骨密度与股骨颈抗骨折能力对骨质疏松诊断价值的比较研究

目的 探索骨密度及股骨颈抗骨折能力两种骨质疏松的诊断方法在临床上应用中各自的特点。方法 用双能X线骨密度仪(DEXA)及神经-肌肉-关节-骨骼综合测量分析系统(MES)分别对118例绝经后妇女进行测量，比较两者的结果，探讨两者的差异的原因。结果 118例绝经后妇女中被DEXA诊断为骨质疏松者48人，患病率为40．67％。有24例被MES诊断为骨质疏松，患病率为20．34％。结论 研究提示DXEA测定骨密度(BMD)的方法更容易发现在正常体重者中的骨质疏松患者，而MES测定股骨颈抗骨折能力指标(FS)的方法在超体重和肥胖者中的骨质疏松诊断中占有优势。FS和BMD结合应用于骨质疏松诊断克服了骨密度(BMD)由于体重影响造成的漏诊和误诊现象。即在正常体重的患者进行诊断时选择BMD，而对于超体重和肥胖者使用FS指标则更为合理。     

福善美对绝经后妇女骨密度的影响

目的　评价福善美 (Fosamax)治疗绝经后骨质疏松症妇女的近期及中期疗效 ,以及改善骨量作用。方法　绝经 1年以上女性 80名 ,分成 4组 ,A组 :14例 ,年龄 5 4 . 97± 5. 5 1(47～ 6 2 )岁 ,绝经年限≤10年 ,疗程 6个月～ 1年 ;B组 :2 3例 ,年龄 5 5 . 5 5± 3. 6 6 (5 0～ 6 2岁 ) ,绝经年限≤ 10年 ,疗程 1年以上 ;C组 :18例 ,年龄 6 8. 18± 5 . 5 9(5 9～ 78岁 ) ,绝经年限 >10年 ,疗程 6个月～ 1年 ;D组 :2 5例 ,年龄6 7. 2 5± 6 .19(5 2～ 80岁 ,绝经年限 >10年 ,疗程 1年以上。患者每天接受口服福善美 10mg和元素钙5 0 0mg,疗程 6个月～ 2 8年。治疗前、后应用双能X线吸收仪 (HologicQDR 2 0 0 0型 )进行骨密度(BMD)测定。结果　 4组不论绝经年限长短 ,通过 6个月～ 2年以上福善美治疗 ,腰椎BMD平均增加百分率 3 74 %～ 5 4 5 % ,较基础值均有明显增加 (P <0 . 0 0 1) ,4组间差异无统计学意义 (P >0 . 0 5 )。股骨颈部位治疗后BMD平均增加百分率为 0 84 %～ 4 2 1% ,其中绝经年限相同时 ,疗程长者高于短者 ,即B组高于A组 ,D组高于C组 ;疗程相同时 ,绝经年限长者高于短者 ,即C组高于A组 ,D组高于B组 ,但 4组间差异无显著性 (P >0 . 0 5 )。大转子部位治疗后BMD增加平均变化百分率 1 4. 2 %～     

中药对绝经妇女股骨颈骨密度及股骨颈抗骨折能力的影响

目的 观察中药强骨胶囊（QGJN）对绝经妇女股骨颈骨密度（BMD）及股骨颈抗骨折能力（FS）的影响。方法 择自愿参加研究的绝经1年以上，年龄60岁以下的骨量减少或骨质疏松的绝经妇女150例，随机分为3组：中药＋激素组（50例）：采用中药QGJN联合雌激素戊酸雌二醇治疗；中药组（50例）：单纯用中药QGJN治疗；激素组（50例）：单纯用雌激素戊酸雌二醇周期序贯治疗；另50例符合上述条件，目前不愿接受研究用药的绝经妇女作为对照组。各组均于治疗前及治疗后24W采用DEXA骨密度仪测定股骨颈（BMD）。采用肌肉功能分析仪测定股骨颈抗骨折能力（FS）。结果 因各种原因失访18例，182例（包括对照组）完成了总疗程。中药＋激素组（46例）、中药组（48例）、激素组（42例）、股骨颈BMD及FS较治疗前均有明显升高，增幅分别为7．33％、9．04％（P〈0．01）；3．38％，5．87％（P〈0.01）；3．57％，5．91％（P〈0．01），其中中药＋激素组BMD及FS升高幅值均明显高于中药组（P〈0．01）和激素组（P〈0.01）；而激素组上述指标较中药组略高，但差异无显著性（P〉0．05）；对照组（46例）的BMD及FS明显下降。下降幅值分别为3、30％、5．31％。P〈0．01）。结论 中药强骨胶囊能提高绝经妇女股骨颈骨密度及股骨颈抗骨折能力。从而对绝经妇女骨质疏松具有较好的防治作用。其效果与雌激素戊酸雌二醇相仿。两药联用效果更好。     

No effect of vitamin K1 intake on bone mineral density and fracture risk in perimenopausal women

Introduction Vitamin K functions as a co-factor in the post-translational carboxylation of several bone proteins, including osteocalcin.Aim The aim of this study was to investigate the relationship between vitamin K₁ intake and bone mineral density (BMD) and fracture risk in a perimenopausal Danish population.Design The study was performed within the Danish Osteoporosis Prevention Study (DOPS), including a population-based cohort of 2,016 perimenopausal women. During the study approximately 50% of the women received hormone replacement therapy (HRT). Associations between vitamin K₁ intake and BMD were assessed at baseline and after 5-years of follow-up (cross-sectional design). Moreover, associations between vitamin K₁ intake and 5-year and 10-year changes in BMD were studied (follow-up design). Finally, fracture risk was assessed in relation to vitamin K₁ intake (nested case–control design).Results In our cohort, dietary vitamin K₁ intake (60 μg/day) was close to the daily intake recommended by the Food and Agriculture Organization (FAO). Cross-sectional and longitudinal analyses showed no associations between intake of vitamin K₁ and BMD of the femoral neck or lumbar spine. Neither did BMD differ between those 5% that had the highest vitamin K₁ intake and those 5% that had the lowest. During the 10-years of follow-up, 360 subjects sustained a fracture (cases). In a comparison between the cases and 1,440 controls, logistic regression analyses revealed no difference in vitamin K₁ intake between cases and controls.Conclusion In a group of perimenopausal and early postmenopausal women, vitamin K₁ intake was not associated with effects on BMD or fracture risk.     

Effect of intranasal salmon calcitonin therapy on bone mass and bone turnover in early postmenopausal women: A dose-response study

We examine the dose-related effect of intranasal salmon calcitonin (sCT) on the early postmenopausal bone loss and bone turnover; a 2-year, prospective, randomized, double-blind, placebo-controlled study was carried out with 134 healthy women who had passed a natural menopause within 6 months to 3 years. The women were allocated randomly to 2 years of treatment with either 100, 200, or 400 IU of sCT given intranasally or placebo. All groups received a calcium supplement of 500 mg. Twenty-one women left the study before its end and 91 complied with the study criteria throughout. Bone mineral content/density of the distal forearm and lumbar spine and biochemical parameters of bone turnover were measured. Although the measurements after 24 months revealed no significant difference between groups in bone mineral density of the lumbar spine, the average changes over time revealed prevention of bone loss in the groups treated with 200 and 400 IU of sCT (0.2 to-0.6%) and declines of 0.8-1.7% in the groups treated with 100 IU of sCT and placebo (P<0.05–0.01; within-group testing). There was no dose-related response to sCT but there was a significant difference between the pooled groups treated with 200 plus 400 IU of sCT versus the 100 IU sCT and placebo-treated groups (P=0.030–0.005). The same difference between groups was seen for biochemical parameters of bone turnover (P=0.022–0.003). The biochemical parameters of bone turnover revealed decreases of 10–20% (P<0.001; within group testing) in the groups treated with the two highest sCT doses. It was concluded that nasal sCT in doses of 200 and 400 IU has some effect in women soon after the menopause—preventing the bone loss in the spine throughout the first year of therapy and lowering the bone turnover. It may be used as an alternative to hormone replacement when estrogens are contraindicated. The present data indicate that discontinuous strategies should be preferred.     

用骨强度概念探索骨密度测量的诊断指标

30多年来，医学上一直用骨矿密度（BMD,g/cm^2）诊断骨质疏松，骨质疏松引起骨折，骨折由骨强度减低引起，体重是骨强度的重要决定因素。 本引入体重评价BMC（g）和BMD两个指标。结果，体重与BMC的相关明显强于与BMD的相关，证明男女之间的BMC差由体重引起，男女间相同体重配对的BMC没有差异，所以在评价骨的 力学强度上体重标准化后BMC优于BMC指标。     

Increased trabecular bone density due to bone-loading exercises in postmenopausal osteoporotic women

Summary A program of diverse and dynamic loading exercises of the distal forearm, a common site of osteoporotic fractures, was applied three times a week for 5 months to 14 postmenopausal osteoporotic women. Two parameters were used to assess the effect of the exercises on bone mass. The mass density of bone (g/cm³) was measured by the Compton scattering technique. The bone mineral content (g/cm²) was measured by single photon absorptiometry. Both measurements were taken at the same location in the distal radius 1 year prior to the exercise period, at its beginning, and at its end, in both the exercised group and a matched control group of 25 osteoporotic women. During the exercise period the mean bone density decreased by 1.9% in the control group whereas it increased by 3.8% in the exercise group. The bone mineral content results did not demonstrate any significant trend over the whole period of the study. It is concluded that the trabecular bone tissue in the distal radius of postmenopausal osteoporotic women responds favorably to dynamic and diverse bone stressing exercises even in the seventh decade of life.     

乌鲁木齐城市和农村绝经后妇女血清维生素D与骨质疏松状况调查

目的调查乌鲁木齐城市及周边农村绝经后妇女血清25(OH)D水平及骨质疏松状况。方法纳入乌鲁木齐城市及周边农村年龄≥55岁,绝经时间≥1年的女性,收集其一般资料、完成调查问卷、测定血清25(OH)D、甲状旁腺激素(parathyroid hormone,PTH)、碱性磷酸酶(alkaline phosphates,ALP)、Ca、P水平及骨密度。结果 1)符合条件者共231人,其中城市有114人,农村有117人。(2)城市妇女血清25(OH)D水平为17(11.75,23)ng/m L,高于农村妇女15(8,21)ng/m L(P=0.017),且城市妇女中25(OH)D充足人数所占比例高于农村(10.53%vs 3.42%,P=0.033)。(3)在骨量减少和骨质疏松人群中,城市妇女血清25(OH)D_3水平高于农村。(4)血清25(OH)D_3水平在城市妇女中与PTH呈负相关(ρ=-0.247,P=0.008),在农村妇女中与PTH、ALP、白蛋白(albumin,ALB)呈负相关(ρ=-0.344,P0.001;ρ=-0.193,P=0.037;ρ=-0.202,P=0.029),与腰椎骨密度值呈正相关(ρ=0.195,P=0.035)。结论乌鲁木齐城市与农村绝经后女性骨质疏松的患病率高,维生素D缺乏及不足情况较为普遍。城市和农村绝经后妇女血清维生素D与骨质疏松状况存在差异。     

Effect of combined administration of vitamin D3 and vitamin K2 on bone mineral density of the lumbar spine in postmenopausal women with osteoporosis

The effect of the combined administration of vitamin D₃ and vitamin K₂ on bone mineral density (BMD) of the lumbar spine was examined in postmenopausal women with osteoporosis. Ninety-two osteoporotic women who were more than 5 years after menopause, aged 55–81 years, were randomly divided into four administration groups: vitamin D₃ (1α hydroxyvitamin D₃, 0.75 μg/day) (D group; n = 29), vitamin K₂ (menatetrenone, 45 mg/day) (K group; n = 22), vitamin D₃ plus vitamin K₂ (DK group, n = 21), and calcium (calcium lactate, 2 g/day) (C group; n = 20). BMD of the lumbar spine (L2–L4) was measured by dual energy X-ray absorptiometry at 0, 1, and 2 years after the treatment started. There were no significant differences in age, body mass index, years since menopause, and initial BMD among the four groups. One-way analysis of variance (ANOVA) with repeated measurements showed a significant decrease in BMD in the C group (P < 0.001). Two-way ANOVA with repeated measurements showed a significant increase in BMD in the D and K groups compared with that in the C group (P < 0.05 and P < 0.001, respectively), and a significant increase in BMD in the DK group compared with that in the C, D, and K groups (P < 0.0001, P < 0.05 and P < 0.01, respectively). These findings indicate that combined administration of vitamin D₃ and vitamin K₂, compared with calcium administration, appears to be useful in increasing the BMD of the lumbar spine in postmenopausal women with osteoporosis. Received: January 13, 2000 / Accepted: June 5, 2000     

Interpretation of lumbar spine densitometry in women with fractures

Identification of postmenopausal women at risk of developing osteoporotic fractures is a major clinical problem. In this study the use of projected planar lumbar bone density values for individual fracture risk assessment was questioned. Osteodensitometry (DXA) results from 415 normal women, 62 women with previous vertebral compressions, and 76 women with previous low-energy fractures were analyzed, together with their body size and lumbar vertebral body size variables. The following were found: (1) Lumbar vertebral projected bone mineral areal density (BMD) and bone mineral content (BMC) of normal women correlated with body size variables (p<0.001). (2) Lumbar vertebral body size variables also correlated with body size variables (p<0.001). Logistic regression analysis of measured and derived physical variables from women without and with vertebral compression fractures (n=477) showed: (3) The best compression fracture discriminator, significantly better than BMD, was BMC divided by (H_max/165 cm)¹⁵×(D/4.35 cm)^1.5, where H_max is the body height (cm) at the menopause, and D the mean lumbar vertebral diameter of the three mid-lumbar vertebral bodies (cm). This parameter was termed BMC_corr.. ROC analysis showed: (4) At a BMC_coor. true positive ratio of 80% the corresponding uncorrected BMC or BMD true positive ratio was only 60%. The corresponding false positive ratio was 6%. Lumbar osteodensitometry could not be used to identify women with a history of peripheral low-energy fractures. (5) BMC_coor. did not, unlike BMC and BMD, correlate with body size and vertebral size variables. (6) Likewise, an observed correlation between BMC and lean body mass in a subpopulation of 116 normal women was abolished when BMC_corr. replaced BMC. We suggest that vertebral compression fracture risk limits based on BMC, corrected for individual differences in body size and vertebral body size, replace the commonly used BMD fracture risk limits. The discriminatory ability of BMC_corr. for low-energy fractures needs to be tested in a different population.This investigation was carried out as part of a collaborative study by the Danish Osteoporosis Study Group (DOPS: O. Helmer Sørensen, L. Mosekilde, P. Charles, H. Beck-Nielsen and S. Pors Nielsen).     

Femoral neck geometry and hip fracture risk: the Geelong osteoporosis study

To determine the relationship between femoral neck geometry and the risk of hip fracture in post-menopausal Caucasian women, we conducted a retrospective study comparing the femoral neck dimensions of 62 hip fracture cases to those of 608 randomly selected controls. Measurements were made from dual-energy X-ray absorptiometry scans (Lunar DPX-L), using the manufacturers ruler function, and included: hip axis length (HAL), femoral neck axis length (FNAL), femoral neck width (FNW), femoral shaft width (FSW), medial femoral shaft cortical thickness (FSCT_med), and lateral femoral shaft cortical thickness (FSCT_lat). The fracture group was older (median age 78.3 years vs 73.8 years), lighter (median weight 59.9 kg vs 64.5 kg), and, after adjustment for age, taller (mean height 158.7±0.8 cm vs 156.7±0.2 cm) than the controls. Furthermore, bone mineral density was lower in this group (0.682±0.016 g/cm² vs 0.791±0.006 g/cm²). After adjustment for age, bone mineral content (BMC) or height, hip fracture patients had greater FNW (up to 6.6%) and FSW (up to 6.3%) than did the controls. Each standard deviation increase in FNW and FSW was associated with a 1.7-fold (95% CI 1.3–2.3) and a 2.4-fold (95% CI 1.8–3.2) increase in the fracture risk, respectively. BMC-adjusted FNAL was greater in the fracture group (+2.1%) than in the controls, while the age-adjusted FSCT_med was reduced (–7.2%). There was a trend towards longer HAL (up to 2.1%) after adjustment for age or BMC, and thinner age-adjusted FSCT_lat (–1.7%) in fracture patients that did not reach statistical significance. In multivariate analysis, the risk of hip fracture was predicted by the combination of age, FNW, FSW, BMC and FSCT_med. HAL was not analyzed because of the small number of HAL measurements among fracture cases. We conclude that post-menopausal women with hip fractures have wider femoral necks and shafts, thinner femoral cortices and longer femoral neck axis lengths than do women with no fractures. Alteration in hip geometry is associated with the risk of hip fracture.The authors declare no conflicts of interest with regard to this article     

绝经后骨质疏松症妇女血清痩素水平与骨密度的关系

目的 观察绝经后骨质疏松症妇女血清瘦素水平与骨密度(BMD)、骨矿含量(BMC)的相关性。方法 ELISA法检测32名绝经后骨质疏松症妇女(绝经组)和27名体重指数(BMI)相匹配的非绝经正常对照者(非绝经组)的空腹血清瘦素浓度,双能X线骨密度仪测定受试者腰椎BMD、BMC、T值、Z值。结果 绝经组和非绝经组的血清瘦素浓度分别为12.43±7.90ng/ml和11.76±4.42ng/ml,两组之间无差异;两组血清瘦素浓度均与体重、BMI和脂肪含量(Fat％)显著正相关,绝经组的瘦素水平与BMD及BMC无相关性,非绝经组瘦素浓度与BMDIL3和BMCL5相关(r=0.132,P<0.05;r=0.140,P<0.05),但调整BMI后瘦素浓度与BMD及BMC:的相关性消失(r=0.079,P>0.05;r=0.067,P>0.05)。结论成年妇女瘦素水平与体重、体脂及脂肪含量显著相关,瘦素不是绝经后妇女骨质疏松症的主要影响因素。     

维生素k2 —新型骨质疏松防治药物

骨质疏松症是以骨量减少及骨组织的微观结构退化为特征的系统性骨骼疾病,主要表现为骨密度减少,骨质量降低,骨强度下降及骨折增加。维生素K2在骨形成及维持骨健康方面扮演重要角色且具有良好的药用安全性。临床上,可利用维生素K2防治妇女绝经导致的骨质疏松及其他类型的骨质疏松症,大量的人体试验研究证实,定期摄入维生素K2不仅可显著增加骨密度,而且可改善骨质量,从而提高骨强度,有效降低骨折风险及减少骨流失。     

股骨颈骨折合并抑郁老年男性骨密度和骨代谢变化

目的分析老年男性股骨颈骨折合并抑郁患者骨密度和骨代谢生化指标变化,探讨抑郁对骨质疏松骨代谢的影响。 方法选取于北京医院骨科2017年1月至2019年1月住院的老年男性股骨颈骨折患者102例。排除病理性骨折、认知功能障碍等患者。依据老年抑郁量表(GDS)将老年男性股骨颈骨折患者分为抑郁组和对照组。通过测定并比较两组患者的骨密度(BMD)、血清碱性磷酸酶(ALP)、血钙、血磷、25-羟基-维生素D[25(OH)D]、骨钙素(OC)、Ⅰ型原胶原氨基端前肽(P1NP)、血清Ⅰ型胶原羧基末端肽交联β特殊序列(β-CTX)水平,分析抑郁严重程度(GDS评分)与骨密度及骨代谢生化指标的相关性。分类变量的比较采用卡方检验,连续变量的比较采用t检验,两组连续性变量的相关性应用Pearson相关分析。 结果抑郁组患者BMD明显低于对照组(腰椎t ＝5.964、髋部t ＝2.845,P <0.05)。与对照组相比,抑郁组血清25(OH)D水平下降(t ＝3.077,P <0.05),抑郁组血清OC水平低于对照组(t ＝2.013,P <0.05),而血清β-CTX水平高于对照组(t ＝2.938,P <0.05),P1NP水平与对照组差异无统计学意义(t ＝0.684,P >0.05)。抑郁严重程度(GDS评分)与BMD(r＝-0.456,P <0.05)、25(OH)D(r＝-0.546,P <0.05)、OC(r＝-0.215,P <0.05)呈负相关,与P1NP(r＝-0.115,P>0.05)相关性不显著,与β-CTX(r＝0.372,P<0.05)呈正相关。 结论抑郁症患者的骨形成标志物水平降低和骨吸收标志物水平升高,抑郁症是低骨密度和骨折的危险因素。应重视老年抑郁症患者骨代谢指标和25(OH)D的检测,及时进行维生素D的补充和有效的抗骨吸收药物治疗。     

Effects of calcium supplements on femoral bone mineral density and vertebral fracture rate in vitamin-D-replete elderly patients

The efficacy of calcium (Ca) in reducing bone loss is debated. In a randomized placebo-controlled double-masked study, we investigated the effects of oral Ca supplements on femoral shaft (FS), femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD), and on the incidence of vertebral fracture in vitamin-D-replete elderly. Ninety-three healthy subjects (72.1±0.6 years) were randomly allocated to three groups receiving 800 mg/day Ca in two different forms or a placebo for 18 months. Sixty-three patients (78.4±1.0 years) with a recent hip fracture were allocated to two groups receiving the two forms of Ca without placebo. FS BMD changes in Ca-supplemented non-fractured women were significantly different from those in the placebo group (+0.6±0.5% v –1.2±0.7%,p<0.05). There was no difference in effect between the two forms of Ca. The changes of +0.7±0.8% v –1.7±1.6% in FN BMD of Ca-supplemented women and the placebo group did not reach statistical significance. In fractured patients, FS, FN and LS BMD changes were –1.3±0.8, +0.3±1.6 and +3.1±1.2% (p<0.05 for the last). The rate of new vertebral fractures was 74.3 and 106.2 fractures per 1000 patient-years in Ca-supplemented non-fractured subjects and in the placebo group, respectively, and 144.0 in Ca-supplemented fractured patients. Thus, oral Ca supplements prevented a femoral BMD decrease and lowered vertebral fracture rate in the elderly.     

No effect of vitamin A intake on bone mineral density and fracture risk in perimenopausal women.

In recent studies from Sweden and the United States, a high vitamin A intake has been associated with low bone mineral density (BMD) and increased fracture risk. In Sweden and the United States, food items such as milk and breakfast cereals are fortified with vitamin A, whereas in Denmark there is no mandatory fortification with vitamin A. In the present study, we investigated relations between vitamin A intake and BMD and fracture risk in a Danish population consuming mostly unfortified food items. Within a population-based cohort study in 2,016 perimenopausal women, associations between BMD and vitamin A intake were assessed at baseline and after 5-year follow-up. Moreover, associations between baseline vitamin A intake and 5-year changes in BMD were studied. Finally, fracture risk was assessed in relation to vitamin A intake. In our cohort, dietary retinol intake (0.53 mg/day) was lower than the intake reported in recent studies form Sweden (0.78 mg/day) and the United States (1.66 mg/day). Cross-sectional and longitudinal analyses showed no associations between intake of vitamin A and BMD of the femoral neck or lumbar spine. Neither did BMD differ between those 5% who had the highest, and those 5% who had the lowest, vitamin A intake. During the 5-year study period, 163 subjects sustained a fracture (cases). Compared to 978 controls, logistic regression analyses revealed no difference in vitamin A intake. Thus, in a Danish population, average vitamin A intake is lower than in Sweden and the United States and not associated with detrimental effects on bone.     

Relationship between leg bone mineral values and muscle strength in women with different physical activity

This study examines whether knee extensor muscle isometric, isokinetic, and isoinertial strength values in women with different physical activity and body composition patterns are related to leg bone mineral density (BMD) and bone mineral content (BMC) values. A total of 129 women aged 17–40 participated in this study. They were divided into four groups: strength-trained (n = 33), endurance-trained (n = 32), normal weight sedentary (n = 41), and overweight sedentary (n = 23) women. In addition, the subjects were grouped as physically active (n = 65) or sedentary (n = 64) women. BMD and BMC for both legs (LBMD and LBMC, respectively) and for the dominant leg alone (DLBMC), body fat percentage and lean body mass (LBM), maximal knee extension isometric (ISOM) and isokinetic (ISOK) strength at the angular velocity of 60 deg·s⁻¹, and isoinertial leg explosive strengths (countermovement jump CMJ) were measured. In endurance-trained women, LBMD was dependent on body mass index (BMI) (33.7% of the variance, R² × 100), and in the physically active group and the total group with LBM (14.6% and 15.6%, respectively). In the overweight group, LBMD was dependent on ISOK strength (21.7% of the variance, R² × 100). In the sedentary and total groups, ISOM strength was more important (10.3% and 5.0%, respectively); in the strength-trained group, body weight influenced LBMC, accounting for 71.6% of the variance (R² × 100). In the endurance-trained women, height influenced LMBC (37.9%, R² × 100). In sedentary and overweight women, LBM accounted for 52.1% and 61.4% of the total variance in LBMC. In these groups, ISOM strength accounted for 15.3% and 25.9% of the variance in LBMC. In overweight women, ISOM and ISOK strength together influenced LBMC highly (64.8% of the variance, R² × 100). In the sedentary group, the influence of LBM on LBMC was higher than in the active group (82.1% and 50.5% of the variance, respectively). In the total group, LBM influenced LBMC, accounting for 54.5% of the variance (R² × 100). ISOM strength (22.7%) alone or in combination with ISOK strength (35.8%) and CMJ (41.7%) (R² × 100) in LBMC in the sedentary group explained the variance. In the total group, ISOM strength alone (13.2%) or in combination with CMJ (17.1%) influenced LBMC (R² × 100). Our results suggest that (1) muscle strength and anthropometrical parameters were associated with LBMD; (2) LBM and ISOM strength had a significant relationship with DLBMC and LBMC only in nonathletic women; and (3) strength measured with different regimens highly influenced LBMC compared with LBMD, especially in the sedentary groups.     

Bone Parameters are Improved with Intermittent Dosing of Vitamin D<Subscript>3</Subscript> and Calcitonin

Intermittent combination of an anabolic agent to promote bone formation and an antiresorptive agent that would prevent further bone loss is a theoretically attractive approach for restoring bone mass. We tested the potential of intermittently dosed calcitriol and calcitonin (CT) to restore bone properties in ovariectomized (Ovx) rats. Rats had Ovx or sham surgery at 8 weeks old and 4 weeks later were assigned to experimental groups: (1) sham vehicle, (2) Ovx vehicle, (3) Ovx + parathyroid hormone (PTH, 40 μg/kg), and (4) Ovx + calcitriol (2 μg/kg) + CT (2 μg/kg). Group 3 received PTH every week throughout the study, and group 4 received calcitriol at weeks 1, 3, 5, and 7 and CT at weeks 2, 4, 6, and 8. Dosing was carried out for 8 weeks with serum, and micro-computed tomographic analysis was done at 0, 4, and 8 weeks. Femurs and tibias were used for radiological analyses and for mechanical testing. Dosing with PTH improved bone mass and structure of cancellous bone at metaphyses of tibias and femurs as well as properties of cortical bone including geometry and strength. Intermittent dosing with calcitriol and CT was less potent in correcting loss of cancellous bone relative to treatment with PTH and had no effect on cortical bone parameters. However, intermittent dosing with calcitriol and CT was robust enough to improve cancellous bone mass and structure through bone formation without causing deleterious side effects. Our data provide additional evidence that therapies can be devised to ameliorate the skeletal defects associated with established osteoporosis.     

Menatetrenone (Vitamin K<Subscript>2</Subscript>) Acts Directly on Circulating Human Osteoclast Precursors

It is still not certain what the direct effect of menatetrenone is on osteoclast precursors. In the present study, we investigated whether menatetrenone has a direct effect on circulating osteoclast precursors to influence osteoclast differentiation. Monocytes isolated from human peripheral blood were cultured with receptor-activated NF-B ligand (RANKL) and macrophage colony-stimulating factor (M-CSF). Menatetrenone or vitamin K₁ was then added to the cultures. Geranylgeraniol or phytol (the respective side chain) was also added to the cultures instead of menatetrenone or vitamin K₁, respectively. After 7 and 14 days incubation, cultures were evaluated for cytochemical and functional evidence of osteoclast formation. The number of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells (MNCs) and the percentage area of lacunar resorption induced by RANKL and M-CSF were decreased when menatetrenone or geranylgeraniol was added to the cultures. Dose-dependent inhibition of osteoclast formation and lacunar resorption was seen when the cultures were treated with menatetrenone or geranylgeraniol. In contrast, vitamin K₁ or phytol did not affect the number of TRAP-positive MNCs nor the percentage area of lacunar resorption. These results indicate that menatetrenone not only influences osteoclast formation via bone stromal cells but also acts directly on circulating osteoclast precursors to influence osteoclast differentiation. These findings also suggest that geranylgeraniol, the side chain of menatetrenone, plays an important role in this inhibitory effect.     

维生素K2对绝经后骨质疏松症的防治作用及血清组织蛋白酶K影响

目的研究维生素K_2对绝经后女性骨质疏松患者骨密度、骨代谢及血清组织蛋白酶K(cathe K)的影响。方法选取自2014年5月至2016年1月我院骨质疏松患者,共有120例符合纳入标准。患者随机分为维生素K_2组、雷奈酸锶组和空白对照组(各N=40)。雷奈酸锶组每天口服2 g雷奈酸锶。维生素K_2组给予固力康胶囊:每次15 mg,每天3次。药物治疗前、术后6个月检测其骨密度,同时测量血清中血清骨钙素(BGP)、β-胶原降解产物(β-crosslaps)、Ⅰ型前胶原氨基端前肽(PINP)、血清组织蛋白酶K(cathe K)及抗酒石酸酸性磷酸酶(TRAP)水平。结果药物治疗前后,各组的骨密度,骨代谢指标和cathepsin K均有不同的变化;相对空白对照组,维生素K_2组、雷奈酸锶组髋部及腰椎密度都有不同程度的升高,其中雷奈酸锶组骨密度变化更明显,和其他组比较有明显的统计学意义(P0.05);雷奈酸锶组破骨活性(β-crosslaps、TRAP)最低,成骨活性(BGP、PINP)较高,而维生素E组破骨活性降低(β-crosslaps、TRAP),成骨活性(BGP、PINP)也增高,各组比较有明显的统计学意义(P0.05);相对于其他组,雷奈酸锶组cathepsin K下降的最明显,各组比较有明显的统计学意义(P0.05)。结论适量维生素K_2可以通过促进成骨活性,降低破骨活性及cathepsin K表达来改善绝经后女性骨质疏松患者髋部及腰部的骨密度。