绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系分析

目的 探讨绝经后妇女年龄、绝经年龄、绝经年限与腰椎和髋部骨密度的关系.方法 调查248名健康的绝经后妇女的年龄、绝经年龄、绝经年限,测量身高、体重、正位腰椎（L2～L4）、髋部骨密度进行分析.结果 随着绝经年限的增长,腰椎和髋部骨密度逐渐降低.单因素相关分析表明年龄、绝经年限与腰椎及髋部各部位骨密度呈显著负相关（P＜0.01）,绝经年龄与腰椎及髋部各部位骨密度无显著相关性（P＞0.05）.调整身高、体重指数后,年龄、绝经年龄与腰椎及髋部骨密度呈显著负相关（P＜0.01）,绝经年龄与腰椎及髋部各部位骨密度无显著相关性（P＞0.05）.多元逐步回归分析显示绝经年限与腰椎、股骨颈及股骨大转子的骨密度呈显著负相关（P＜0.01）,年龄与腰椎、股骨颈及Ward三角区骨密度呈显著负相关（P＜0.05）.结论 年龄、绝经年限与腰椎和髋部骨密度有关.     

绝经后妇女腰椎和髋部骨密度分布特点的分析研究

目的 绝经后妇女年龄、绝经年限、绝经年龄与腰椎和骨密度的关系.方法 采用双能X线骨密度仪对500例健康绝经后妇女进行骨密度检测,并且分析绝经年龄、绝经年限对腰椎(L2-L4)和髋部骨密度分布特点的影响.结果 随着绝经年龄的增长,腰椎和髋部骨密度均逐渐降低,单因素相关分析表明,年龄、绝经年限与腰椎和髋部各部位的骨密度呈负相关(P＜0.05),绝经年龄与腰椎和髋部各部位的骨密度无显著相关性(P＞0.05).结论 年龄、绝经年限与腰椎和髋部骨密度有关联,而绝经年龄与腰椎和髋部骨密度关联性不显著.     

绝经后2型糖尿病妇女骨质疏松与颈动脉粥样斑块关系的初探

目的探讨绝经后2型糖尿病妇女骨质疏松与颈动脉粥样硬化的相关性,为患者的预防治疗提供依据。方法回顾性分析在我科住院的100例绝经后2型糖尿病妇女,均行颈动脉彩超,观察颈动脉内膜中层的厚度及斑块的情况,依据超声的诊断结果分成有斑块组和无斑块组;采用双能X线骨密度仪检测所有患者腰椎1~4及左髋部的骨密度。结果 (1)有斑块组与无斑块组相比,年龄、糖尿病病程、体重指数、血压、血脂、血糖等一般资料在两组间的差异无统计学意义(P均0.05),而前组第1~4腰椎骨密度均值明显低于后组,差异有统计学意义(P均0.05);(2)绝经后2型糖尿病妇女颈动脉内膜中层厚度的均值与腰椎1~4骨密度均值呈负相关(r=-0.219,P0.05),与空腹血糖、糖化血红蛋白呈正相关(r=0.295~0.300,P均0.05)。结论在绝经后2型糖尿病妇女中腰椎1~4骨密度的减少是加速颈动脉粥样斑块出现的危险因素,反之粥样斑块形成也促进腰椎骨质的流失,因此治疗和预防时应采用系统性的措施。     

血清S1P与绝经后2型糖尿病患者骨密度和骨代谢指标之间的相关性研究

目的探讨血清1-磷酸鞘氨醇(S1P)与绝经后2型糖尿病患者骨密度(bone mineral density,BMD)和骨代谢指标之间的相关性。方法选取2018年2月至2019年12月期间在海口市妇幼保健院就诊的绝经后2型糖尿病女性,收集患者一般临床资料和获取其血液标本,检测生化指标、S1P和髋部、腰椎骨密度。结果最终选取130名血糖控制较好的绝经后2型糖尿病女性参与本研究,年龄为(59.3±8.9)岁,血糖为(8.75±1.5)mmol/L;S1P平均浓度为(6.46±0.78)μmol/L。相关分析表明S1P与腰椎(L1~4)、全髋和股骨颈BMD呈显著负相关(P均<0.05)。多步逐步回归分析表明,血清S1P和Ⅰ型胶原交联C末端肽(β-CTX)与腰椎(L1~4)、全髋和股骨颈BMD密切相关;而血清S1P和β-CTX是各部位BMD独立危险因素。结论1-磷酸鞘氨醇与绝经后2型糖尿病女性骨密度和β-CTX水平密切相关。     

仅通过饮食和运动控制血糖的绝经后2型糖尿病患者中血脂、骨代谢与骨密度的相关性研究

目的分析在仅通过饮食和运动控制血糖的绝经后2型糖尿病患者中血脂、骨代谢与骨密度的相关性。方法纳入2018年1月至2020年1月在宁夏回族自治区人民医院内分泌科治疗的105例2型糖尿病患者,年龄45～70岁。记录受试者的糖尿病病程、身高、体重、体质量指数(body mass index,BMI),检测血脂(TC、TG、HDL、LDL)、糖化血红蛋白(HbA1c)。采用双能X线骨密度仪测定受试者腰椎(L_(1～4))、股骨颈(Neck)、大转子(Troch)和Ward三角(Ward’s)的骨密度(bone mineral density,BMD),并进行统计学分析。结果随年龄增高,骨密度呈下降趋势,年龄、病程、糖化血红蛋白、TG、LDL、PTH、OC、TPINP、β-CTX与各部位的骨密度呈负相关; BMI、25(OH) D与各部位的骨密度呈正相关;多元逐步回归分析显示糖化血红蛋白、TG、LDL、TPINP与骨密度存在负相关,25(OH) D与骨密度正相关。结论绝经后2型糖尿病患者应注意补充维生素D制剂、良好控制血糖,全面检查血脂、骨代谢,尽早对骨质疏松相关危险因素进行管控。     

在仅通过饮食和运动控制血糖的绝经后2型糖尿病患者中血脂、骨代谢与骨密度的相关性研究

目的 分析在仅通过饮食和运动控制血糖的绝经后2型糖尿病患者中血脂、骨代谢与骨密度的相关性。方法 纳入2018年1月至2020年1月在宁夏回族自治区人民医院内分泌科治疗的105例2型糖尿病患者,年龄45～70 岁。记录受试者的糖尿病病程、身高、体重、体质量指数(body mass index,BMI),检测血脂(TC、TG、HDL、LDL)、糖化血红蛋白(HbA1c)。采用双能X线骨密度仪测定受试者腰椎( L1～4 )、股骨颈(Neck)、大转子(Troch)和Ward 三角(Ward’s)的骨密度(bone mineral density,BMD),并进行统计学分析。结果 随年龄增高,骨密度呈下降趋势,年龄、病程、糖化血红蛋白、TG、LDL、PTH、OC、TPINP、β-CTX与各部位的骨密度呈负相关;BMI、25(OH)D与各部位的骨密度呈正相关;多元逐步回归分析显示糖化血红蛋白、TG、LDL、TPINP与骨密度存在负相关,25(OH)D与骨密度正相关。 结论 绝经后2型糖尿病患者应注意补充维生素D制剂、良好控制血糖,全面检查血脂、骨代谢,尽早对骨质疏松相关危险因素进行管控。     

绝经后2型糖尿病妇女血脂水平和骨密度的关系

目的探讨绝经后2型糖尿病妇女血脂和骨密度改变的相关性。方法将290例绝经后2型糖尿病妇女按T值分成骨质疏松组和非骨质疏松组;检测各组患者血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇LDL-C)以及腰椎骨密度(BMD),然后分析血脂和骨密度的关系;对骨密度和血脂、年龄、绝经年龄等变量之间的关系进行多元逐步回归分析。结果(1)绝经后2型糖尿病妇女的HDL-C与腰椎BMD存在负相关(r=-0.305,P=0.001),LDL-C、TG、TC与腰椎BMD无相关;(2)在校正体重指数、年龄和绝经年限影响因素后,绝经后2型糖尿病妇女的HDL-C与腰椎BMD仍存在负相关(r=-0.160,P=0.018),而LDL-C、TG、TC与腰椎BMD仍无相关。(3)在多元逐步回归分析中,HDL-C(β1=-0.199,P=0.005)仍与骨密度独立相关。结论绝经后2型糖尿病妇女的HDL-C与腰椎BMD存在负相关而TC、TG、LDL-C与腰椎BMD无相关。     

2型糖尿病患者骨密度变化及其相关因素的探讨

目的：研究2型糖尿病（DM）患的骨密度变化，以了解2型DM患是否易合并骨质疏松（OP）及其相关影响因素，方法：采用双能X线骨密度仪，测定80例2型DM及62例性别年龄相匹配的健康前臂、腰椎、股骨颈、ward区以及大转子的骨密度，并对其与年龄，病程，体重指数、绝经年限，空腹血糖，糖基化血红蛋白及部分钙磷调节激素的相关性进行了分析。结果：均经统计学处理分析。结果：80例2DM患的骨密度较健康有不同程度下降，按中国人OP推荐诊断标准，本组有36例（45％）合并OP，OP与非OP组的病程，24h尿蛋白，绝经年龄，FSH、LH水平也存在显性差异（P均＜0．05）。相关性分析结果发现：骨密度与患年龄、病程、绝经年限，FSH、LH呈显负相关（P均＜0．05）。结论：2型DM型患较易发生OP，良好的DM及其并发症治疗对预防OP有益，糖代谢紊乱加速了绝经后妇女OP的发生，控制血糖并适时以激素补充治疗对治疗OP也是必需的，建议糖尿病医生在治疗DM的同时应注意OP防治。     

骨硬化蛋白水平与绝经后妇女体脂含量及骨密度的相关性研究

目的 探讨绝经后妇女血清骨硬化蛋白水平与体脂含量及骨密度(bone mineral density, BMD)之间的相关性。方法 对230名年龄在50~75岁之间健康的绝经后妇女进行横断面研究。通过双能X射线吸收仪测量受试者全身、腰椎、左侧股骨BMD及全身脂肪和肌肉含量。通过定量夹心酶联免疫吸附法测量受试者血清骨硬化蛋白水平。结果 与非骨质疏松症的女性相比,骨质疏松女性血清硬化蛋白水平显著降低(P <0.05)。血清骨硬化蛋白水平与体重和脂肪量呈正相关(P <0.05)。即使在校正年龄、绝经年龄、身高和体重之后,骨硬化蛋白水平与全身及各个部位的BMD均呈正相关(P <0.05)。多元线性逐步回归分析显示,与年龄、绝经年龄、脂肪量和肌肉量相比,血清骨硬化蛋白水平是全身和腰椎BMD最重要的决定因素(P <0.05)。年龄与血清硬化蛋白对髋部BMD的影响相似。结论 在绝经后妇女中,骨质疏松症患者的血清硬化蛋白水平低于非骨质疏松症患者。血清硬化蛋白与全身、腰椎、髋部的BMD和体脂含量呈正相关。     

围绝经期及绝经后妇女骨量变化规律的初步分析

目的了解广东省围绝经期及绝经后妇女的骨量变化规律及特点，并分析妇女骨量的有关影响因素，为妇女骨质疏松症的防治提供科学依据。方法在广东居住10年以上的妇女214例，均接受腰椎和股骨上端骨密度测定，并对测量结果进行统计分析。结果妇女腰椎和髋部的骨密度值自围绝经期即开始缓慢下降，绝经以后下降速度加快，其中绝经后前4年内下降迅速，以后则相对缓慢。同时，体重和生育次数可以影响妇女骨密度值。结论妇女各部位骨密度值从围绝经期开始即有不同程度的下降，因此早期对敏感部位进行骨密度检测，并早期治疗，有利于预防骨质疏松性骨折。     

沈阳地区绝经后妇女绝经年限与股骨近端骨密度的关系分析

目的 探讨绝经年限与股骨近端BMD的关系。方法 随机调查沈阳地区285例健康的绝经后妇女，调查其年龄和绝经年限，测量其身高、体重、股骨近端骨密度(BMD)，应用SPSS软件统计分析。结果 随绝经年限的增加股骨近端各部位BMD有下降的趋势，随绝经年限的增加股骨近端各部位BMD下降速度减慢，并且相对而言Neck、Ward’s区的BMD下降速度高于其他部位。以年龄和体重指数(BMI)为协变量，经协方差分析显示Ward’s区BMD与绝经年限具有显著相关，而其他部位无显著相关。结论 对绝经后妇女应注意绝经早期的股骨近端BMD变化。     

Bone density in white Brazilian women: Rapid loss at the time around the menopause

Dual energy x-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) of the lumbar spine and proximal femur (neck, Ward's triangle, and trochanter) in 417 normal women (aged 20–79) living in São Paulo, Brazil. Bone density decreased with age at all sites. At the spine, the greatest decrease occurred during the sixth decade, with an average 11.4% bone loss compared with the previous decade. Stratifying the subjects according to menopausal status revealed that the fastest bone occurred at the time around the menopause (ages 45–60) when the rate of bone loss (-0.66%/year) was almost twice as rapid as in postmenopausal women (-0.39%/year). Although significant linear rates of bone loss were detected in all proximal femur sites before the menopause, a menopause-dependent pattern was less evident that at the spine. Lifetime rates of bone loss at the appendicular skeleton were-0.43,-0.62, and-0.35%/year at the femoral neck, Ward's triangle, and trochanteric area, respectively. After the menopause, BMD declined with menopausal age at all sites, although the rate of bone loss was faster at the femoral neck (-0.62%/year) and Ward's triangle (-0.84%/year) than at the spine-0.49%/year). The results are consistent with the notion that in women, the fastest bone loss occurs at the time round the menopause, most likely consequent to ovarian failure; and that faster rates of bone loss are detected at the proximal femur than at the lumbar spine in late postmenopausal women.     

Bone mineral density measured by dual-energy X-ray absorptiometry in healthy finnish women

Summary A cross-sectional study of 351 healthy Finnish women aged 20–76 years was done to establish reference values of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA). The effects of age and of several physical and lifestyle factors on BMD of the lumbar spine and proximal femur (femoral neck, trochanter, and Ward's triangle area) were investigated. Altogether 58 women were excluded from the final analysis due to significant spinal osteoarthritis or other diseases or drugs known to influence calcium or bone metabolism. The precision of the method was 0.9, 1.2, 2.7, and 2.4% in the lumbar, femoral neck, Ward's triangle and trochanter area, respectively. Lumbar BMD was increased by 30% (P<0.001) in 15 patients with osteoarthritis (21% of women 50 years or older), but it was apparently unaffected in 5 cases with aortic calcification. Except for the trochanter area, BMD diminished along with age, and this was significant after the menopause. The peak of mean BMD was observed at the age of 31–35 years in the spine and at the age of 20–25 years in the femoral neck and Ward's triangle. BMD was in a positive relationship to weight both in premenopausal and postmenopausal women and to the use of oral contraceptives in premenopausal women and to that of estrogen replacement therapy in postmenopausal women. Labors and pregnancies had a weak positive effect on BMD in premenopausal women. As compared with nonusers premenopausal women who had used alcohol showed a slightly decreased BMD of Ward's triangle. In postmenopausal women there was a positive correlation between alcohol intake and BMD.     

The effect of age and menopause on bone mineral density of the proximal femur

Although the menopause has been associated with increased bone loss at several skeletal sites, it has not previously been noted in the hip, yet estrogen therapy has been reported to reduce the incidence of hip fractures. We investigated the effect of age and menopause on bone loss in the proximal femur by measuring bone mineral density (BMD) of the femoral neck, Ward's triangle, and trochanter by dual-photon absorptiometry in 263 normal women aged 20-84. Multiple regression analyses revealed a significant decrease in BMD of the femoral neck and Ward's triangle with age in both pre- and postmenopausal women (p less than 0.001). In the trochanter the decrease with age was significant only in postmenopausal women (p less than 0.001). Further analysis revealed that BMD decreased faster at all sites in the early postmenopausal years. During the first 6 years postmenopause, the decrease in BMD of the femoral neck and trochanter was 3-10 times higher than the change in the decade prior to menopause. About 20% of the lifetime femoral neck loss and 30% of the trochanteric loss occurred in the early postmenopausal period. It is concluded that both age and menopause are major determinants of BMD in the proximal femur. These findings could explain why estrogen therapy has been reported to prevent hip fracture. The rapid early postmenopausal loss in BMD of the proximal femur demonstrates the importance of starting estrogen replacement therapy immediately after menopause for maximum effect.     

Bone density of the radius,spine, and hip in relation to percent of ideal body weight in postmenopausal women

Summary Bone mineral content (BMC) and bone mineral density (BMD) of the spine (L2–L4) and hip (at femoral neck, Ward's triangle, and greater trochanter sites) were determined by dual-photon absorptiometry (DPA), and of the radius by single-photon absorptiometry (SPA) in healthy postmenopausal women aged 40–70 years. The relationships of BMC and BMD to years since menopause were examined separately in 97 women who were above 115% of ideal body weight (IBW) and in 128 women below. The heavier women had significantly greater mean BMC and BMD at each site than did the normal-weight women. In the normal-weight women, there was a significant negative correlation between BMD and years since menopause at each measurement site except the greater trochanter. In the obese women, BMD decreased with increasing years since menopause at the radius site only and BMC declined with increasing years after menopause at the hip (femoral neck and Ward's triangle region) as well as the radius. Thus, body size is a significant determinant of BMD in this population. The pattern of loss of BMD from Ward's triangle and femoral neck regions of hip are similar to that of the spine. The BMC and BMD findings in the hip suggest that remodeling occurs at this weight-bearing site which has a favorable effect on bone strength.     

维生素D受体基因TaqⅠ多态性与绝经后妇女骨密度的关系

目的 了解福州地区绝经后妇女维生素D受体基因TaqⅠ多态性的分布,探讨维生素D受体基因TaqⅠ多态性与绝经后妇女骨密度的关系.方法 用双能X线骨密度仪检测592例绝经后妇女的腰椎、股骨颈、大转子和Wards三角骨密度,应用PCR-RFLP技术检测维生素D受体基因TaqⅠ多态性.结果 ①维生素D受体基因型分布频率为TT型90.37%,tt型0.17%,Tt型9.46%.等位基因频率为T 95.1%,t 4.9%,基因型分布符合Hardy-Weinberg定律.②分析其基因型与骨密度的关系:TT、tt、Tt 3种基因型在腰椎、股骨颈、大转子、Ward's区4个部位骨密度差异均无显著性.结论 维生素D受体基因TaqⅠ多态性与骨密度间无关联,不能作为预测福州地区绝经后妇女发生骨质疏松危险性的遗传标志.     

Spine and femur BMD by DXA in patients with varying severity spinal osteoporosis

Summary Bone mineral density (BMD) at the lumbar spine, femoral neck, trochanteric region, and Ward's triangle was measured using dual-energy X-ray absorptiometry (DXA) in 118 women with osteoporotic vertebral collapse (average age 65 years), divided into four groups according to numbers and SD of vertebral deformation below norms: group 1:-3SD deformations only; group 2: one-4SD deformation; group 3: two-four-4SD deformations; and group 4: 5 or more-4SD deformations. There were no significant differences between the groups. Results were compared with those from 80 premenopausal (average age 32 years, range 20–40 years) and 109 postmenopausal normal women (average age 64, range 60–70 years). Mean BMD in osteoporotic group 1 was lower than premenopausal normal women by 32% at the lumbar spine, 31% femoral neck, 30% trochanteric region, and 44% at Ward's triangle, and postmenopausal controls by 17% lumbar spine, 16% femoral neck, 17% trochanter, and 14% Ward's triangle. There was a clear trend to reduction in mean BMD between osteoporotic groups 1 and 4 at all four measured sites with significant differences at the spine of 0.102 g/cm² (P<0.01) and Ward's triangle 0.059 g/cm² (P<0.01). When compared with premenopausal controls, there was a reduction in mean BMD between osteoporotic groups 1 and 4 of 10% at the lumbar spine, 7% femoral neck, 8% trochanteric region, and 13% Ward's triangle. Receiver operating characteristic analysis showed no significant differences in diagnostic sensitivities among the four measured sites for vertebral fractures. We conclude from this crosssectional data that the majority of bone loss in spinal osteoporosis occurs before the onset of fractures.     

814例绝经后女性初潮年龄、绝经年龄及月经维持年限与骨质疏松症相关性研究

目的调查了解广州市社区绝经后妇女的生理因素对骨质疏松症的患病率及骨密度(BMD)的影响,为围绝经期女性骨质疏松的预防提供进一步证据。方法采用现场问卷调查了解受试者的基本资料,美国双能X线骨密度仪测量1199例绝经后女性的腰椎正位和左髋部骨密度,以年龄分组进行分析。结果共纳入的814名绝经后妇女当中,腰椎发生骨质疏松症300例,发生率36.9%;髋部发生骨质疏松的312例,发生率38.3%。绝经年限10年内的妇女中,初潮年龄较晚的骨密度越低,发生骨质疏松的风险越高; 55～65岁的绝经后妇女中,绝经年龄较早的骨密度越低,骨质疏松发生的风险越高;月经维持的年限越短,骨密度越低,发生骨质疏松的风险越高。结论广州市社区中绝经后妇女的骨质疏松患病率较高,初潮年龄较晚、绝经年龄较早或月经维持年限较短的妇女骨质疏松的发病率明显升高,建议早筛查、早诊断、早治疗。髋部BMD值是评价骨质疏松症较为敏感的指标,应该首选髋部作为骨密度测量的部位。     

绝经后骨质疏松人群雌激素受体基因Xba I多态性和年龄对骨密度的影响

目的 分析绝经后骨质疏松人群雌激素受体(ER)基因XbaⅠ多态性与骨密度的相关性以及在基因多态性下年龄、绝经年限及体重指数(BMI)对骨密度的影响。方法 用双能X线骨密度仪检测患者151例，以PCR-RFLP的方法检测ER基因XbaⅠ多态性，SPSS软件进行相关回归分析。结果 ER基因型的频率分布为XX型16．6％，Xx型67．5％，xx型15．9％，XX型的骨密度在腰椎、股骨颈和Ward’s三角要高于Xs型和xx型。但ER多态性与骨密度无相关性。在Xx型和XX型人群中年龄越大，绝经年限越长，腰椎和股骨上端骨密度则越低。在XX型中，BMI是影响股骨颈和Ward’s三角骨密度的主要因素。而在xx型中，腰椎和ward’s三角骨密度与年龄、BMI和绝经年限无相关性，绝经年限与股骨颈骨密度相关，大转子与BMI相关。结论 福州地区绝经后骨质疏松人群ER基因XbaⅠ基因型与骨密度无明显相关性，但在不同基因型人群中，其骨密度的丢失趋势和影响因素也各异，临床上应采用不同的防治措施。