绝经后妇女雌激素缺乏与胆固醇酯转运蛋白水平改变的关系

目的　探讨雌激素是否影响血清胆固醇酯转运蛋白 (CETP)水平的调节。方法　采用放射免疫分析法测定了 196例包括绝经前 (5 2例 ,年龄 18～ 40y)、绝经后妇女 (87例 ,年龄 61～ 81y)及围绝经期妇女 (5 7例 ,年龄 41～ 60 y)的血清雌二醇(E2 )、促卵泡生成激素 (FSH) ;自制CETP单抗建立的ELISA法测定CETP水平 ,同时测定血脂类指标。结果　绝经后妇女CETP水平明显低于绝经前和围绝经期妇女 (P <0 0 0 0 1) ,E2 水平较绝经前和围绝经期妇女显著下降 (P <0 0 0 0 1) ,而FSH水平显著升高 (P <0 0 0 0 1) ,各组血脂水平亦有显著性差异。CETP与E2 呈正相关 (r =0 .2 4,P <0 0 0 1) ,与FSH呈负相关(r =- 0 .2 7,P <0 0 0 1) ,与年龄呈负相关 (r=- 0 .3 1,P <0 0 0 0 1)。结论　雌激素水平的下降可影响绝经后妇女血清CETP水平     

绝经后骨代谢激素紊乱对妇女骨密度及相关生化指标的影响

目的观察绝经前后妇女骨密度的变化与甲状旁腺激素、降钙素和 1,2 5 (OH) 2 D3 及相关生化指标间的关系。方法采用X线骨密度仪测量骨密度 ,用放免法检测患者血中甲状旁腺激素、降钙素水平 ,利用全自动生化仪检测血钙、血磷、血碱性磷酸酶 (ALP)。结果绝经后妇女各部位骨密度均下降 (P <0 .0 5 ) ;血甲状旁腺素水平升高 (P <0 .0 5 ) ;降钙素水平有下降趋势 ;血钙、血磷均无明显变化 (P >0 .0 5 ) ;血中ALP水平较绝经前升高 (P <0 .0 5 )。结论妇女绝经后 ,骨代谢激素分泌发生紊乱 ,骨密度下降     

中国绝经后妇女血清组织蛋白酶K水平与骨密度、骨转换指标相关性研究

目的：本研究的目的是探讨中国汉族绝经后妇女血清血清组织蛋白K（cathepsin K,CTSK）水平与骨密度、骨转换指标的关系, 方法：研究中共纳入590名绝经后妇女,年龄范围为50.0-84.0岁,检测其血清CTSK、PTH、25(OH)D、β-1型胶原羧基末端肽（β-CTX）、1型原胶原N端前肽（P1NP）等指标,并应用双能X线吸收仪（DXA）检测腰椎1-4（L1-4）、左侧股骨近端包括股骨颈、全髋部骨密度。 结果：在本研究中,血清CTSK水平与绝经后妇女年龄、BMI、腰椎骨密度、髋部骨密度及骨转换指标水平无明显相关性。 结论：中国汉族绝经后妇女血清CTSK水平与绝经后妇女骨密度、骨转换指标无明显相关性,血清CTSK水平可能不适合作为一项新的骨转换指标。     

绝经后妇女骨密度与肥胖指标的相关性

目的探讨绝经1～10年妇女腰椎和股骨近端的骨密度与肥胖相关指标之间的相关性.方法[1]选择2001-08在广州医学院第二附属医院门诊进行健康体检的绝经1～10年的妇女85例,年龄46～63岁.均自愿接受各项指标测定.[2]计算体质量指数(体质量/身高2);用放射免疫法测定胰岛素和瘦素.采用生物阻抗法测定体脂量.采用骨密度仪测定腰椎及左侧股骨颈、Wards区和大转子的骨密度.[3]用直线相关分析数据间的相关性.其中三酰甘油、瘦素和胰岛素的数据分析前先经自然对数转换.结果纳入绝经后妇女85例进入结果分析.[1]单因素相关分析结果腰椎骨密度与绝经年限呈显著负相关(t=-0.431,P＜0.01),与体质量呈显著正相关(t=0.244,P＜0.05);股骨颈和Wards区骨密度与绝经年限呈显著负相关(t=-0.334,-0.374,P＜0.01),股骨颈、Wards区和大转子骨密度与体质量、身高、体质量指数、体脂量呈显著正相关(t=0.225～0.520,P＜0.05～0.01).股骨颈骨密度与瘦素呈显著正相关(t=0.225,P＜0.05).[2]多元逐步回归分析结果腰椎骨密度=1.077-0.022绝经年限;股骨颈骨密度=-0.376+0.651身高+0.011体质量指数-0.006绝经年限-0.028 ln三酰甘油;Wards区骨密度=0.398+0.008体质量-0.011绝经年限-0.048 ln三酰甘油;大转子骨密度=0.389+0.006体质量.结论[1]胰岛素、瘦素、三酰甘油、总胆固醇水平与骨密度无明显相关性.[2]影响骨密度的主要因素是身高、体质量、体质量指数、绝经年限和三酰甘油,与肥胖密切相关的胰岛素和瘦素不是影响骨密度的重要因素.     

绝经后妇女骨密度与肥胖指标的相关性

目的:探讨绝经1～10年妇女腰椎和股骨近端的骨密度与肥胖相关指标之间的相关性。方法:①选择2001-08在广州医学院第二附属医院门诊进行健康体检的绝经1～10年的妇女85例,年龄46～63岁。均自愿接受各项指标测定。②计算体质量指数(体质量/身高2);用放射免疫法测定胰岛素和瘦素。采用生物阻抗法测定体脂量。采用骨密度仪测定腰椎及左侧股骨颈、Wards区和大转子的骨密度。③用直线相关分析数据间的相关性。其中三酰甘油、瘦素和胰岛素的数据分析前先经自然对数转换。结果:纳入绝经后妇女85例进入结果分析。①单因素相关分析结果:腰椎骨密度与绝经年限呈显著负相关(t=-0.431,P<0.01),与体质量呈显著正相关(t=0.244,P<0.05);股骨颈和Wards区骨密度与绝经年限呈显著负相关(t=-0.334,-0.374,P<0.01),股骨颈、Wards区和大转子骨密度与体质量、身高、体质量指数、体脂量呈显著正相关(t=0.225～0.520,P<0.05～0.01)。股骨颈骨密度与瘦素呈显著正相关(t=0.225,P<0.05)。②多元逐步回归分析结果:腰椎骨密度=1.077-0.022绝经年限;股骨颈骨密度=-0.376+0.651身高+0.011体质量指数-0.006绝经年限-0.028ln三酰甘油;Wards区骨密度=0.398+0.008体质量-0.011绝经年限-0.048ln三酰甘油;大转子骨密度=0.389+0.006体质量。结论:①胰岛素、瘦素、三酰甘油、总胆固醇水平与骨密度无明显相关性。②影响骨密度的主要因素是身高、体质量、体质量指数、绝经年限和三酰甘油,与肥胖密切相关的胰岛素和瘦素不是影响骨密度的重要因素。     

1768例中老年妇女绝经后骨质疏松患病率及危险因素调查分析

目的调查并分析小榄地区中老妇女骨质疏松症的患病现状及引起该疾病的危险因素。方法采取问卷调查及现场测量方式分别获得研究人群的年龄、性别、身高、体质量以慢性病史及家族病史。酶联免疫吸附法(ELISA)检测血清25羟维生素D[25-(OH)D],全自动生化仪测血生化及血脂。使用美国HOLOGIC公司Saraha型号超声骨密度仪测定左侧跟骨骨密度。结果在调查的1 768例绝经后中老年妇女中,骨质疏松的患病率为39.2%,50~59岁年龄组为19.0%,60~69岁年龄组为36.5%,70岁以上年龄组为70.1%。年龄与骨密度负相关(r=-0.437,P0.01),体质量指数(BMI)(r=0.28,P0.01)及绝经年龄(r=0.115,P0.01)与骨密度正相关,三酰甘油及高密度脂蛋白与骨密度呈正相关,总胆固醇、低密度脂蛋白及血25-(OH)D与骨密度无相关性。结论小榄地区绝经后中老年妇女骨质疏松高发,与多种因素有关。     

绝经和中老年妇女骨密度的关系

目的:研究绝经和中老年妇女骨密度的关系,为骨质疏松的诊断和预防提供科学依据.方法:选择45～55岁153例女性为检测对象,分为绝经组和未绝经组,用定量超声骨密度仪(QUS)测定受栓者足跟部骨密度(BMD)值,同时测量受检者体重、身高、体质指数.结果:绝经组骨密度值明显低于未绝经组,差异有统计学意义(t=-2.313,P=0.022),且绝经组骨量减少和骨质疏松发生率明显高于未绝经组,绝经和中老年妇女骨密度值呈正相关(r=0.185),年龄与骨密度呈负相关(r=-0.224),身高、体重、体质指数和骨密度无明显相关性.结论:绝经和中老年妇女骨密度关系密切,绝经后妇女骨密度明显降低,绝经可能是导致中老年妇女骨质疏松的重要因素.     

绝经后妇女骨密度与肥胖指标的相关性

目的：探讨绝经1～10年妇女腰椎和股骨近端的骨密度与肥胖相关指标之间的相关性.方法：[1]选择2001-08在广州医学院第二附属医院门诊进行健康体检的绝经1～10年的妇女85例,年龄46～63岁.均自愿接受各项指标测定.[2]计算体质量指数（体质量/身高2）;用放射免疫法测定胰岛素和瘦素.采用生物阻抗法测定体脂量.采用骨密度仪测定腰椎及左侧股骨颈、Wards区和大转子的骨密度.[3]用直线相关分析数据间的相关性.其中三酰甘油、瘦素和胰岛素的数据分析前先经自然对数转换.结果：纳入绝经后妇女85例进入结果分析.[1]单因素相关分析结果：腰椎骨密度与绝经年限呈显著负相关（t=-0.431,P＜0.01）,与体质量呈显著正相关（t=0.244,P＜0.05）;股骨颈和Wards区骨密度与绝经年限呈显著负相关（t=-0.334,-0.374,P＜0.01）,股骨颈、Wards区和大转子骨密度与体质量、身高、体质量指数、体脂量呈显著正相关（t=0.225～0.520,P＜0.05～0.01）.股骨颈骨密度与瘦素呈显著正相关（t=0.225,P＜0.05）.[2]多元逐步回归分析结果：腰椎骨密度=1.077-0.022绝经年限;股骨颈骨密度=-0.376＋0.651身高＋0.011体质量指数-0.006绝经年限-0.028 ln三酰甘油;Wards区骨密度=0.398＋0.008体质量-0.011绝经年限-0.048 ln三酰甘油;大转子骨密度=0.389＋0.006体质量.结论：[1]胰岛素、瘦素、三酰甘油、总胆固醇水平与骨密度无明显相关性.[2]影响骨密度的主要因素是身高、体质量、体质量指数、绝经年限和三酰甘油,与肥胖密切相关的胰岛素和瘦素不是影响骨密度的重要因素.     

绝经后妇女基质金属蛋白酶-2水平及其与骨密度和骨代谢指标的关系

目的:探讨绝经后妇女血清基质金属蛋白酶-2 (MMP-2) 水平及其与骨密度和骨代谢生化指标的关系.方法:用酶联免疫吸附试验(ELISA)测定78例48～65岁绝经后妇女的血清MMP-2, 用双能X线吸收法(DEXA)测定腰椎正位,股骨颈,Ward's三角和大粗隆的骨密度(BMD),用自动生化仪测定血清钙(Ca)、血清骨碱性磷酸酶 (AKP)和血清磷(P).将骨密度检测正常的30例妇女列为正常组,有骨质疏松症(OP)的48例为OP组.结果:①OP组患者血清MMP-2水平(1388±121)μg/L高于正常组(1126±141)μg/L(P<0.01).②OP组血清MMP-2与腰椎、股骨颈和Ward's三角骨密度呈负相关,在校正年龄和体重指数后,与股骨颈骨密度相关性消失.③OP组血清MMP-2与血清Ca负相关(P<0.05),与血清AKP和P无相关性.结论:绝经后妇女血清MMP-2与骨密度和Ca呈相关性,血清MMP-2水平升高可能为绝经后骨质疏松症伴随骨代谢转换过程增快的表现.     

血清视黄醇结合蛋白4 及骨桥蛋白与绝经后骨质疏松症的相关性研究

目的　探讨绝经后妇女血清视黄醇结合蛋白4（retinol binding protein 4,RBP4）及骨桥蛋白（osteopontin,OPN） 水平与骨密度（bone mineral density,BMD） 的关系， 分析其在绝经后骨质疏松症（postmenopousalosteoporosis,PMOP）中的应用价值。方法　对262 例绝经后妇女进行研究双能X 线骨密度仪测量腰椎1-4（L1-4）和左侧股骨颈（FN），测定血中RBP4，OPN，I 型原胶原N- 端前肽（PINP），β- 胶原降解产物（β-CTX），甲状旁腺素（PTH），骨钙素（OC），血钙（Ca）及血磷（P）水平。ROC 曲线分析RBP4 及OPN 诊断PMOP 的价值。结果　骨质疏松组血清 RBP4(μg/ml)（25.13±4.74 , 18.46±4.25 和15.30±3.87）及OPN(ng/ml)（13.58±4.42 , 10.47±3.46 和8.24±3.13）水平均明显高于骨量减少组和正常组，差异有统计学意义（均P ＜ 0.05）。相关分析显示，骨质疏松症组血清RBP4及OPN 水平与β-CTX 呈正相关（r=0.291，0.284，均P ＜ 0.05），与Ca,L1-4 及左FN 骨密度呈负相关（r = - 0.247，-0.513，-0.486，-0.265，-0.556，-0.574，均P ＜ 0.05）。ROC 曲线显示，血清RBP4 及OPN 水平为21.53μg/ml 和12.27 ng/ml 是诊断PMOP 的最佳截值。结论　血清RBP4 及OPN 水平升高与低BMD 相关，是影响PMOP 发生的关键因子。     

Pernicious anaemia as a risk factor for osteoporosis.

1. If gastric acid is necessary for the absorption of dietary calcium, the total absence of gastric acid secretion that occurs in pernicious anaemia could result in bone loss. To investigate this, we measured calcium absorption and bone density in 21 postmenopausal women (ages 51-76 years) with pernicious anaemia and in 24 normal postmenopausal women (ages 51-79 years). 2. Relative to the normal women, in the women with pernicious anaemia the bone mineral density of the lumbar spine was decreased by 16% (P less than 0.001). 3. After adjustment for age and body weight, lumbar spine bone mineral density correlated with the serum concentration of group 1 pepsinogens (a group of proteins produced by the gastric fundus) (r = 0.61, P less than 0.01). 4. Despite achlorhydria, the women with pernicious anaemia had normal true fractional calcium absorption and normal serum levels of parathyroid hormone and 1,25-dihydroxyvitamin D. 5. We conclude that gastric acid is not required for the absorption of dietary calcium. Thus, the loss of cancellous bone must be caused by some mechanism yet to be identified.     

Age-related changes in bone turnover markers and ovarian hormones in premenopausal and postmenopausal Indian women

This study characterizes age-related changes in bone turnover markers in relation to ovarian hormones. The data (N = 236) were divided into 5-year age bands and three groups: premenopausal (Group I, N = 139), perimenopausal (Group II, N = 30), and postmenopausal (Group III, N = 67). Age-related increases in mean parathyroid hormone (PTH), osteocalcin (OC), and collagen telopeptide (CTx) levels were observed. Women in Group II (N = 37) with osteopenia had lower levels of E1G (P<0.001) with normal FSH levels as compared to 50 women in the same group with normal bone mineral density (BMD). Their mean OC levels were reduced (P<0.05) and CTx levels were significantly elevated (P<0.01). The mean E1G levels were significantly lower (P<0.001) and mean CTx levels were significantly higher (P<0.001) in 30 perimenopausal women (Group II) compared to premenopausal women. In 28 postmenopausal women (group III) the mean BMD levels and E1G were significantly lower (P<0.001) with elevated FSH levels (P<0.001). Increased CTx levels (P<0.0001) reflected a higher rate of bone resorption. These observations suggest that perimenopausal women with low E1G, elevated FSH should be screened for osteoporosis, and it may be valid to combine simultaneous measurements of bone turnover markers with ovarian hormones when screening women at risk for osteoporosis.     

激素替代疗法和负重健走对绝经妇女骨密度及血脂的影响

目的探讨雌激素、负重健走运动及两者的联合对绝经妇女血脂、骨代谢和骨密度的影响。方法52名绝经妇女分成激素替代疗法组(n=12)、负重健走组(n=14)、激素替代疗法+负重健走组(n=12)和对照组(n=14)。激素替代疗法组服用复方尼尔雌醇片;负重健走组负5 kg重量,以60%～80%最大耗氧量进行健走运动;激素替代疗法+负重健走组同时接受前两组的干预。试验期为6个月,试验前后检测血脂、血碱性磷酸酶(ALP)、尿钙(Ca)和尿肌酐(Cr)的比值、L₂～L₄及左腿股骨头密度。结果试验结束后,3个试验组被试的血胆固醇(TC)、TC/高密度脂蛋白胆固醇(HDL-C)均低于试验前和对照组(P<0.05);负重健走组和激素替代疗法+负重健走组的HDL-C高于试验前水平和对照组(P<0.05);试验组血清ALP和空腹尿Ca/Cr均低于试验前(P<0.05)及对照组(P<0.01);3个试验组L₂～L₄及左腿股骨头骨密度均高于对照组(P<0.01)及试验前(P<0.05)。结论激素替代疗法和负重健走运动均能有效改善绝经后妇女的血脂组成,并有效预防和逆转妇女绝经引发的骨质疏松症。     

Nyctohemeral changes in bone turnover assessed by serum bone Gla-protein concentration and urinary deoxypyridinoline excretion: effects of growth and ageing.

1. To investigate whether there is a nyctohemeral rhythm in bone turnover, we measured serum bone Gla-protein (osteocalcin, an index of osteoblast activity) concentration every 2h and urinary deoxypyridinoline (a marker of bone collagen resorption) excretion for 8h periods in 10 pubertal girls (aged 10-14 years), 15 premenopausal women (aged 20-49 years) and 17 postmenopausal women (aged 50-75 years). 2. The serum concentration of bone Gla-protein and the urinary excretion of deoxypyridinoline were five times higher in the pubertal girls than in the premenopausal women. The urinary excretion of deoxypyridinoline in the postmenopausal women was twice that in the premenopausal women. 3. There was a nyctohemeral pattern in all age groups with mean night-time increases of 28% (P < 0.001) in the urinary excretion of deoxypyridinoline and of 5% (P < 0.001) in the serum bone Gla-protein concentration. 4. There also were nyctohemeral patterns in the urinary excretion of calcium (P < 0.02), sodium (P < 0.001) and potassium (P < 0.001), with decreases at night. There was a negative correlation between the night-time changes in the urinary excretion of deoxypyridinoline and calcium, especially in adult women (P < 0.01). 5. The serum level of parathyroid hormone increased with age, but this effect was only observed at night (01.00 to 07.00 hours). There was a nyctohemeral rhythm of the serum intact parathyroid hormone level at all ages, with a peak in the afternoon and night. 6. Thus, at night, there is a large increase in bone resorption and a small increase in osteoblastic activity, representing a nyctohemeral rhythm of bone turnover.(ABSTRACT TRUNCATED AT 250 WORDS)     

绝经后骨质疏松症患者血清几丁质酶壳三糖苷酶、血管活性肠肽水平与骨密度及骨代谢标志物的相关性研究

目的　探讨绝经后骨质疏松症（postmenopausal osteoporosis, PMOP） 患者血清几丁质酶壳三糖苷酶1（Chitortiosidase 1, CHIT1）,血管活性肠肽（vasoactive intestinal peptide, VIP）水平与骨密度及骨代谢标志物的相关性。方法　纳入厦门大学附属东南医院2017 年12 月～ 2020 年12 月收治的PMOP 患者60 例为PMOP 组,取同期于医院体检的绝经后妇女60 例为对照组,比较两组血清CHIT1 和VIP 水平、腰椎L1-4 和股骨颈的骨密度、甲状旁腺素（parathyroid hormone, PTH）、I 型羧基端交联端肽胶原（type I collage cross-linked-telopeptide, CTX）和I 型前胶原氨基端前肽（procollagen I N-terminal peptide, PINP）水平,分析上述指标的相关性,观察PMOP 发生的影响因素。结果　PMOP 组血清CHIT1（9.64±2.25）,CTX（0.52±0.13mg/L）,PINP（60.84±23.51 mg/L） 水平高于对照组（5.83±1.26nmol/mol/h,0.25±0.07mg/L, 39.83±12.52mg/L）,血清VIP（161.32±27.86 pg/ml）,PTH（10.49±2.52pmol/L）水平以及腰椎L1-4（0.74±0.13g/cm2）,股骨颈的骨密度（0.62±0.0.14g/cm2）低于对照组（302.61±43.92pg/ml,15.19±4.64pmol/L,1.19±0.16g/cm2,0.88±0.12g/cm2）, 差异均有统计学意义（t=6.110 ～ 21.042,均P=0.000）。PMOP 患者血清CHIT1 水平与血清PTH,腰椎L1-4,股骨颈的骨密度呈负相关（r=-0.327,-0.479,-0.485,均P ＜ 0.05）,与血清CTX,PINP 水平呈正相关（r=0.482,0.423,均P ＜ 0.05）,血清VIP 水平与血清PTH,腰椎L1-4,股骨颈的骨密度呈正相关（r=0.515,0.482,0.535,均P=0.000）,与血清CTX,PINP 水平呈负相关（r= -0.414,-0.386,均P ＜ 0.05）。Logistic 回归分析提示,CHIT1 ＞ 7.73nmol/mol/h 是PMOP 发生的危险因素,而VIP ＞ 231.97pg/ml,腰椎L1-4 骨密度＞ 0.97g/cm? 是预防PMOP 发生的保护性因素（P ＜ 0.05）。结论　PMOP 患者血清CHIT1 水平增高,而VIP 水平降低,且二者均与腰椎L1-4,股骨颈骨密度以及骨代谢标志物有相关性,临床有望将二者作为评估PMOP 病情的辅助指标。     

Effects of levothyroxine suppressive therapy on bone mineral density in premenopausal women

BACKGROUND: Levothyroxine (L-T4) is widely prescribed for treating thyroid disorders, but its effect on bone mineral density (BMD), is being debated. OBJECTIVES: We studied the effect of supraphysiologic doses of L-T4 on BMD in a group of premenopausal women. PATIENTS AND METHODS: We included 50 women (mean age=36.8 +/- 7.6 years) receiving L-T4 for at least 1 year for treating their benign cold thyroid nodules. Serum T3, T4, thyroid-stimulating hormone (TSH), parathyroid hormone (PTH), calcium, and phosphate and urine calcium and sodium levels of all patients were measured. Bone density at femoral neck and lumbar (L1-L4) regions was measured, using dual energy X-ray absorptiometry (DXA). RESULTS: No significant decrease was detected in the bone density of the subjects treated with L-T4 compared with the control group. CONCLUSION: L-T4 treatment for 1 year is not associated with increased risk of osteoporosis in premenopausal women but other potential adverse effects still need to be monitored in women receiving L-T4 especially long-term.     

Relationship between whole plasma calcitonin levels, calcitonin secretory capacity, and plasma levels of estrone in healthy women and postmenopausal osteoporotics.

The exact role of calcitonin (CT) in the pathogenesis of postmenopausal osteoporosis remains unknown. Whole plasma calcitonin (iCT) basal levels, metabolic clearance rate (MCR), and production rate (PR) of CT were measured in 9 premenopausal and 16 postmenopausal women, including 11 osteoporotics (OP). Basal iCT levels were statistically lower in postmenopausal women than in the premenopausal group (P less than 0.01) and strongly correlated (r = 0.72; P less than 0.001) with estrone circulating levels (E1). MCR were similar in all groups. PR were similar in eugonadal women between 22 (mean +/- SD = 30.9 +/- 9.9 micrograms/d) and 37 yr (mean +/- SD = 25.5 +/- 11.1 micrograms/d) premenopausal women. In healthy postmenopausal women PR were reduced, but not significantly (mean +/- SD = 19.5 +/- 6.95 micrograms/d), whereas osteoporotic patients presented a highly significant reduction of CT PR (mean +/- SD = 9.8 +/- 4 micrograms/d) (P less than 0.01). Because there is a strong relationship between E1 and PR (r = 0.64; P less than 0.001), CT secretory capacity appears to be modulated by estrogen circulating levels. This modulation leads to a menopause-related decrease in iCT. In osteoporotics, an independent impairment of CT production drastically lowers PR and basal iCT levels. CT might be one of the determining factors in the pathogenesis of postmenopausal osteoporosis.     

绝经后女性血清鸢尾素、25羟维生素D水平与骨代谢、骨质疏松的相关性

目的观察绝经后女性血清鸢尾素(Irisin)、25羟维生素D [25(OH)D]水平与骨代谢、骨密度(bone mineral density,BMD)、骨质疏松的相关性。方法选择2018年1月至2020年1月在河南科技大学第二附属医院健康中心体检的年龄>45岁的绝经后女性为研究对象,分为骨质疏松组(n=370)和非骨质疏松组(n=321),检测血生化、血清鸢尾素、25(OH)D、I型前胶原氨基端肽(procollagen typeⅠN-terminal propeptide,P1NP)和1型胶原羧基端肽β特殊序列(beta C-terminal cross-linked telopeptides of type icollagen,β-CTX)骨代谢指标,测量BMD,计算四肢骨骼肌指数(ASMI),并统计分析。结果绝经后女性骨质疏松组的鸢尾素[(16.53±4.46)ng/mL VS(20.32±4.52)ng/mL,P <0.001]和25 (OH)D [(23.66±5.46)ng/mL VS(31.42±4.93)ng/mL,P <0.001]水平均低于非骨质...     

Statins decrease bone turnover in postmenopausal women: a cross-sectional study

BACKGROUND: Statins have been suggested as potential agents in the management of osteoporosis. Reviews of medical records have shown an increased bone mass and some studies have shown a reduced occurrence of fractures in subjects on long-term treatment with statins. We studied the effects of treatment with statins on calcium homeostasis, bone turnover and bone mineral density. DESIGN: In a cross-sectional design, plasma levels of parathyroid hormone (PTH) and biochemical markers of bone turnover, bone mineral density (BMD) and body composition (fat- and lean tissue-mass) were measured in 140 postmenopausal women who had been treated with a statin for more than 2 years (median 4 years) and compared to 140 age- and gender-matched, population-based controls. RESULTS: Plasma levels of bone turnover markers were lower in the statin-treated subjects than in the controls: osteocalcin (-9%, P = 0.03), bone-specific alkaline phosphatase (-14%, P < 0.01), and C-terminal telopeptide of type I collagen (-11%, P < 0.01). On the other hand, plasma PTH levels were 16% higher in the statin-treated subjects than in the controls (P < 0.01). However, body composition and BMD at the lumbar spine, hip, forearm and whole body did not differ between the two groups. No correlation could be demonstrated between changes in biochemical quantities and dose or duration of statin use. CONCLUSION: Our data show that statins affect the function of bone cells. Most likely, the effect is antiresorptive.     

女性骨生化指标与髋部骨密度的关系

目的探讨血清Ⅰ型胶原N末端肽(sNTX)、血清碱性磷酸酶(sALP)与女性年龄、绝经和髋部骨密度(BMD)之间的关系。方法采用酶联免疫吸附法测定824名20-80岁女性志愿者的sNTX;用全自动生化分析仪测定sALP;采用双能X线骨密度仪测量左髋部BMD。结果(1)sNTX和sALP与年龄呈正相关(r分别为0.333和0.541,P<0.01);在30-39岁年龄段最低,自40-49岁明显升高,与30-39岁年龄段比较有显著差异(P<0.01);两者随年龄的变化以三次回归模型拟合最优(R2分别为0.142和0.343,P=0.000);sNTX和sALP在绝经后较绝经前明显升高,分别达25%和48%。(2)sNTX和sALP与BMD呈显著负相关(r=-0.300--0.492,P<0.01);控制年龄、绝经年限和体重指数后,这种负相关关系仍然存在(P<0.05-0.01);与骨量正常组比较,低骨量组和骨质疏松组妇女的sNTX和sALP显著升高(P<0.01),特别在骨质疏松组升高更显著。结论sNTX和sALP能反映女性随年龄和绝经变化的骨转换状态;高骨转换状态是绝经后女性髋部骨量丢失的重要原因之一。