Comparison of the effects of heparin and the direct factor Xa inhibitor,rivaroxaban, on bone microstructure and metabolism in adult rats

Aim: Deep venous thrombosis is a significant complication following surgery, and is associated with high morbidity and mortality in adults. The direct factor Xa inhibitor, rivaroxaban, is used to prevent venous thromboembolism in patients suffering from trauma and joint arthroplasty. The present study compared the effects of rivaroxaban and heparin on bone microstructure and metabolism in adult rats.

Materials and methods: Twenty-four Wistar rats were divided into sham, rivaroxaban and heparin groups. Rivaroxaban (1.5?mg·kg^?1·d^?1) and heparin (2?IU·g^?1·d^?1) were administered for 4 weeks. To assess changes in bone metabolism, serum calcium and phosphorus levels, and bone formation and resorption markers were examined. Micro-CT analysis was used to examine the microstructure of both trabecular and cortical bone. Dual energy X-ray absorptiometry was employed to detect bone mineral density (BMD).

Results: Serum phosphorus levels were significantly lower in both rivaroxaban (1.33?±?0.07?mmol/L) and heparin (1.33?±?0.21?mmol/L) rats than in sham rats (1.71?±?0.14?mmol/L). Activity and levels of bone formation markers, bone-specific alkaline phosphatase (BAP) and type I procollagen N-terminal pro-peptide (PINP), were 32.4 and 38.2% lower in heparin-treated rats than in sham rats. Bone resorption markers, pyridinoline (PYD) and deoxypyridinoline (DPD), were 20.1 and 34.3% higher in heparin-treated rats than in sham rats, respectively. By contrast, rivaroxaban only resulted in a decrease PINP levels. Bone volume fraction (BV/TV) decreased by 23.5 and 20.5% from those in sham rats, while trabecular separation (Tb.Sp) increased by 28.2 and 16.3% in trabecular bone of rivaroxaban- and heparin-treated rats, respectively. Moreover, the microstructure of cortical bone and BMD were negatively affected by heparin but not by rivaroxaban.

Conclusion: Rivaroxaban leads to fewer adverse effects on bone microstructure than heparin.     

Serum leptin levels,bone mineral density and osteoblast alkaline phosphatase activity in elderly men and women

Although primarily secreted by adipose cells, leptin, a polypeptide hormone that influences body weight, satiety and lipid metabolism, and its receptor are also expressed in human osteoblasts. Leptin plays a role in the central, hypothalamic modulation of bone formation, as well as locally within the skeleton by enhancing differentiation of bone marrow stroma into osteoblasts and inhibiting its differentiation into osteoclasts and adipocytes. The purpose of this investigation was to compare serum leptin values in 100 postmenopausal women (age 62-97) and 31 men (age 72-92) to bone mineral density (BMD) measurements made by dual X-ray absorptiometry and additionally to biochemical markers of bone resorption and formation, including crosslinked collagen N-telopeptides (NTx), aminoterminal extension procollagen propeptides (PINP) and bone-specific alkaline phosphatase (bAP). The circulating level of leptin directly correlated with body mass index (BMI) (r=0.61-0.78, P<0.001) and was modestly, but significantly and positively associated with bAP activity (r=0.24-0.33, P<0.01) in the sera of men and women after adjustment for BMD, age and BMI. The association of circulating leptin levels with bAP, a specific marker of osteoblast activity suggests that leptin levels influence osteoblast activity in vivo in elderly women and men.     

Association of radial bone mineral density with CA repeat polymorphism at the interleukin 6 locus in postmenoposal Japanese women

Twin studies have shown strong correlations between bone mass and genetic factors. Some of the genes involved could regulate bone metabolism and bone formation and resorption, all processes that determine bone mass. One candidate gene, interleukin 6 (IL-6), has been implicated in the pathogenesis of bone loss because it stimulates osteoclasts. We investigated a possible association between the CA repeat polymorphism at the IL-6 gene locus and the bone mineral density (BMD) of radial bone in 472 postmenopausal Japanese women. Genotypes were classified into six groups according to the number of CA repeats present, from 13 to 18. BMD was expressed as adjusted BMD, which was the body mass index (BMI)- and age-adjusted average BMD. The 73 women who possessed an A1 allele (134 bp, containing 18 repeats of CA) had significantly lower adjusted BMD than those participants (n = 399) who did not carry an allele of that size (mean ± SD values, 0.294 ± 0.064 vs 0.312 ± 0.061 g/cm²; P = 0.0221). This result suggests that genetic variation at the IL-6 gene locus is associated with some determinants of BMD in postmenopausal women. Received: October 21, 1998 / Accepted: December 15, 1998     

Decrease of bone formation in adult women with fragility fractures

Objectives: To compare bone mineral density (BMD) and some markers of bone metabolism in women with fragility fractures and in normal age-matched subjects. Methods: A 100 women with at least one vertebral deformity >25%, and 219 age-, BMI- and parity-matched healthy women, were recruited for the study. In all the patients fractures were symptomatic and occurred at least 1 year before densitometric measurement. Forearm bone mineral density (BMD) as well as biochemical assessment of some markers of bone turnover were measured in all the subjects. Results: BMD was significantly lower in the fracture than in the control group (0.326 ± 0.073 vs. 0.379 ± 0.079; P<0.001). Fractured women showed alkaline phosphatase (ALP) and osteocalcin (OC) serum levels significantly lower than controls, while no differences were found in fasting urinary calcium and hydroxyproline excretion. Women without fractures showed a significant correlation between ALP and both age and years since menopause (YSM). Such a correlation is lacking in the fracture group. Conclusions: Women with vertebral deformities likely due to a fracture had a forearm BMD and markers of bone formation lower than normal. Whether low bone density is due to a low peak of bone mass or to an increased postmenopausal bone loss sustained by an uncoupling between the two bone remodelling processes is still unclear.     

Lack of benefit with omega-3 fatty acid supplementation in HIV patients: A randomized pilot study

Objective: To assess the effect of omega-3 polyunsaturated fatty acids (n-3 PUFA) supplementation on bone metabolism in HIV-infected patients presenting with hypertriglyceridemia.

Methods: Patients were randomized 1:1 to receive 2?g of n-3 PUFA or fenofibrate (FF). The primary endpoint was % change in bone mineral density (BMD) from baseline to month 24 in lumbar spine (LS) and femoral neck (FN). Secondary endpoints were changes in Z-score, calcitriol, calcitonin, parathyroid hormone, osteocalcin, and C-terminal telopeptide of type I collagen (CTX-I) at 12 and 24?months. Differences in continuous variables were evaluated using the t test or Mann-Whitney U-test for independent samples and differences in means of intra- and inter-subject continuous variables using a general linear model. Categorical variables were compared by the chi-squared or Fisher’s exact test.

Results: 30 patients were included in each arm; 23 in the n-3 PUFA arm and 22 in the FF arm completed follow-up. No significant differences between arms were observed after 24?months in either region (FN: ?12.51% ± 7.89 in the n-3 PUFA arm and -8.18% ± 7.72 in the FF arm, p?=?.07; LS: 2.94% ± 6.63 in the n-3 PUFA arm, ?3.07% ± 16.85 in the FF arm, p?=?.07), although the BMD reduction in the FN region after 24?months was noticeable in both arms (n-3 PUFA: ?12.51% ± 7.89%, p?=<?.001; FF: ?8.183% ± 7.72%, p?=<?.001). There was a significant difference in calcitriol changes between arms after 96?weeks. No differences in Z-score or bone turnover markers were observed between the two arms.

Conclusions: Omega-3 fatty acid supplementation resulted in no beneficial changes in BMD or bone turnover markers. n-3 PUFA supplementation achieved similar reductions in triglyceride levels as FF.     

Non-association Between Polymorphisms of the Frizzled Receptor Genes and Bone Mineral Density in Postmenopausal Korean Women

We investigated the association between single nucleotide polymorphisms (SNPs) in the frizzled (FZD) genes in the Wnt signal pathway and circulating osteoprotegerin (OPG), soluble receptor activator of NF-κB ligand (sRANKL) levels, bone turnover markers, and bone mineral density (BMD) in postmenopausal women. The SNPs in the FZD1, FZD5, FZD6, FZD7, and FZD9 genes were analyzed by direct sequencing in 371 postmenopausal Korean women. Levels of serum OPG, sRANKL, osteocalcin, C-telopeptide of type I collagen, calcium, parathyroid hormone and calcitonin, and BMD at the lumbar spine and femoral neck were measured. The SNPs in the FZD1, FZD5, FZD7, and FZD9 genes, and in exon 2 of the FZD6 gene were not observed. No significant differences in the adjusted BMD of lumbar spine and femoral neck and serum levels of OPG, sRANKL, and bone markers were noted among the single or haplotype genotypes of the L345M and E664A SNPs in the FZD6 gene and the distributions of these single or haplotype genotypes were not different according to the bone mass status. In conclusion, the polymorphisms of the FZD genes are not associated with BMD of the lumbar spine and femoral neck, bone turnover markers, or circulating OPG-sRANKL in Korean women.     

艾塞那肽对新诊断2型糖尿病患者骨代谢的影响

 目的:观察24周胰高糖素样肽1受体激动剂艾塞那肽治疗对新诊断2型糖尿病患者骨密度及骨转化标志物的影响。方法:20名新诊断2型糖尿病患者,予以艾塞那肽治疗24周。治疗前后检测体重、空腹血糖（FPG）、餐后2 h血糖（PBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、骨密度、体脂分布和空腹血清中的骨转化标志物水平,包括骨形成标志物骨钙素（OC）、骨吸收标志物Ⅰ型胶原交联羧基末端肽（CTX）和抗酒石酸酸性磷酸酶5b（TRAcP5b）。结果:新诊断2型糖尿病患者经过24周艾塞那肽治疗后,FPG、PBG和HbA1c降低（P<0.01）,HOMA胰岛素抵抗指数改善(P<0.05),体重及体脂含量下降（P<0.05）;虽然患者OC水平下降,骨吸收标志物（CTX和TRAcP5b）水平上升,骨密度增加,但均未达统计学意义。结论: 24周艾塞那肽治疗改善新诊断2型糖尿病患者的血糖和胰岛素抵抗,使体重及体脂含量下降,但尚未对患者骨密度及骨转化标志物产生影响。     

Microstructural trabecular bone from patients with osteoporotic hip fracture or osteoarthritis: Its relationship with bone mineral density and bone remodelling markers

Osteoporosis (OP) and osteoarthritis (OA) are the most prevalent musculoskeletal disorders in the elderly but the relationship between them is unclear. The purposes of this study are to analyze the bone turnover markers (BTM), bone mineral density (BMD) and the structural and mechanical properties of trabecular bone in patients with OP and OA, and to explore the relationship between these two diseases. We studied 12 OP patients and 13 OA patients. We analyzed BTM (β-CrossLaps and PINP), BMD and microstructural and biomechanical parameters (micro-CT). Our results were: OP group has higher levels of β-CrossLaps and lower BMD at the femoral neck. Also, OP patients have a decreased volume of trabecular bone and less trabecular number, with architecture showing prevalence of rod-like trabeculae and worse connectivity than OA patients. The biomechanical parameters were worse in OP patients. BMD was correlated with almost all the structural and biomechanical parameters. Moreover, β-CrossLaps was negatively correlated with hip BMD and with bone surface density and positively with trabecular separation. BTM, BMD and bone microstructural changes in osteoporosis are opposite to those of OA. These findings justify a less resistant bone with higher risk of fragility fractures in OP patients. These histomorphometric and biomechanical changes may be suspected by measuring of BMD and β-CrossLaps levels.     

Bone metabolism in elite male rowers: adaptation to volume-extended training

We examined the effect of 6-month volume-extended training on bone metabolism in elite male rowers. Twelve elite male rowers (20.8±3.0 years; 192.9±4.7 cm; 91.9±5.3 kg; body fat 10.1±2.3%; 6.2±0.5 l min⁻¹) participated in this study. Bone biochemical markers, hormones, bone mineral content (BMC), and bone mineral density (BMD) were assessed before and after training. Average weekly training volume was significantly higher (P<0.05) during the 6 months of heavy training compared to relative rest (11.6±0.4 h week⁻¹ vs. 16.8±0.6 h week⁻¹), while intensity remained the same. At the end of training, only arm BMD was significantly increased by 5.7%. Osteocalcin (16.6%), insulin-like growth factor-1 (IGF-1) (20.2%) and the bioavailability IGF-1 index (17.9%) were significantly increased. Before heavy training, relationships were observed between the whole body BMD and growth hormone (r=0.64; P≤0.02), lumbar spine BMD and 1.25(OH)₂ vitamin D (r=0.69; P≤0.04), arm BMD and testosterone (r=0.59; P≤0.05), and arm BMD and adiponectin (r=0.59; P≤0.05). No relationship was found between BMC or BMD and blood biochemical measures 6 months later (r=0.56; P≥0.05). In addition, osteocalcin was related to IGF-1 (r>0.58; P<0.048) and bioavailability IGF-1 index (r>0.59; P≤0.055) before and after training. In summary, heavy training had a moderately favorable effect on BMD. Bone tissue at specific skeleton sites is sensitive to changes in training volume even in athletes with already high BMD values. Changes in BMD and bone formation may be caused by changes in specific hormones such as IGF-1 and adiponectin in male athletes.     

Conversations between insulin and bone: Potential mechanism of high bone density in patients with Berardinelli-Seip Congenital Lipodystrophy

Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty storing lipid in adipocytes, low body fat, hypertriglyceridemia, and fat liver. The serum leptin is usually very low, and serum insulin, as well as HOMA_IR (homeostasis model assessment), is very high and correlated positively with bone mineral density (BMD). Despite deficiency/insufficiency of vitamin D, low body mass index, low daily calcium intake, physical inactivity, and menarche at a later age, BSCL patients usually have normal or even high BMD. We hypothesize that low leptin and high insulin may play a role in this outcome. Understanding the potential pathophysiological mechanism of these bone abnormalities will help to clarify the effects of extreme insulin resistance in the bone.     

Spine and total body bone mineral density and serum testosterone levels in male athletes

Summary The aim of this study was to compare the effects of intense endurance vs strengthening exercise on bone mass and serum testosterone levels in male athletes. Bone mineral density (BMD) of the total body and spine and serum testosterone levels were measured in male rowers (n=12), triathletes (n=8) and sedentary controls (n=13). The total body scan also gave values for percentage body fat and regional bone densities. Calcium intake and physical activity levels were measured by questionnaire. The rowers had significantly higher BMD in the spine and total body than the triathletes (P < 0.01 and P < 0.05 respectively) and sedentary controls (P < 0.01 and P < 0.05). There were no differences between the triathletes and controls. Serum testosterone levels were significantly lower in the triathletes than in the controls (P < 0.05); there was no significant difference between the rowers and controls. All groups fell within the normal range for testosterone. In a step-wise multiple regression, including age, body mass, height, calcium intake and activity, no single factor had a significant effect on spine BMD. Body mass had a significant effect on total body BMD and could account for the differences between the groups. A significant positive correlation was found between calcium intake and total body BMD. The heavy weight training typical of rowing training seemed to result in significant bone accretion. The low testosterone levels in the triathletes may have negated any positive effect of the increased exercise on BMD.     

育龄期女性骨代谢与碘摄入过量及甲状腺功能亢进之间的关系研究

目的 观察伴有碘摄入过量或伴有甲状腺功能亢进育龄期女性骨密度及骨代谢指标的变化,探讨碘摄入量及甲状腺功能对育龄期女性骨密度及骨代谢指标的影响.方法 从2500例体检育龄期女性汇总筛选出30例健康育龄期女性,30例伴有甲状腺功能亢进育龄期女性,和30例伴有碘摄入过量育龄期女性,该三种不同状态育龄期女性分别归为对照组、甲亢组和碘摄入过量组.采用双能X线检测仪检测了各组育龄期女性骨密度(BMD)及血清骨代谢指标[骨碱性磷酸酶(BAKP)、骨钙素(OSC)、I型胶原交联羧基末端肽(ICTP)、甲状旁腺素(PTH)和25-(OH) D]的变化.结果 与对照组相比,甲亢组及碘摄入过量组腰椎(L2-4)和右侧桡骨中远1/3处的BMD水平均显著降低(P<0.05);与对照组相比,甲亢组ICTP、BAKP与OSC均显著增加(P< 0.05),碘摄入过量组的ICTP、BAKP、OSC水平则均显著降低(P<0.05),但两组的25-(OH) D和PTH水平无明显改变(P>0.05).结论 伴有碘摄入过量及甲状腺功能亢进的育龄期女性无继发性甲状旁腺功能亢进,无维生素D代谢异常,但有骨代谢失衡(即骨吸收与骨形成失衡)及骨密度降低异常.临床上育龄期女性若出现甲亢或长期碘摄入过量时,应提早治疗或调整以防止骨密度降低即骨质疏松的发生.     

Seasonal variation of bone turnover markers in top-level female skiers

Different levels of weight-bearing activities imply different levels of anabolic effects on skeletal tissue and this can be assessed by measuring biochemical markers reflecting bone metabolism. With this study we wanted to determine how the serum levels of bone turnover markers change during different phases of annual training in elite female skiers. Fourteen top-level Caucasian athletes, from the Italian Women’s Alpine Ski Team (slalom and giant slalom), were tested at the end of the relative rest period (T1), the pre-competitive season (T2) and the competitive season (T3). Serum levels of bone-specific alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase (TRAP5b) activities and of osteocalcin (OC), and crosslaps (the carboxyterminal crosslinked telopeptide of type I collagen—β-CTx), were assayed together with the determination of 25(OH)D levels. The formation markers, BAP and OC and the resorption marker TRAP5b significantly increased from T2 to T3, while crosslaps showed no significant changes. The peculiar trends of bone formation markers correlated one to each other at T2 versus T3, and this was probably linked to the highly demanding period of competitions when, in athletes performing weight-bearing exercise, bone is more stimulated by mechanical forces. 25(OH)D levels, instead, changed from T1 to T2 and from T1 to T3 and its trend do not show any correlation with that of bone markers. In conclusion, we found that both the bone formation markers and TRAP5b, marker of resorption, are significantly increased from the pre-competitive season to the competitive season.     

雌性去卵巢大鼠体脂、瘦素与骨密度关系的初步探讨

本文旨在探讨体脂与骨量的关系,以及调节体脂的瘦素对骨的作用。选用6月龄雌性Wistar大鼠40只,随机分为两组,一组切除双侧卵巢,另一组行假手术。饲养2月后采用ELISA检测血清中瘦素浓度,检测大鼠体质量、腹腔内脂肪含量,DEXA测定大鼠股骨骨密度(BMD)。结果提示大鼠体质量在去卵巢组增加明显(P<0.05),腹腔内脂肪量在去卵巢后增加不明显(P=0.499),脂肪细胞分泌的瘦素两组之间没有差异(P=0.166),去卵巢组单位体质量的骨矿含量(BMC)较假手术组明显降低(P=0.003)。第8周体质量在假手术组与单位体质量BMC负相关,在去卵巢组与BMD正相关,假手术组腹腔内脂肪含量及瘦素浓度与单位体质量的BMC呈负相关关系。因此,体脂、瘦素与单位体质量BMC相关。     

Soy isoflavones for osteoporosis: an evidence-based approach

Effects of soy isoflavones on osteoporosis remain unclear. This review aimed to clarify the effect of soy isoflavones on bone mineral density (BMD) and turnover markers in menopausal women. PubMed and the Cochrane Library were searched in July 2011 for relevant meta-analyses of randomized controlled trials evaluating effects of soy isoflavones on BMD and bone turnover markers. Three meta-analyses evaluated the effects of soy isoflavones on lumbar spine, total hip, femoral neck, and trochanter BMD. Soy isoflavones significantly improved lumbar spine BMD in a moderate manner, but did not affect total hip, femoral neck, and trochanter BMD in menopausal women. Ingestion of soy isoflavones for six months appeared to be enough to exert a beneficial effect on lumbar spine BMD. Two meta-analyses evaluated the effects of soy isoflavones on a bone resorption marker (urine deoxypyridinoline) and two formation markers (serum alkaline phosphatase and osteocalcin). Soy isoflavones significantly decreased urine deoxypyridinoline in a moderate manner, but did not affect serum alkaline phosphatase and osteocalcin in menopausal women. Soy isoflavones may prevent postmenopausal osteoporosis and improve bone strength thus decreasing risk of fracture in menopausal women by increasing lumbar spine BMD and decreasing bone resorption marker urine deoxypyridinoline. Further studies are needed to address factors affecting the magnitude of the beneficial effects of soy isoflavones and to assess the possible interactions between soy isoflavones and anti-osteoporosis drugs, and to verify effects on BMD of other skeletal sites and other bone turnover markers.     

Relationship between BMD, dental panoramic radiographic findings and biochemical markers of bone turnover in diagnosis of osteoporosis

OBJECTIVE: Mandibular indices, measured on panoramic radiographs, may be useful screening implements for low skeletal bone mass density (BMD). Recent studies suggest that radiographic examination of mandible may constitute an effective process for the early diagnosis of osteoporosis. Biochemical markers of bone turnover may be of value for prediction of individual bone loss and they may help in predicting risk of fracture in elderly women. In contrast to the vast information available on dental radiographic findings and BMD only scarce data exist on the relationship between panoramic mandibular indices and biochemical markers. The aim of this study was to examine the diagnostic performance of dental panoramic radiography and biochemical markers of bone turnover in relation to BMD at the spine in a group of postmenopausal women. SUBJECTS AND METHODS: An assessment of the number of lost teeth, mandibular cortical width (MCW) at the mental region and morphologic classification of mandibular inferior cortex (MIC grade) was performed on dental panoramic radiographs in a group of 141 postmenopausal women 38-81 years of age. BMD at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than 1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Serum bone alkaline phosphatase (BAP) was measured with an enzyme immunoassay. Cross-linked N-telopeptides of type I collagen (NTx) corrected for creatinine secretion, was measured with a competitive-inhibition enzyme-linked immunosorbent assay ELISA. RESULTS: In our study, a decrease in MCW by 1mm increases the likelihood of osteopenia or osteoporosis to 47% (p-value<0.05), having taken into consideration the effect of the years elapsed since menopause. The increase of alkaline phosphatase (ALP) per unit increase the likelihood of osteopenia or osteoporosis to 14% (p-value<0.05), having checked the effect of the years since menopause. A decrease in MCW by 1mm increases the likelihood of moderately or severely eroded cortex to 97% (p-value<0.001). The increase in ALP per 1 unit increases the likelihood of moderate or severe erosion per 10% (p-value<0.05), taking into account the years since menopause. CONCLUSIONS: Our results suggest that dentists have sufficient clinical and radiographic information that enables them to play a significant role in early diagnosis of osteoporosis in postmenopausal women. Panoramic radiographs and biochemical markers of bone turnover may be of value for prediction of individual bone loss and they may help in predicting risk of fracture in elderly women.     

Effects of Body Composition, Leptin, and Adiponectin on Bone Mineral Density in Prepubertal Girls

Body weight is positively associated with bone mineral density but the relationship between obesity and bone mineral density is unclear. Leptin and adiponectin are potential independent contributors to bone mineral density. We assessed the correlations of body composition, leptin and adiponectin with bone mineral density, and whether leptin, adiponectin and body composition determine bone mineral density independently in prepubertal girls. Forty-eight prepubertal girls were classified into obese and control groups by body mass index. Serum leptin and adiponectin levels were determined by enzyme immunoassay. Bone mineral density was measured using dual energy radiography absorptiometry and body composition was measured using bioelectrical impedance analysis. Lean and fat mass, and leptin were positively correlated with bone mineral density. Lean mass was a positive independent predictor of femoral and L-spine bone mineral density. Serum leptin was a postivie independent predictor of femoral bone mineral density. Fat mass was a negative independent predictor of femoral bone mineral density. In prepubertal girls, lean mass has a favorable effect on bone mineral density. Fat mass seems not to protect the bone structure against osteoporosis, despite increased mechanical loading. Serum leptin may play a biological role in regulating bone metabolism.     

甲状腺功能亢进患者骨代谢指标和甲状腺激素水平变化及其临床意义

为探讨甲状腺功能亢进(甲亢)患者骨代谢指标与甲状腺激素水平的变化, 本文对70例甲亢患者及60名健康对照者采用放射免疫分析法(RIA)测定了Ⅰ型胶原羧基末端肽(ICTP), 全自动微粒子化学发光分析法测定了骨碱性磷酸酶(BAP)及甲状腺激素(T3、T4、FT3、FT4)水平, 同时用二维骨密度仪测定骨密度(BMD).结果表明: 甲亢患者血清BAP、ICTP与甲状腺激素水平均明显高于健康对照组(P均小于0.01), 骨密度(BMD)则显著低于健康对照组(P＜0.01).相关分析显示, 甲亢患者血清BAP、ICTP水平与BMD呈明显负相关(r分别为-0.298和-0.276, P＜0.05), 与T3呈正相关(r分别为0.452和0.531,P＜0.01), 与T4亦呈正相关(r分别为0.419和0.398, P＜0.01).提示甲亢患者骨转换增强, 并以骨吸收增加更为显著, 与甲亢时甲状腺激素分泌过多有关. 定量检测血清BAP、ICTP水平对于甲亢代谢性骨病的诊断、病情研究均有重要的临床价值.     

男性吸烟与骨密度及骨生化指标关系的调查与分析

目的研究男性吸烟与骨密度及骨生化指标关系的调查与分析遥方法选择2012 年1 月~2016 年1 月某社区的500 例 吸烟男性为观察组,另外选择500 例不吸烟的男性作为对照组,比较两组研究对象的骨代谢及骨生化指标,分析吸烟对上述两 种因素造成的影响遥结果观察组各部位骨密度均显著低于对照组（约0.05）,观察组sBAP和年龄明显高于对照组（约0.05）,但 25-羟基总维生素D则显著低于对照组（约0.05）,差异有统计学意义遥结论男性随着年龄的增长骨量会逐渐丢失,而吸烟会造 成男性骨生化指标和骨转换水平升高,加速骨量的丢失,所以吸烟是造成骨质疏松的危险因素之一,要预防骨质疏松的发生应 当提倡戒烟