参考值和低骨量干预参考值。     

中老年女性腰椎、髋部、前臂骨密度和骨质疏松检出率的对比分析

目的 探讨中老年女性在应用双能X线骨密度仪检测不同部位骨密度时应关注检测的部位。 方法 选取2012年9月至2014年4月在我院行双能骨密度检测的中老年女性,比较腰椎、髋部、前臂桡骨下1/3的骨密度（BMD）和T值。结果 中老年女性腰椎、髋部、前臂桡骨下1/3 3个部位的BMD和T评分比较,P<0.001有显著差异。随着年龄逐渐增大,腰椎、髋部和前臂BMD逐渐降低,但70岁以后腰椎BMD趋于平稳。腰椎T评分在40岁和50岁年龄段下降幅度较快,60岁以后下降有所减缓,70岁以后趋于平稳。髋部T评分在各年龄段呈匀速下降。前臂T评分随着年龄的增大下降幅度明显大于腰椎和髋部。骨质疏松检出率也随年增加而增加,重度骨质疏松检出率也以前臂为最高。结论 应用双能X线骨密度仪检测腰椎、髋部、前臂3个部位,经比较发现老年女性前臂骨密度和T评分明显低于腰椎和髋部,提示对老年女性骨质疏松诊断应同时检测前臂骨密度,以免出现骨质疏松的漏诊。     

北京市老年人腰椎与前臂骨密度的调查及相关分析

采用DEXA检查了北京市三个地区共625例60岁以上老年人腰椎与前臂的bone muneral densiny BMD)及骨质疏松患病率的情况．其中腰椎588例、前臂472例。女性腰椎BMD随年龄增高而逐渐递减(P＞0.05)；男性BMD与年龄无显相关(P＜0.05)。接年龄组比较，男性69岁。女性79岁“前．L1-4的BMD均由城区大于山区及平原。男性的骨质疏松患病率在各地区间无显性差异．女性则为城区小于平原及山区前臂BMD可不论男、女均与年龄呈负相关(P＜0.01)；60岁以后男性及女性BMD下降率最快的部位均为10%处。地区间同一年龄组BMD的比较：男性以10％部位最为敏感．均为城区大于平原；女性80岁以前．在UD及10%的部位敏感，为城区大于平原。骨质疏松的患病卑．男性各部位均为城区小于平原．女性在UD、33%两个部位为城区小于平原。在调查中发现，BMD较低的受试常伴有前瞥尺。桡骨远端长度变他，尺骨远端转桡骨远端长，形成一“台阶”样改变。经统计分析表明．“台阶”与UD部位BMD之间有显相关美系(P＜0．05)．骨质疏松(OP)试的“台阶”样变化比无OP受试的变化明显(P＜0.15)。作认为尺桡骨远端出现“台阶”样变化的原因可能是桡骨远端微小压缩骨折累积的结果。     

健康成人前臂不同部位骨密度的测定

健康成人前臂不同部位骨密度的测定姜杉，敖邦华，樊国锋，董立军，刘东红，虞至忠采用单光子吸收法测量骨密度通常都选取前臂中远１／３部位［１］。在我们对骨密度的测量中，选择了前臂中远１／３和１／６两个测量部位，以探索骨质疏松症诊治中更佳的测量部位和更好的检...     

京城区居民骨密度随年龄变化的特点--3285例骨密度测定结果分析

目的 了解北京城区居民骨密度(BMD)的变化规律和骨质疏松症(OP)的患病率.方法 应用法国MEDILINK公司牛产的OSTEOCORE1型双能X线骨密度仪对北京市城区3285名20～89岁人群进行股骨近端及腰L2-L4椎的BMD测定.结果 北京市城区男、女性人群的股骨近端及腰椎的BMD峰值均出现在20～29岁年龄组,峰值后随着年龄的增长骨密度BMD降低,女性在50～59岁BMD下降明显加速,男性没有出现下降加速现象.北京市城区中国人40岁以后OP患病率男性23.19%,女性OP患病率28.7%.结论 通过对北京市城区中国人群的BMD变化规律及患病率研究,为北京市城区中国人群的骨质疏松症预防、诊断及治疗提供客观有效的依据.     

Prediction of bone strength of distal forearm using radius bone mineral density and phalangeal speed of sound

This investigation compares quantitative ultrasound (QUS) measurement of the phalanges with peripheral quantitative computed tomography (pQCT) and dual X-ray absorptiometry (DXA) measurement of the forearm, to estimate the strength of the distal radius in 13 cadaveric forearms. The cadavers were scanned at the distal radius by pQCT and DXA for bone mineral density (BMD) and at the approximate phalanges by QUS for speed of sound (SOS). The distal radii were subjected to a simulated Colles fracture produced with a materials testing machine. The load at which the distal radius was fractured was considered as a representation of bone strength. The bone strength correlated significantly with SOS at different phalanges (r = 0.63-0.72), BMD at different regions of interest by DXA (r = 0.67-0.75), and cortical BMD at different sites by pQCT (r = 0.61-0.67). Standard stepwise regression analysis showed that adding phalangeal SOS into forearm densitometric variables significantly enhanced the statistical power for prediction of the strength of the distal radius. Our results suggest that, for assessment of site-specific distal forearm strength, QUS measurement of the phalanges is comparable to forearm densitometry. Phalangeal QUS may add clinical value if distal forearm strength has a high priority.     

The changes in bone mineral density of the forearm and distal radius–ulna subcortical bone due to ulnar variance

The aim of this study was to evaluate the changes in subcortical bone mineralization of the distal radius and ulna in the presence of negative ulnar variance. A total of 77 healthy right hand-dominant volunteers [34 women and 43 men of mean age 38 ± 14.8 years (range 14–71)] were enrolled in this study. Bilateral bone mineral density (BMD) and bone mineral density ratio (BMDR) measurements of the distal radius and ulna were performed by using dual energy X-ray absorptiometry. We found a significant decrease of ulnar subcortical BMD and BMDR subcortical in the dominant forearms of the subjects with negative ulnar variance when compared to that of subjects with neutral ulnar variance (P < 0.02). But this difference was not seen on the non-dominant side. There was no significant difference in BMDRs between the dominant and non-dominant forearms for all subjects. Radial and ulnar subcortical BMD values were significantly different between dominant and non-dominant forearms in subjects with bilateral neutral ulnar variance, whereas not significantly different in subjects with bilateral negative ulnar variance. The increase found in the BMD value of radial subcortical bone in subjects with negative ulnar variance may be due to the indirect shift of axial forces through the ulna to radius.     

Physical training preserves bone mineral density in postmenopausal women with forearm fractures and low bone mineral density

Summary One hundred and twelve postmenopausal women with low bone mineral density (BMD) and forearm fractures were randomized to physical training or control group. After one year the total hip BMD was significantly higher in the women in the physical training group. The results indicate a positive effect of physical training on BMD in postmenopausal women with low BMD. Introduction The fivefold increase in hip fracture incidence since 1950 in Sweden may partially be due to an increasingly sedentary lifestyle. Our hypothesis was that physical training can prevent bone loss in postmenopausal women. Methods One hundred and twelve postmenopausal women 45 to 65 years with forearm fractures and T-scores from −1.0 to −3.0 were randomized to either a physical training or control group. Training included three fast 30-minute walks and two sessions of one-hour training per week. Bone mineral density (BMD) was measured in the hip and the lumbar spine at baseline and after one year. Results A per protocol analysis was performed, including 48 subjects in the training group and 44 subjects in the control group. The total hip BMD increased in the training group +0.005 g/cm2 (±0.018), +0.58%, while it decreased −0.003 g/cm2 (±0.019), −0.36%, (p = 0.041) in the control group. No significant effects of physical training were seen in the lumbar spine. A sensitivity intention to treat analysis, including all randomized subjects, showed no significant effect of physical training on BMD at any site. Conclusions The results indicate a small but positive effect of physical exercise on hip BMD in postmenopausal women with low BMD.     

Low calcaneal bone mineral density and the risk of distal forearm fracture in women and men: A population-based case-control study

ObjectiveWe used dual X-ray absorptiometry (DXA) to measure calcaneal bone mineral density (BMD) and estimate the prevalence of osteoporosis in a population with distal forearm fracture and a normative cohort.MethodsPatients 20 to 80 years of age with distal forearm fracture treated at one emergency hospital during two consecutive years were invited to calcaneal BMD measurement; 270 women (81%) and 64 men (73%) participated. A DXA heel scanner estimated BMD (g/cm²) and T-scores. Osteoporosis was defined as T-score ≤? 2.5 SD. Of the fracture cohort, 254 women aged 40–80 years and 27 men aged 60–80 years were compared with population-based control cohorts comprising 171 women in the age groups 50, 60, 70 and 80 years and 75 men in the age groups 60, 70, and 80 years.ResultsIn the fracture population no woman below 40 years or man below 60 years of age had osteoporosis. In women aged 40–80 years the prevalence of osteoporosis in the distal forearm fracture cohort was 34% and in the population-based controls was 25%; the age-adjusted prevalence ratio (PR) was 1.32 (95% CI 1.00–1.76). In the subgroup of women aged 60–80 years the age-adjusted prevalence ratio of osteoporosis was 1.28 (95% CI 0.95–1.71). In men aged 60–80 years the prevalence of osteoporosis in the fracture cohort was 44% and in the population-based controls was 8% (PR 6.31, 95% CI 2.78–14.4). The age-adjusted odds ratio for fracture associated with a 1-SD reduction in calcaneal BMD was in women aged 40–80 years 1.4 (95% CI 1.1–1.8), in the subgroup of women aged 60–80 years 1.2 (95% CI 0.95–1.6), and in men aged 60–80 years 2.6 (95% CI 1.7–4.1). Among those aged 60–80 years the area under the ROC curve was in women 0.56 (95% CI 0.49–0.63) and in men 0.80 (95% CI 0.70–0.80).ConclusionsThe age-adjusted prevalence of osteoporosis based on calcaneal BMD is higher in individuals with distal forearm fracture than in population-based controls. BMD impairment is associated with increased odds ratio for forearm fracture in both women and men but the differences between cases and controls are more pronounced in men than in women, which may have implications in fracture prevention.     

Peripheral bone mineral density in patients with distal radial fractures

Fractures of the distal forearm are widely regarded as the result of "fragility". We have examined the extent to which patients with Colles' fractures have osteopenia. We measured the bone mineral density (BMD) in the contralateral radius of 235 women presenting with Colles' fractures over a period of two years. While women of all ages had low values for ultra-distal BMD, the values, in age-matched terms, were particularly low among premenopausal women aged less than 45 years. This result was not due to the presence of women with an early menopause. This large survey confirms and extends the findings from earlier small studies. We consider that it is particularly important to investigate young patients with fractures of the distal forearm to identify those with osteoporosis, to seek an underlying cause and to consider treatment.