一分钟自测你是不是潜在的骨质疏松患者

<正>一分钟自测题您是否曾经因为轻微的碰撞或者跌倒就会伤到自己的骨骼?您的父母有没有过轻微碰撞或跌倒就发生髋部骨折的情况?您经常连续3个月以上服用"可的松、泼尼松"等激素类药品吗?您的身高是否比年轻时降低了(超过3厘米)?您经常大量饮酒吗?您每天吸烟超过20支吗?您经常患腹泻吗(由于消化道疾病或者肠炎而引起)?     

148例围绝经期妇女双能X线骨密度结果分析

目的:探讨围绝经期妇女年龄、月经情况、身高、体重与骨密度(BMD)的关系,筛选绝经后骨质疏松症的高危人群。方法:随机选取148例2004年9～11月青岛市部分金融系统女职员健康查体中的围绝经期(40～60岁)妇女,加查双能X线BMD(已筛除影响骨代谢性疾病如糖尿病、甲亢等及药物因素,如性激素补充),将BMD测定结果与其年龄、月经情况、体重、身高进行相关分析。结果:148例围绝经期妇女平均腰椎低骨量发生率为26.35%。50～60岁妇女腰椎低骨量发生率为48.44%,明显高于40～50岁妇女(9.52%);绝经者腰椎低骨量发生率为61.70%,明显高于未绝经者(9.90%);体重低于60kg者腰椎低骨量发生率为36.92%,高于体重在60kg以上者(18.07%);身高在160cm以下者腰椎低骨量发生率为44.12%,高于身高在160cm以上者(21.05%),其差异均有统计学意义;年龄、绝经与否、身高、体重与左髋部BMDt值无相关性。结论:围绝经期妇女腰椎低骨量发生率与绝经、年龄及其身高体重有关,绝经、年龄50岁以上、体重60kg以下、身高160cm以下的妇女是发生绝经后骨质疏松症的高危人群。     

肌力、脂肪含量与绝经后骨质疏松症患者骨密度T值的相关性分析

目的探讨肌力、脂肪含量与绝经后骨质疏松症患者骨密度T值的相关性,为临床防治绝经后骨质疏松症提供依据。方法选择2015年6月-2017年6月江苏省中医院骨伤科收治的骨质疏松症患者84例设为观察组,根据骨密度T值测定结果分为骨量减少组32例、骨质疏松组41例及严重骨质疏松组11例;另选择同期入院健康体检者40例设为对照组。采用Inbody720型电子背力计分别测定各组腰背部伸肌力(取平均值),利用美国Hologic公司生产的全身型双能X线骨密度仪测定各组全身脂肪及腰椎L1～4骨密度值,采用SPSS Pearson相关性分析软件对肌力、脂肪含量对绝经后骨质疏松症患者骨密度T值的相关性进行分析。结果观察组绝经后骨质疏松症患者肌力、骨密度水平低于对照组,腹部脂肪含量高于对照组,差异均有统计学意义(P0. 05)。骨量减少组肌力、骨密度水平高于骨质疏松组和严重骨质疏松组,脂肪含量低于骨质疏松组和严重骨质疏松组,差异均有统计学意义(P0. 05);骨质疏松组肌力、骨密度水平高于严重骨质疏松组,脂肪含量低于严重骨质疏松组,差异均有统计学意义(P0. 05)。绝经后骨质疏松症骨密度水平与肌力呈正相关性(P0. 05),与脂肪含量呈负相关性(P0. 05)。结论绝经后骨质疏松症患者肌力、脂肪含量较少,并且与骨密度之间存在紧密的联系。     

青岛市市区部分金融单位妇女围绝经期低骨量状况调查

[目的]探讨围绝经期妇女的骨密度,筛选绝经后骨质疏松症的高危人群。[方法]2004年9～11月,随机选取青岛市部分金融系统职工健康查体中的围绝经期(40～60岁)妇女148人,进行双能X线骨密度测定。[结果]腰椎低骨量检出率为26.35%。腰椎低骨量检出率50～60岁为48.44%,40～49岁为9.52%;绝经者为61.70%,未绝经者为9.90%;体重低于60kg为36.92%,体重在60kg以上者的18.07%;身高160cm以下者为44.18%,160cm以上者为21.53%;以上各组间低骨量检出率的差异均有统计学意义(P<0.01)。[结论]围绝经期妇女腰椎低骨量检出率与绝经、年龄及其身高体重有关,绝经、50岁以上、体重60kg以下、身高<160cm是围绝经期妇女发生低骨量的高危人群。     

武汉市江岸区中小学教师骨质疏松症患病率调查及相关因素分析

目的了解中小学教师骨质疏松症的患病率和影响因素,为针对性采取预防措施提供参考。方法检测1075例武汉市江岸区中小学教师的骨密度,采用SPSS 16.0软件包进行统计分析。结果男性中小学教师身高、体重、BMI均明显高于女性(P<0.05);40~49年龄组与50岁及以上年龄组男女中小学教师脚跟骨、腰椎总骨密度均明显低于29岁及以下年龄组(P<0.05),50岁及以上年龄组男女中小学教师脚跟骨、腰椎总骨密度明显低于30~39年龄组(P<0.05);随着男女中小学教师年龄逐渐增长,骨量流失和骨质疏松症发生率明显升高(P<0.05),且女性中小学教师骨量流失和骨质疏松症发生率明显高于男性中小学教师(P<0.05);经多因素Logistic回归分析发现,年龄为脚跟骨、腰椎总骨密度的负相关因素,身高、体重、BMI为脚跟骨、腰椎总骨密度的正相关因素。结论随着年龄增长,中小学教师脚跟骨、腰椎总骨密度明显下降,骨量流失和骨质疏松症发生率明显升高,且女性表现尤为明显,建议采取适宜运动锻炼和合理饮食配伍等多方面综合措施,早期防治骨质疏松症的发生。     

绝经期妇女骨质疏松症综合治疗

骨质疏松症是绝经期妇女的常见病、多发病。其主要原因是绝经后的妇女体内雌激素水平下降,导致的骨吸收加快,骨量减少,骨密度下降,有研究者统计,绝经前后骨密度值有显著查异〔1〕。随着我国人口老龄化,骨质疏松症的患病率也呈上升趋势。骨质疏松症的最主要的并发症是骨关节病和     

廊坊市1128例正常人群指骨骨密度分析

骨质疏松症是全世界严重的公共卫生问题,骨密度(BMD)是诊断骨质疏松症以及评估骨质疏松症患者发生骨折危险性的可靠指标.流行病学研究证实,老年人的低骨量是骨质疏松症发生的重要因素,青年时期达到的骨量水平和进入中年期后骨量丢失的速率是决定老年人骨量的关键因素[1].为了解廊坊市正常人群骨密度的变化规律.为预防骨质疏松症、评估中老年营养膳食提供科学依据.笔者对廊坊市1128名正常人群进行了指骨骨密度检测.     

骨质疏松危害大 及早预防是上策

生活中,经常看到一些老年人弯腰驼背,身高越来越矮;人过60岁磕磕碰碰就骨折;有的老年人用力咳嗽,可能＂咳＂断几根肋骨……这都是骨质疏松症给老年人带来的麻烦。骨质疏松症是以骨量减少、骨组织显微结构退化为特征,以致骨的脆性增高而骨折危险性增加的一种全身骨病。体内降钙素、雌激素、甲状旁腺素等调节紊乱而导致的骨代谢异常是其发病原因。     

绝经后骨质疏松症的药物治疗进展

骨质疏松症(Osteoporosis)是一种以骨量减少和骨组织显微结构退化为特征,继而导致骨脆性增加和骨折危险性增高的系统性骨骼性疾病[1].60岁以上老年人OP发病率约为59.87%,OP并发骨折的发病率约为9.60%[2].近年来国内、外研究的重点是绝经后骨质疏松症.本文针对绝经后骨质疏松的药物治疗作了综述.报告如下.     

长沙地区健康体检人群跟骨骨密度测量结果及影响因素分析

目的 了解长沙地区健康人群骨密度情况,探讨骨质疏松症及低骨量者的影响因素。方法 对2012年6月至2013年7月健康体检者行骨密度测定, 同时记录性别、年龄、身高、体重、职业、停经年数、生活习惯(如烟、酒、膳食营养、运动)等。结果 骨质疏松症发生率为女15.68 % (50 岁以上20.42 %,60 岁以上54.60%,70 岁以上77.33%) ,男9.53 %(50 岁以上10.60 %,60 岁以上30.50%,70 岁以上65.26%) 。女性与男性之间相比,差异有统计学意义(X²=1753.41, P <0.01) ;50 岁以后的健康体检者,骨超声传导速率随年龄增高而下降(F=4.41, P <0.05)。单因素分析后多元Logistic回归分析结果表明,年龄、性别、体质量指数(BMI)、运动、饮酒及吸烟是影响骨密度的重要因素。结论 低骨量和骨质疏松症发生率与增龄有关,年龄越大,发生率越高。坚持运动、限烟酒及控制合适的体重是预防骨质疏松症的经济、有效的措施。     

Bone Health in Immigrant Hispanic Women Living in Texas

Osteoporosis is a serious national public health problem, and is expected to increase significantly over the next few decades, especially in women. A limitation of bone health research exists since few studies have involved Hispanic women, and even fewer, Hispanic immigrant women. For this study we examined the effects of anthropometric, behavioral, and health history variables on bone mineral density (BMD) in 84 immigrant Hispanic women, age 40 and above. BMD was assessed at the spine, femur, and forearm using dual energy x-ray absorptiometry (DXA). Demographic information, health histories, and behavioral risk factors were obtained from a questionnaire. In the younger group (mean age = 44.1 years) 61% had spinal osteopenia, and in the postmenopausal group (mean age = 53.0 years) 59% had osteopenia and 13% had osteoporosis. Femur sites were free of osteoporosis. Mean body mass index (BMI) was 31.8 ± 6.1 and mean waist girth was 95.6 ± 12.5 cm, indicating overall and abdominal obesity. Partial correlations indicated a significant positive relationship between body fat variables and total femur BMD values. ANOVAs revealed no differences in BMD values at any bone site across tertile levels for calcium intake or for physical activity. However, supplemental and dietary calcium intakes were very low and few participants engaged in regular physical activity outside of work and activities of daily living (ADL). In light of the expected increase in osteoporosis in this population and the prevalence of spinal osteopenia in the younger participants, education about the health risks of osteoporosis should be made available to this group.     

Relationship of nutrient intakes and bone mineral density of elderly women in Daegu, Korea

The purpose of this study was to examine the relationship between nutrient intake and bone mineral density (BMD) of elderly women in Daegu, Korea. In this study, the bone mineral densities of 101 elderly women in Daegu were measured, and their nutrient intake, dietary habits, and maternal factors were determined through a survey. The subjects were divided into the normal group, the osteopenia group, and osteoporosis group to find out if there is a correlation between bone mineral density and maternal factors, dietary habits, and nutrient intake through their T-scores, analyzed according to the standards of WHO. Classification by T-scores of the participants were the normal group 25.7%, the osteopenia group 39.6%, the osteoporosis group 34.7%. Menopause age of the osteoporosis group was lower, postmenopausal period was longer, and last delivery age was significantly higher than the normal group (p<0.05). Osteoporosis group had a lower percentage of ''everyday'' fruit and vegetable intakes and higher percentage of ''never'' dairy intake than of the normal group. Vitamin A, vitamin B₁, and vitamin B₂ intakes of participants in the osteoporosis group were lower than those in the normal group (p<0.05). In conclusion, nutritional education is necessary to encourage high intake of milk and vegetables and fruits along with calcium, vitamin A, B₁, and B₁ intakes and low intake of sodium for the prevention of elderly women''s osteoporosis.     

Underuse of procedures for diagnosing osteoporosis and of therapies for osteoporosis in older nursing home residents

OBJECTIVE: To investigate the prevalence of osteoporosis, the prevalence of utilization of bone mineral density (BMD) measurements for diagnosis of osteoporosis, and prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis in postmenopausal women in an academic nursing home. METHODS: The charts of all women aged 56 years and older residing in an academic nursing home were analyzed by one of the authors for the prevalence of osteoporosis, the prevalence of use of BMD measurements to diagnose osteoporosis, and the prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis. RESULTS: Of 136 postmenopausal women, mean age 79 +/- 10 years, 66 (49%) had measurements of BMD. Of these 66 women, 31 (47%) had osteoporosis, 21 (32%) had osteopenia, and 14 (21%) had normal BMD. Elemental calcium carbonate 1500 mg daily was prescribed to 17 of 31 women (55%) with osteoporosis, to 12 of 21 women (57%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 27 of 70 women (39%) with no BMD obtained. Any dose of calcium was prescribed to 78 of 136 elderly women (58%). Vitamin D supplements were prescribed to 13 of 31 women (42%) with osteoporosis, to 9 of 21 women (43%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 20 of 70 women (29%) with no BMD obtained. Vitamin D supplements were prescribed to 44 of 136 elderly women (32%). Biphosphonates were prescribed to 19 of 31 women (61%) with osteoporosis. Of 20 women on medications that increased the risk of osteoporosis, 6 (30%) had BMD measured. Nine of these 20 women (45%) were on calcium supplements. CONCLUSIONS: Older postmenopausal women in an academic nursing home have a high prevalence of osteoporosis and osteopenia, a low prevalence of measurement of BMD, and underuse of calcium, vitamin D supplements, and other antiresorptive therapies for treatment of osteoporosis.     

Prevention and Treatment of Osteoporosis in Postmenopausal Women

Postmenopausal osteoporosis is characterized by an increased rate of bone turnover accompanied by a reduction in bone mineral density (BMD) that results in an increased risk of fracture, especially of the vertebrae, hip, or wrist. Alendronate (Fosamax®, Fosamax Once-Weekly®), an oral bisphosphonate that inhibits osteoclast-mediated bone resorption and modulates bone metabolism, is a first-line therapy for the management of postmenopausal women with, or at risk of developing, osteoporosis.Alendronate produces sustained increases in BMD and reductions in bone turnover from baseline, and reduces the risk of vertebral, hip, wrist, and other fractures in women with postmenopausal osteoporosis. It also prevents bone loss, and reduces the risk of radiographic or clinical vertebral fracture in postmenopausal osteopenia. Provided administration instructions are followed, alendronate is generally well tolerated. Adverse events are usually transient and are associated with the upper gastrointestinal tract (abdominal pain, nausea, acid regurgitation, dyspepsia); moreover, the incidence of these adverse events with alendronate was similar to those with placebo. More serious events (esophagitis, gastric or duodenal ulceration or bleeding) are uncommon. Once-weekly formulations are as effective and as well tolerated as once-daily alendronate in postmenopausal women.Pharmacoeconomic evaluations suggest that alendronate is a viable treatment option in postmenopausal osteoporosis. The reduction in fracture-related healthcare utilization seen with alendronate results in decreased direct costs, including inpatient or long-term care. Markov state-transition models suggest that this could at least partially offset costs incurred with alendronate therapy. Treatment of women with osteoporosis aged 65 years and older, and postmenopausal women with a previous osteoporotic fracture, are cost-effective strategies. Alendronate is also likely to increase quality-adjusted life-years in any postmenopausal women with osteoporosis.In conclusion, clinical and economic data support the use of alendronate in postmenopausal osteoporosis. It effectively reduces bone turnover, increases BMD, and reduces the risk of osteoporotic fracture in postmenopausal women with established osteoporosis, especially older women with a higher risk of fracture. Although its cost effectiveness in postmenopausal women with osteopenia is not clearly established, alendronate is clinically effective in these patients. In addition, it is generally well tolerated when taken as recommended. Consequently, alendronate should be considered a therapy of choice in the prevention and treatment of osteoporosis in postmenopausal women.     

南通市4174例健康体检者的指骨骨密度调查

目的了解南通市骨质疏松症患病情况,为骨质疏松防治工作提供参考。方法对4174例健康体检者应用Metriscan TM测量非惯用手指指骨的骨密度（BMD）。结果骨密度（BMD）男性T值为（0．123±1．124）,正常者为84．6％,骨质减少为12．8％,骨质疏松为2．6％;女性丁值为（-0．101±1．421）,正常者为76．9％,骨质减少为12．9％,骨质疏松为10．2％;45岁以上各组,随年龄增加,骨密度T值呈逐渐下降,女性降低幅度高于男性（P〈0．05）。骨质疏松的检出率女性在50岁开始增高,男性≥70岁者明显增高,女性骨质疏松症检出率明显高于男性,差异有统计学意义（P〈0．01）。结论BMD测量可及早检出骨质疏松,而指骨BMD是一种简便易行的方法。骨质疏松症多见于中老年女性,应加强防治。     

Low bone mass and postfall fracture risk among elderly nursing home men

OBJECTIVE: To study postfall fracture risk in relation to bone mineral density. SETTING: The study was conducted in men residing in nursing homes. PARTICIPANTS: A total of 212 men above the age of 65 years were recruited, and of these, 172 satisfied the inclusion criteria of the study. Among them, 82 were less than 85 years old, and 90 were at least 85 years old. INTERVENTION: Bone mineral density (BMD) of the calcaneus was measured, using the Lunar PIXI Bone Densitometer (version 1.43) and charts were reviewed for age, falls, and fractures. MEASUREMENTS: The values of BMD were expressed as T-scores, and the Lunar criteria equivalents of T-scores were used (T-scores more than -0.6 for normal BMD, -0.6 to -1.6 for osteopenia, and below -1.6 for osteoporosis). RESULTS: The median age of all participants was 84 years (range 65 to 102 years), and their mean T-score at the calcaneus was -1.51. In about 51% of them, the T-score was in the osteoporotic range. For subjects less than 85 years old, the mean T-score was -1.19, and for those 85 years and older, the mean T-score was -1.81; the mean bone density of those in the older old group was significantly lower than those in the younger old group if there was a history of a fracture. Analysis by age quartiles showed a progressive decline in BMD with advancing age. About 53% of the subjects who fell (37.2%) sustained a nontraumatic fracture. Among them, 67.6% had osteoporosis. CONCLUSION: At any given age after age 65, men who sustained a postfall fracture had a significantly lower BMD than those who did not sustain a postfall fracture.     

中老年男性雄激素部分缺乏患者骨密度测定的临床价值

目的 探讨中老年男性雄激素部分缺乏(PADAM)患者的骨密度(BMD)特点和骨质疏松的发生率.方法 采用双能X线骨密度仪对56例PADAM患者(PADAM组)和与之年龄、体重指数(BMI)相匹配的51例健康中老年人(对照组)进行腰椎及股骨颈等部位的BMD测定,采用MES-01S20肌肉功能分析仪测定肌肉分布和力学特性,并收集相关生化指标、激素水平及部分骨代谢指标进行多元逐步回归分析.结果 与对照组比较,PADAM组腰椎BMD无显著改变(P＞0.05),而股骨颈、Ward三角区和大转子的BMD显著降低(P＜0.01),且其抗骨折能力和下肢最大肌力显著降低(P＜0.01).PADAM组和对照组的骨量减少发生率分别为48.2%(27/56)和35.3%(18/51),骨质疏松患病率分别为30.4%(17/56)和21.6%(11/51),两组比较差异有统计学意义(P＜0.05).PADAM患者的腰椎BMD与BMI呈正相关,而股骨颈、Ward三角区、大转子的BMD与年龄呈负相关,与BMI、血清总睾酮呈正相关(P＜0.05).结论 PADAM患者的BMD及抗骨折能力明显降低,存在骨质疏松性骨折的潜在危险,加强PADAM患者骨折的预防和治疗有重要意义.

Abstract：

Objective To explore the characteristics of bone mineral density (BMD) and the incidence of osteoporosis in partial androgen deficiency in aging male (PADAM) patients.Methods Fifty-six PADAM patients (PADAM group) and 51 healthy persons (control group) were selected according to their age and body mass index (BMI),and measured their BMD in the second to fourth lumber and the neck of femur with the dual-energy C X-ray BMD measuring instrument.MES-01S20 muscle function analyzer was used to determinate the distribution and mechanical properties of muscle.The biochemical and bone metabolic markers and sexual hormones were collected and observed by multivariate stepwise regression analysis.Results Compared with control group,BMD significantly decreased in the Ward triangle,femoral neck and big rotor (P ＜ 0.01 ) and no significant change in lumbar in PADAM group (P ＞ 0.05 ),and the fracture strength of femoral neck (FS) and the lower-limb muscular strength (MS) also significantly decreased (P ＜ 0.01 ).The incidence of osteopenia were 48.2% (27/56) and 35.3% ( 18/51 ),osteoporosis were 30.4% (17/56) and 21.6% ( 11/51 ) respectively in PADAM group and control group.There was significant difference between two groups (P＜0.05).The BMD was positively correlated to BMI at the first to fourth lumber and negatively correlated to age,positively correlated to BMI and serum level of andrusol at the proximal left femur in the patients with PADAM.Conclusion BMD and the resistance to fracture aresignificantly lower in PADAM patients,and aging lower BMI and androgen deficiency are the risk factors of low BMD in PADAM patients.There is the potential of osteoporotic fracture risk,and it is important to strengthening the prevention and treatment of fractures in elderly PADAM patients.     

Fracture thresholds revisited. Geelong Osteoporosis Study

Osteoporosis, in the absence of fracture, is defined as a deficit in bone mineral density (BMD) of 2.5 SD or more below the young adult reference mean in postmenopausal Caucasian populations. BMD is a measure of fracture risk but not the sole predictor. We have assessed a combination of easily accessible measures of age, height, weight, and BMD to improve fracture risk assessment. Women with low trauma fractures and a control group were recruited from south-eastern Australia. Discriminant analysis derived multivariate equations that assessed fracture risk. Age was not in the best models at the spine and forearm sites. Weight and height contributed to the relationship for the forearm sites only. At the proximal femur, the BMD level that separates fracture cases from nonfracture cases, increases with age. These separation levels of BMD were higher than the WHO's level of osteoporosis (T-score < -2.5 SD) at ages older than 62 years. This increasing BMD threshold with age suggests that other age-related risk factors assume increasing importance among the elderly.     

Effectiveness of screening for osteoporosis by bone density measurement for the prevention of fractures: a review of the evidence

To review evidence on the benefits of screening women and men for osteoporosis, a Pub Med search was performed in English papers published between 1990 and 2002. We used data from a cohort study to estimate risk of fracture from bone mineral density. Bone mineral density measured by dual X-ray absorptiometry (DXA) can predict bone fracture among elderly women, peri- and early post-menopausal women, and elderly men. It is recommended that all white women older than 65 years be screened routinely for osteoporosis. We suggest that Japanese elderly women should receive BMD measurements as a screening, but we have still issues to be solved including age from when the screening should be started, methods, and how to treat the women found to have osteoporosis at the screening. For peri- and postmenopausal women and elderly men, it might be beneficial to measure BMD as a screening and start treatment for those patients found to have osteoporosis. However, incidence of fractures for these people is lower than that for elderly women. One bone mass measurement can predict bone fracture risk for as long as over 10 years or more, but predictive ability of BMD decreases with time. Therefore, cost effectiveness needs to be reviewed to determine the benefits of screening among peri-menopausal women and men. Although bone assessment by quantitative ultra sound (QUS) method by ultrasound can also predict future fractures, only a relatively small number of longitudinal studies have been conducted in the Western countries, and there is no established evidence by means of longitudinal studies among Japanese. It is necessary in Japan to seek such evidence, however, since this method is widely used for an osteoporosis examinations.     

Prevalence of osteoporosis in postmenopausal women in family practice

OBJECTIVE: To assess the prevalence of osteopenia, osteoporosis and severe vertebral deformities in general practice. DESIGN: Cross-sectional study. METHODS: Of a randomly selected group of 712 women aged 55 to 84 years in a general practice in Noordwijk, the Netherlands, 449 (63%) participated in a study in 1996, in which Dual Energy X-ray Absorptiometry (DXA) of the femoral neck was performed: in 428 women vertebral morphometry of lateral radiographs of the spine was also done. The World Health Organization definitions of osteopenia and osteoporosis were used. RESULTS: The mean bone mineral density (BMD) was 0.866 g/cm2 (SD: 0.135). With increasing age the BMD decreased statistically significantly by 0.0073 g/cm2/year. There were 189 women with osteopenia (42%). 33 (7%) with osteoporosis and 44 (10%) with one or more severe vertebral deformities. A significantly lower mean BMD was found in those with severe vertebral deformities than in those without.