体育锻炼及烟酒爱好对青壮年男性骨密度影响的初步调查

目的探讨体育锻炼及烟酒爱好对青壮年男性骨密度（bone mineral density,BMD）的影响。方法选择体重指数（body mass index,BMI）在正常值以上的314例健康青壮年男性,采用记分法调查其对体育锻炼及烟酒爱好程度,利用双能X线骨密度仪（DEXA）测量正位腰椎（L1-4）以及左侧股骨颈（Neck）、股骨粗隆（Troch）、沃氏（Wards）区BMD,分3个年龄组对各区域BMD进行逐步法线性回归分析。结果3个年龄组内年龄、BMI均未被纳入回归方程;体育锻炼与3个年龄组受检者左侧Neck、Troch、Wards区的BMD正性相关（b值在0.052～0.079之间,P值在0.000～0.043之间）;饮酒爱好与31～40、41～50岁两个年龄组的Neck、Troch、Wards区BMD负性相关（b在-0.068～-0.076之间,P值在0.000～0.003之间）;吸烟与41～50岁年龄组L1～4及Neck、Troch、Wards区的BMD均负性相关（b在-0.047～-0.053之间,P值在0.008～0.015之间）。结论体育锻炼有利于维持青壮年男性骨量,过量饮酒和吸烟会加速骨量丢失,尤其对髋部骨量影响较大。随着年龄增长,过量饮酒对髋部BMD的影响有逐渐成为主导因素的趋势。     

新编五禽戏练习对老年女性平衡能力和骨密度的影响

目的探讨有规律的五禽戏练习对老年女性平衡能力和骨密度(bone mineral density, BMD)的影响,为运动健身预防老年人跌倒、提升骨密度提供依据。方法根据年龄、身高、体重的情况分为实验组(n=36)和对照组(n=35),进行静态、动态平衡能力测试,腰椎以及优势侧股骨近端BMD测试。实验组进行为期24周(4次/周,70 min/次)的新编五禽戏练习。结果 24周实验组相比对照组:①静态平衡的左右方向开、闭眼压力中心移动距离显著缩短12.3%和13.1%(P0.05),左右方向闭眼压力中心移动速度显著降低12.9%(P0.05),开、闭眼单脚站立时间显著增加32.5%和49.4%(P0.01)。动态平衡的左右方向移动速度显著降低21.8%(P0.01)。静态和动态前后方向各项指标无统计学意义(P0.05);②腰椎L_(2～4)(增加6.8%)、大转子、Ward三角和股骨颈BMD虽不同程度增加但无显著变化(P0.05)。结论 24周五禽戏练习显著提高了老年女性左右方向静态和动态平衡能力,但前后方向变化不明显;对腰椎和股骨近端BMD改善不明显,可能延缓因增龄引起的BMD下降。     

广场舞结合钙尔奇对绝经后妇女骨密度、血清性激素及平衡能力的影响

目的通过观察广场舞对绝经后妇女骨密度、血清性激素及平衡能力的影响,探讨广场舞防治绝经后妇女骨质疏松症、降低跌倒风险的作用。方法 80名绝经后妇女随机分为实验组和对照组,实验组应用广场舞运动联合钙剂干预,对照组单纯予以钙剂干预。实验前及实验干预后3个月和6个月分别检测两组受试者胫骨及足跟骨密度、血清性激素、睁眼和闭眼状态下单腿站立时间(TIME-SLC,TIME-SLO)、足底压力中心在左右和前后方向的最大位移量(D x,D y)。结果实验组治疗3个月及6个月后胫骨及足跟骨骨密度明显增加,与对照组比较有有显著性差异(P0.05);血清雌二醇(E_2)、孕酮(P)水平明显提高,与对照组比较有有显著性差异(P0.05);睁眼和闭眼状态下的单腿站立时间明显增加,与对照组比较有有显著性差异(P0.05);而TIME-SLC,TIME-SLO及Dx,Dy明显下降,具有显著性差异(P0.05)。结论广场舞运动结合钙剂能有效减缓绝经后妇女胫骨及足跟骨密度下降速度,提高血清性激素水平,改善平衡能力,且随着干预时间延长,效果更明显。     

吸烟对男性骨密度的影响

为探讨吸烟对男性骨密度的影响，我们用单光子骨矿分析仪测量了１４５例３０～５０岁吸烟男性的骨密度和１１２例同年龄不吸烟男性的骨密度，报告如下。资料和方法１．病例选择：本组２５７例３０～５０岁男性患者。均无糖尿病、甲状旁腺机能亢进、肿瘤、肾病等病史。其中有吸烟嗜好１４５例。吸烟标准为个人史中有吸烟嗜好，每天吸烟１包以上。另设对照组１１２例，为无吸烟嗜好的同年龄男性患者。２．方法：骨密度测量用中国原子能科学研究所和北京广播技术研究所联合研制的ＢＭＤ—４型骨矿分析仪，测量部位为前臂，右力者测左臂，左力者…     

吸烟对老年男性糖尿病患者骨密度的影响

目的探讨吸烟对老年男性糖尿病患者骨密度的影响。方法选取2009年4月一 2010年6 月来我院就诊的老年男性2型糖尿病患者，分为吸烟组（61例）和不吸烟组（65例），测量骨密度。结 果对于老年男性糖尿病患者，吸烟组与不吸烟组相比，骨密度明显减低，骨质疏松人数增多，差异有 显著性(P<0.01);在吸烟的老年糖尿病患者中，吸烟年限(rs =0.481，P<0. 01 )、每日吸烟量(rs = 0. 432，P <0.01)与骨密度减低呈显著正相关。结论吸烟致老年男性糖尿病患者骨质疏松发病率 高，且与吸烟年限和每日吸烟量呈显著正相关，及早戒烟是明智选择。     

H型高血压对老年男性骨密度的影响

目的通过比较H型高血压、普通高血压和血压正常人群骨密度(Bone Mineral Density,BMD)情况,探讨H型高血压对BMD的影响。方法对绵阳地区城市、郊区及农村1215例70岁以上男性自愿者进行腰椎、股骨颈和股骨转子区BMD检测,符合标准纳入标准的有813人。骨密度按世界卫生组织(WHO)标准分类:骨量正常、骨量减少和骨质疏松。对参与者血压和血清同型半胱氨酸(Homocysteine,HCY)进行检测,根据中华医学HCY和血压的分类标准,高血压同时伴有血清HCY升高称为H型高血压。参与者血压情况分为三类:H型高血压患者、普通高血压患者及血压正常人群。比较三类人群BMD值、骨量减少和骨质疏松患病率。结果 H型高血压患者共有75例,普通高血压患者107例,正常人群631例。H型高血压患者BMD值显著低于普通高血压患者和血压正常人群,骨量减少和骨质疏松患病率显著高于普通高血压患者和血压正常人群(P0.05),普通高血压患者BMD值显著低于普通血压正常人群,骨量减少和骨质疏松患病率显著高于血压正常人群(P0.005)。结论老年男性中,高HCY和高血压对BMD的影响有交互作用,两者同时存在时BMD显著降低,骨量减少和骨质疏松显著升高。     

血清Asprosin水平与绝经后女性骨密度、平衡能力和骨折发生率的相关性

目的 探讨血清Asprosin(白脂素)水平与绝经后女性骨密度(bone mineral density,BMD)、平衡能力和骨折发生率的相关性.方法 回顾性分析海南医学院第一附属医院收治的164例绝经后女性骨质疏松症(osteoporosis,OP)患者的临床资料.记录患者一般临床资料以及骨折发生率、髋部骨密度、平衡...     

老年男性性激素与骨密度测定

目的　为了解老年男性的骨密度和性激素水平,以探讨性激素在老年男性骨质疏松症发病机理中的作用。方法　６３ 例老年男性分为骨质疏松组与非骨质疏松组,测定骨密度（ＢＭＤ）、血清睾酮（Ｔ）、雌二醇（Ｅ２）、黄体生成素（ＬＨ）、促卵泡刺激素（ＦＳＨ）水平,并与３７ 例青年男性对照。结果　老年男性之ＢＭ Ｄ、Ｔ、Ｅ２ 明显低于青年对照组,而ＬＨ、ＦＳＨ 增高明显。老年男性骨质疏松症的发病率为３９．６８％ 。骨质疏松组与非骨质疏松组比较,Ｔ、Ｅ２ 明显降低,ＬＨ、ＦＳＨ 明显增高,尤以Ｔ 降低明显。结论　由于增龄性激素不足引致骨丢失,雄激素降低可能是老年男性骨质疏松症的主要原因。     

老年男性肥胖与骨密度的关系

目的分析老年男性的腰椎2-4(L2-4)、股骨颈(Neck)、大转子(Troch)和粗隆间(InterT ro)的骨密度(BMD),探讨老年男性肥胖与骨密度的关系。方法以我院273名年龄60~75岁的老年男性为研究对象,计算体重指数将研究对象分为肥胖组和对照组,采用双能X线骨密度仪检测腰椎、股骨颈、大转子、粗隆间的骨密度,分析老年男性肥胖与骨密度的关系。结果老年男性各部位的骨密度随年龄的增长而降低,老年男性70~75岁组股骨颈和粗隆间的骨密度均低于60~64岁组(P0.01)。老年男性按不同年龄分组发现,肥胖者不同部位的骨密度均高于对照者(P0.05或P0.01)。结论年龄和体重指数是影响骨密度的重要因素,老年男性肥胖者骨密度较正常体型者高,提示肥胖对骨密度有保护作用。     

济南市城区健康老年男性骨密度分析

目的 探讨济南城区健康老年男性骨密度的变化规律,为防治男性骨质疏松提供依据。方法 于2010年,随机抽取本院所管辖的3个社区,再随机抽取963名健康成年男性作为研究对象,年龄40～90岁,平均年龄（61.3 ± 13.6）岁。采用双能X线骨密度测量仪（GE Lunar DPX-NT, USA）检测腰椎1至4联合值、股骨颈、全股骨、挠骨远端和挠尺骨全部的骨密度。 结果 (1) 40岁以后腰椎、股骨及前臂骨密度缓慢下降,70至74岁,股骨颈及挠骨远端骨密度明显降低,与65至69岁比较,差异有显著性 (P< 0.05)。(2) 股骨颈、股骨全部、挠骨远端、挠尺骨全部骨密度累积丢失率为18.71%、14.80%、20.95%、25.68%。(3) 70至79岁骨质疏松和骨量减少的发生率为29.1%和45.3%,80至90岁为50.0%和32.4%。结论 男性在70至74岁骨丢失加速,70岁以后骨质疏松发生率明显上升。     

Effect of combined exercise training on bone,body balance,and gait ability: a randomized controlled study in community-dwelling elderly women

The purpose of this study was to investigate whether a 48-week multicomponent exercise program could improve the risk factors for fall and hip fracture. Fifty elderly women 65–70 years of age participated. These participants were divided into an exercise group (25 subjects) that attended an exercise program and a control group (25 subjects) that did not. The exercise program included stretching for 9 min, strength training for 10 min followed by 23 min of weight-bearing exercise at an intensity above 65%–75% of the maximal heart rate, and 18 min of balance and posture correction training. The program was conducted three times per week for 48 weeks. The 10-m maximal walk time, maximal step length, and eyes-open-one-legged-stand time in the exercise group improved significantly (P < 0.05). Concerning deoxypyridinoline, the exercise group achieved a significant improvement (P < 0.05) after the 48 weeks. Bone mineral density (BMD) of the femoral neck and trochanter in the exercise group was significantly increased after the exercise program; also body sway was significantly improved (P < 0.05). In conclusion, a multi-component exercise program with weight-bearing exercise at a moderate intensity and gait training may be effective in offsetting a decline in BMD and improving aggravation of bone resorption in this population. In addition, this program has a positive effect on postural stability and gait ability.     

抗阻力量训练对青年和老年女性骨密度的影响

目的探讨相同负荷强度的抗阻力量训练对青年和老年女性骨密度的影响。方法身高、体重相匹配的青年组(n=36)和老年组(n=34)进行16w躯干、上下肢的抗阻力量训练。测试受试者腰椎(L_2~L_4)、股骨近端(股骨颈、Ward三角区、大转子)骨密度,拉力和下肢肌力。结果 (1)(3)干预后青年组股骨颈、Ward三角区和腰椎(L_2~L_4)BMD和拉力显著增大(P0.05),大转子BMD无显著变化;老年组股骨颈、Ward三角区和腰椎(L_2~L_4)BMD、拉力和下肢肌力显著增大(P0.05),大转子BMD无显著变化。(2)拉力与腰椎(L_2~L_4)、股骨颈、Ward三角区和大转子BMD呈显著正相关(r=0.642、0.686、0.600、0.781)、下肢肌力与腰椎(L_2~L_4)和Ward三角区BMD呈显著正相关(r=0.526,r=0.619)。结论 16 w力量训练改善了青年和老年女性腰椎和股骨近端的骨密度且无年龄差异,但对大转子骨密度改善不显著。     

Competitive physical activity early in life is associated with bone mineral density in elderly Swedish men

Summary  In this population-based study of 75-year-old men (n = 498), we investigated the association between physical activity (PA) early in life and present bone mineral density (BMD). We demonstrate that a high frequency of competitive sports early in life is associated with BMD at several bone sites, indicating that increases in BMD following PA are preserved longer than previously believed. Introduction  Physical activity (PA) increases bone mineral density (BMD) during growth. It is unclear if the positive effects remain at old age. In this study, we aimed to determine if PA early in life was associated with BMD in elderly men. Methods  In this population-based study, 498 men, 75.2 ± 3.3 (mean±SD) years old, were included. BMD was assessed using DXA. Data concerning lifetime PA, including both competitive (CS) and recreational sports (RS), and occupational physical load (OPL), were collected at interview. Results  Subjects in the highest frequency group of CS in the early period (10–35 years), had higher BMD at the total body (4.2%, p < 0.01), total hip (7.0%, p < 0.01), trochanter (8.7%, p < 0.01), and lumbar spine (7.9%, p < 0.01), than subjects not involved in CS. A stepwise linear regression model showed that frequency of CS in the early period independently positively predicted present BMD at the total body (β = 0.12, p < 0.01), total hip (β = 0.11, p < 0.01), trochanter (β = 0.12, p < 0.01), and lumbar spine (β = 0.11, p = 0.01). Conclusions  We demonstrate that PA in CS early in life is associated with BMD in 75-year-old Swedish men, indicating that increases in BMD following PA are preserved longer than previously believed. This study was supported by the Swedish Research Council, the ALF/LUA grant from the Sahlgrenska University Hospital, and the Hjalmar Svensson Foundation.     

加压训练搭配振动训练对老年男性骨质代谢和骨密度影响

目的探讨加压训练搭配振动训练对老年人骨质代谢、骨密度、下肢肌力的影响。方法本研究招募55~75岁男性受试者80人,其中69人最终完成实验,受试者随机分为振动训练组、加压训练组、振动搭配加压训练组、对照组、所有受试者进行为期36周,每周4次训练干预。振动训练组:受试者在振动频率30 Hz、振幅2 mm的振动平台,执行训练方案;加压训练组:受试者左右腿,股四头肌、股二头肌、腓肠肌进行局部加压150mmgh,在平地执行训练方案;加压搭配振动训练组:受试者左右腿,股四头肌、股二头肌、腓肠肌进行局部加压150mmgh,在振动频率30 Hz、振幅2 mm的振动平台,执行训练方案;对照组在平地执行训练方案,受试者在第0、36、46周接受肌力、骨密度、生化指标、骨质代谢检测。结果振动训练组、加压训练组、加压搭配振动组、对照组均通过36周运动干预,股骨颈骨密度、大转子骨密度、Ward三角骨密度、下肢肌力、GH、IGF-1、BGP、BALP等指标均得到提高(P0.05),加压搭配振动组受试者对骨密度和肌力的提高显著高于另外三组(P0.05)、而采用单纯采用振动或加压的两组改善效果基本一致。采用传统方式运动的对照组也具有一定改善效果,其程度显著低于其余三组(P0.05)。结论单纯通过加压训练和振动训练进行长期训练均可以达到改善下肢骨密度的效果,加压搭配振动训练对于下肢骨密度和肌力的改善则更为显著。加压搭配振动训练能够有效刺激人体内生长激素和胰岛素样生长因子-1水平提升刺激骨组织生长,在停止训练后能够较长时间维持骨密度。     

Determinants of bone mineral density in Chinese men

Osteoporotic fractures are increasing among Asian populations in both genders, but the risk factors for low bone mineral density (BMD) in Asian men is unclear. To determine the hormonal and lifestyle risk factors for low BMD in Asian men, we studied 407 community-dwelling southern Chinese men aged 50 years and above. Medical history and lifestyle habits were obtained with a structured questionnaire. Dietary calcium and phytoestrogen intake were assessed by a semi-quantitative questionnaire. BMD at the spine and hip were measured by dual-energy X-ray absorptiometry (DXA). Fasting blood was analyzed for 25(OH)D, parathyroid hormone (PTH), total and bioavailable estradiol (bio-E) and testosterone (bio-T). The mean age of the cohort was 68.42±10.4 (50–96) years. In the linear regression model, weight, age, body mass index (BMI), bio-E, PTH, cigarette smoking and weight-bearing exercise were significant determinants of total hip BMD. Together they explained 55% of the total variance of hip BMD, with body weight being the most important determining factor. With age and weight adjustment, height, bio-T and flavonoid intake were identified as additional determinants of total hip BMD. Strategies to prevent bone loss and osteoporosis in Asian men should include lifestyle modification and maintenance of hormonal sufficiency.     

不同运动方式对维持性血液透析患者骨密度的影响

目的探讨维持性血液透析患者骨质疏松危险因素及不同运动方式干预后骨密度的变化。方法选取血液透析中心236例维持性血液透析患者并收集相关临床资料,将患者按照是否合并骨质疏松分为两组,对骨质疏松发生的危险因素进行单因素分析,对经单因素分析有显著差异的危险因素作二元Logistic回归分析;然后从中选取108例研究对象按年龄、性别随机分为4组:对照组(A组)、有氧运动联合抗阻运动组(B组)、有氧运动组(C组)及抗阻运动组(D组),每组各27例,研究观察24周,分别在干预前及24周末比较4组的骨密度。结果骨质疏松组女性比例、年龄、透析月龄、血磷、甲状旁腺素水平均高于非骨质疏松组(P0.05),血红蛋白低于非骨质疏松组(P0.05),性别、年龄、PTH是维持性血液透析患者骨质疏松的危险因素(P0.05)。A组、B组、C组、D组在运动干预前骨密度两两比较差异无统计学意义(P0.05);运动干预24周后,与A组相比较,B组、C组、D组骨密度差异均有统计学意义(P0.05); B组、D组骨密度在运动24周末较运动前比较差异有统计学意义(P0.05)。结论性别、年龄、PTH是维持性血液透析患者骨质疏松的危险因素。有氧联合抗阻运动改善骨密度方面效果更理想,而抗阻运动优于有氧运动;坚持长久持续的康复运动更能有效地改善血液透析患者的骨质疏松问题。     

中等强度跑台运动对去卵巢大鼠后肢骨骨矿物含量和骨密度的双重调节作用

目的 观察中等强度跑台运动对去卵巢大鼠后肢骨骨矿物含量(BMC)和骨密度(BMD)的影响.方法 将60只3月龄未经产雌性SD大鼠按体重随机分为假手术、去卵巢静止、去卵巢运动Ⅰ、去卵巢运动Ⅱ、去卵巢运动Ⅲ和去卵巢运动Ⅳ 6个组.各运动组经1周的跑台适应训练后,按实验设计分别进行为期14周的正式跑台训练.实验结束时,腹主动脉取血处死大鼠,双能χ-射线骨密度仪检测右侧游离股骨和胫骨的BMC和BMD.结果 ①与假手术组相比,去卵巢静止组股骨近端和远端以及胫骨近端BMC和BMD显著下降,但股骨中段以及胫骨中段和远端BMC和BMD无显著变化.②与去卵巢静止组相比,去卵巢运动Ⅰ组股骨近端和远端BMC显著增加,股骨中段以及胫骨3个部位BMC均无显著变化;去卵巢运动Ⅱ组和Ⅲ组股骨和胫骨3个部位BMC 均无显著变化;去卵巢运动Ⅳ组股骨3个部位BMC均无显著变化,而胫骨3个部位BMC均显著下降.③与去卵巢静止组相比,去卵巢运动Ⅰ组股骨近端和远端以及胫骨近端BMD 显著增加, 而股骨中段和胫骨中段和远端BMD无显著变化;去卵巢运动Ⅱ组和Ⅲ组股骨和胫骨任何部位BMD均没有显著变化;去卵巢运动Ⅳ组股骨3个部位BMD无显著变化,而胫骨3个部位BMD却显著下降.结论 较低中等强度跑台运动能减缓去卵巢大鼠股骨近端和远端骨矿物含量和骨密度的下降;而较高中等强度跑台运动却能加速去卵巢大鼠胫骨近端骨矿物含量和骨密度的下降.     

青岛地区成年男性多骨骼部位骨密度数据库的建立

目的确立青岛地区正常成年男性骨密度（BMD）的正常参考范围,探讨青岛地区正常成年男性的骨密度随年龄变化的规律。方法用Challenge双能X线骨密度仪测量692例25-83岁男性参考人群腰椎（L2-L4）正位和左侧髋部（股骨颈、大转子、Ward三角区）6个骨骼区域的BMD。用8种回归模型拟合健康成年男性人群BMD随年龄的变化趋势,找出最佳拟合的方程建立数据库。结果①6个骨骼区域峰值骨密度（PBMD）在30-34岁。②各骨骼区域在达到PBMD之后,均呈现随年龄增高BMD逐渐降低的趋势。③用三次回归模型拟合程度优于其他回归模型,拟合曲线的决定系数（R2）最大。结论：青岛地区正常成年男性的BMD呈现PBMD后随增龄而逐渐下降,但下降趋势较平缓。三次回归是建立BMD正常参考数据库的最佳模型。     

Effect of exercise training and detraining on bone mineral density in postmenopausal women with osteoporosis

We examined the effect of exercise training and detraining on bone mineral density (BMD) in postmenopausal women with osteoporosis. Thirty-five postmenopausal women with osteoporosis, aged 53–77 years, were randomly assigned to three groups: a control group (n = 20), a 2-year exercise training group (n = 8), and an 1-year exercise training plus 1-year detraining group (n = 7). Exercise training consisted of daily brisk walking and gymnastic training. Calcium lactate, 2.0 g, and 1α-hydroxyvitamin D₃, 1 μg were supplied daily to all subjects. No significant differences in initial lumbar BMD, measured by dual-energy X-ray absorptiometry (DXA) were found among the three groups. The mean percent change in BMD compared with the baseline was significantly higher at 1 and 2 years in the exercise training group and at 1 year in the detraining group than in the control group, and did not differ significantly at 2 years between the detraining and control groups. These findings indicate that our exercise training program led to a significant increase in lumbar BMD in postmenopausal women with osteoporosis compared with the control, but that the BMD reverted toward a level that was not significantly different from the control with detraining. Continued exercise training is needed to maintain the bone mass gained through exercise training. Received: May 6, 2000 / Accepted: October 6, 2000