中国部分地区一般人群标准化骨密度正常参考值研究

目的 调查中国部分地区一般人群标准化骨密度的正常参考值。方法 采用双能 X线骨密度仪,对中国部分地区 20岁以上一般人群随机抽样 2 331例进行骨密度测量。所得结果均进行了标准化处理。结果 确定不同年龄组男女腰椎及股骨近端标准化骨密度的正常参考值及峰值。结论 经计算进一步得出骨质疏松症的标准化骨密度诊断参考值及治疗参考值,为骨质疏松症的临床病因研究和流行病学比较研究奠定基础。     

广州地区503例正常骨密度分析及研究

目的 探索广州地区正常人群骨密度（BMD）的变化规律。方法 采用美国Lunar公司的双能X线骨密度仪对广州地区503名20－49岁居民进行腰椎2－4和髋部骨密度测量。结果 男性腰椎骨密度峰值在20－岁，男性髋部骨密度峰值均在25－岁。女性腰椎骨密度峰值在30－岁，女性髋部骨密度峰值在25－岁。峰值后随年龄增加而骨密度下降，女性在50－岁出现明显加速，男性没有加速下降现象。结论 我国男性骨密度峰值略高于女性，但差异无显性（P＞0．05），男性骨密度峰值出现年龄略早于女性。     

西安市区正常人群骨密度和峰值骨密度的调查

目的通过调查西安市区正常人群的骨密度(BMD)和峰值骨密度(PBD),从而为西安市区骨质疏松症的预防、诊断和治疗等工作提供一定的理论依据。方法随机选择564名年龄20～80岁的健康西安城市人群。男女性别均以10岁为一个年龄段分为6组,用双能X光骨密度仪(HolgicQDR-2000)测量骨密度。结果男性腰椎和髋部PBD值出现在30～岁,女性腰椎及髋部PBD值也出现在30～岁这一年龄段。结论男女性各部位PBD的形成大部分处于30～岁这个年龄段,并经过进一步的计算得出了西安市骨质疏松症的骨密度诊断参考值和低骨量干预参考值。     

正常雌猕猴骨密度与年龄关系的初步研究

目的 观察正常雌猕猴骨密度正常值范围及其与年龄的关系。方法 采用双能X线骨密度测定仪（DEXA）测量30只正常雌性猕猴骨密度,猴龄6－20岁。结果 获得正常雌猕猴峰值骨量(12－13岁）、青春期（6－8岁）和绝经初期（15－20岁）骨密度正常值,前者高于后两者,其中头骨、髋骨和全身的骨密度有显著差异。结论 正常雌猕猴增龄性骨丢失与人类相似：青春期后骨量增加,成熟期几年内达峰值,以后随增龄而减少,绝经后骨量丢失加快。     

肝移植手术前后骨密度变化的临床研究

目的 通过双能X线吸收测量仪(DEXA)检测肝移植患者手术前骨密度变化特点，探讨与骨质疏松发生、发展的关系。方法 6例肝移植患者，平均年龄52y，其中重症肝功能衰竭患者3例。原发性肝细胞性肝癌3例。手术方式均为改良背驮式肝移植，术后患者均常规两联应用糖皮质激素及环孢素A抗排斥治疗。术后随访时阳16个月。DFXA仪测定患者左侧髋部骨密度(BMD），个体骨密度测定值以与正常成人骨密度峰值对照值的标准差。结果 手术前、手术后1个月及术后6个月的骨密度差异有非常显著性(P=0.002)。其中，3例肝功能衰竭患者的髋部骨密度从平均-2．7下降到3．1。而3例原发性肝癌患者的骨密度值平均-0．1下降到-1．2；术后6个月复查时发现，3例肝功能衰竭患者中有两例出现非外伤性脊柱压缩骨折。结论 肝移植患者术后骨质疏松症主要和原发病、长期卧床及手术后的免疫抑制有关；易并发骨质疏松性骨折，影响患者的生存质量。     

青少年胫后神经皮层体感诱发电位正常参考值研究

目的探讨及建立青少年胫后神经皮层体感诱发电位正常参考值范围。方法对45名13～24岁健康青少年记录和测量胫后神经皮层体感诱发电位P40、N50及P60的正常值。建立多元回归模型,探讨性别、年龄及身高等生理因素对峰潜伏期的影响。结果所有45例受试者均检测出可清晰辨认的波形。左右侧峰潜伏期差值无明显差异,与性别、年龄及身高无关。P40、N50、P60的峰潜伏期与身高呈XEN关（r=0.766～0．896,P〈0．001）,与年龄及性别无关。结论青少年胫后神经皮层体感诱发电位各波峰潜伏期正常参考值及上限标准可根据峰潜伏期与身高的回归方程确定。     

青少年不同部位骨密度的变化

目的观察12～14岁青少年男女不同部位骨密度(BMD)的变化规律.方法利用双能X线骨密度仪对306例健康男女中学生行左前臂、腰椎和全身扫描,按性别不同,每一岁分一个组.结果该年龄段(12～14岁)女孩BMD年增长速度快于同龄男孩,其BMD值也高于同龄男孩.各部位BMD值腰椎最高,其次为全身总BMD和前臂远端1/3处,前臂远端1/10处最低.男女BMD年增长速度以腰椎和前臂远端1/10处较快.腰椎与全身总BMD相关性最好(P<0.001,r=0.674～0.811).结论该年龄段男女各部位BMD增长快慢不一,松质BMD增加快于皮质BMD.测量腰椎BMD能反映全身BMD状况.     

111名甲亢患者骨密度研究

甲状腺激素对骨骼的生长、成熟和转化具有广泛的调节作用。甲状腺功能亢进症(甲亢）患者由于甲状腺激素分泌过多，干扰骨的正常代谢，易导致骨质疏松及骨折。本文通过对111名甲亢患者及166名健康对照人群进行双能X线法(DEXA)骨密度测定．探讨其临床意义。     

宝石CT的骨密度测量应用于内分泌治疗乳腺癌患者骨质疏松程度评价的可行性研究

目的 探讨宝石CT骨密度(BMD)测量技术对内分泌治疗后乳腺癌患者骨质疏松程度评价的可行性.方法 采用宝石CT骨密度测量技术和双能X线骨密度仪(DEXA),对23例内分泌治疗前及治疗半年后乳腺癌患者分别进行骨密度测量,测量部位为腰2椎体,分别比较两种方法在内分泌治疗前及治疗半年后乳腺癌患者的BMD变化,来判定骨质疏松程度,并比较两种方法的一致性,统计学方法用t检验比较组内差异(P＜0.05),用方差分析比较组间差异(P＞0.05).结果 所有病人经过6个月的治疗,骨密度均有不同程度下降.宝石CT测量治疗前后BMD平均值分别为43.72±18.31 mg/ml、37.18±18.42 mg/ml,明显降低;DEXA测量治疗前后BMD值分别为0.807±0.113 g/cm2、0.76±0.099 g/cm2.两种方法对治疗前后骨密度测量具有一致性(P＞0.05).结论 乳腺癌内分泌治疗半年即可引起患者骨质疏松,宝石CT骨密度测量技术对监测内分泌治疗患者的骨密度变化是一种简单且可行的方法.     

中国长沙地区女性多骨骼部位骨密度参考值横断面调查

目的 横断面调查中国长沙地区女性多骨骼部位骨密度（BMD）随年龄的变化，建立诊断骨质疏松症（OP）参考数据库。方法 用DXA QDR－4500A型扇形束骨密度仪测定2702例5－96岁女性腰椎前后位（AP）和仰卧侧位、髋部及前臂38个不同区域的BMD。结果 按每5岁年龄分组分析的结果显示，38个不同骨骼区域的峰值BMD分别出现在20－24岁至40－44岁之间，其中髋部（股骨颈除外）最早（20－24岁），前臂（超远端除外）最晚（40－44岁）。结论 不同骨骼区域峰值BMD出现的年龄各异。     

Lung function reference values in Singaporean children aged 6-18 years.

BACKGROUND--A study was undertaken to produce reference values of lung function in Chinese children and a means of calculating adjusted standard deviation scores of lung function for Malay and Indian ethnic groups. METHODS--A cross sectional study of lung function (forced expiratory volume in one second and forced vital capacity) measured with a Jaeger spirometer was performed in a representative sample of Singaporean children made up of 1403 Chinese, 335 Malays, and 206 Indians. RESULTS--The relation between natural logarithms of lung function and height was approximately linear until 150 cm in boys and 140 cm in girls. At these heights there were abrupt changes in the gradients of both lines. Separate regression lines were derived for heights above and below these inflection points. Significant differences in lung function were seen in Chinese compared with Malay and Indian children. In particular, values were considerably lower among Indian boys. CONCLUSIONS--The relation between lung function and height in Chinese children is best described by two regression equations over separate height ranges. Information is provided for the calculation of reference values and standard deviation scores, together with the correction factors that need to be applied to derive these values in Malay and Indian children.     

Population-based reference values for bone mineral density in young men

Summary Population-based reference values for peak bone mass density in Danish men. BMD of total hip (1.078 ± 0,14 g/cm²) differed significantly from values from National Health and Nutrition Examination Survey III and of total lumbar spine ((1.073 ± 0.125 g/cm²) differed significantly from Hologic values. Introduction Geographic, ethnic, and socio-economic factors are known to affect bone mineral density (BMD) and peak bone mass significantly. Reference values for male peak bone mass are scarce, and the diagnosis of male osteoporosis often relies on values provided by producers of dual-energy X-ray absorptiometry (DXA) equipment. Methods The aim of the present study was 1) to establish population-based reference values for BMD in young men and 2) to study subgroups based on variables with suspected impact on bone metabolism. We included 783 young Caucasian men aged 20 to 30 years in the Odense Androgen Study (OAS). Results Peak BMD was attained within the third decade. Obesity (BMI > 30 kg/m²) was associated with higher BMD. Abuse of anabolic steroids as well as chronic illness was associated with lower BMD. Our population-based reference values for BMD of the total hip (1.078 ± 0.14 g/cm²) differed significantly from published values from National Health and Nutrition Examination Survey III for non-Hispanic white men, while BMD of total lumbar spine (1.073 ± 0.125 g/cm²) differed significantly from Hologic reference values. Conclusions Locally derived reference values are important to avoid false positive or false negative findings during work-up in patients evaluated for osteoporosis.     

Regional and total body bone mineral content,bone mineral density,and total body tissue composition in children 8–16 years of age

Summary Normative values for total body bone mineral content (TBBM) and total body bone mineral density (TBMD) were derived from measurements on 234 children 8–16 years of age. In addition, bone mineral content (BMC) and bone mineral density (BMD) values for selected regions of interest and soft tissue (bone free lean and fat) for the total body are presented. Bone mineral and soft tissue values were determined by dual energy X-ray absorptiometry (DXA) using a Hologic QDR-2000 in the array mode. Results of a stepwise multiple regression analysis revealed a significant correlation between bone-free lean tissue (BFLT) and BMD (r² = 0.80) in girls. Adding age to the equation accounted for an additional 2% of the variance (P < 0.05) and height accounted for another 1% of the variance (P < 0.05). Body weight and fat tissue (FT) did not account for any additional variance. In boys BFLT correlated significantly with BMD (r² = 0.75;P < 0.05); none of the other predictor variables accounted for additional variance. No significant differences were found in TBBM or TBMD between boys and girls at any age. There was a significant overall gender effect for only three regions of interest. Boys had greater BMC in the head region and had greater BMD in the upper limbs, but post hoc analysis revealed no significant differences for any specific age groups. Girls had greater overall BMD in the pelvis, but this difference was only significant at the 15–6-year age group. The changes in BFLT and FT over the age ranges were consistent with the growth literature.The normative values can be applied to the assessment of children and adolescents with health problems that may impact on the skeleton as well as to research studies investigating bone mineral development in children.     

6?18岁中国女孩腰椎和前臂的骨矿物质含量和骨密度的研究

目的 观察455名6～18岁中国女孩的腰椎和前臂骨骨矿物质含量(bone mineral content,BMC)、骨密度(bone mineral density,BMD)随年龄与发育状况的变化.方法 使用双能量X射线吸收测定术(Dual Energy X-ray Absorptiometry,DXA)测量腰椎(LS)前后位,左前臂(半径 尺骨上,R UUD)以及三分之一的(R U 1/3)的BMC和BMD.结果 BMC和BMD与年龄呈明显的相关性.在LS、R UUD和R U 1/3部位,年龄、高度、重量与BMC和BMD之间有相当多的相互关系.在LS、R UUD和R U 1/3部位,BMC和BMD随着青春期发育显著增加.结论 年龄、发育状况与位于腰椎和前臂骨的BMC和BMD有显著的正关系.BMC和BMD的增长速度在腰椎和前臂之间差异有显著性.BMD和BMC可以用来评价儿童和青少年的骨骼发育健康状况.     

Gene polymorphisms,bone mineral density and bone mineral content in young children:the Iowa bone development study

We examined the association of candidate gene polymorphisms with bone mineral density (BMD) and bone mineral content (BMC) in a cohort of 428 healthy non-Hispanic white children participating in the Iowa Bone Development Study, a longitudinal study of determinants of bone accrual in childhood. BMD and BMC measurements of the hip, spine and whole body were made using a Hologic 2000 Plus densitometer in 228 girls and 200 boys ages 4.5–6.5 years. Genotypes at 14 loci representing eight candidate genes [type I collagen genes (COL1A1 and COL1A2), osteocalcin, osteonectin, osteopontin, vitamin D receptor (VDR), estrogen receptor (ER), androgen receptor (AR)] were determined. Gender-specific and gender-combined prediction models for bone measures that included age, weight, height (and gender) were developed using multiple linear regression analysis. COL1A2 and osteocalcin genotypes were identified as having the strongest and most consistent association with BMD/BMC measures. Osteonectin, osteopontin and VDR translation initiation site polymorphisms were associated with some individual bone measures, but none of the associations was as consistent as those identified for the COL1A2 and osteocalcin genes. No association was identified with COL1A1 (RsaI and Sp1), VDR (BsmI) and ER polymorphisms (PvuII, XbaI, TA) and BMD/BMC. However, we identified significant gene-by-gene interaction effects involving the ER and both VDR and osteocalcin, which were associated with BMD/BMC. Our data suggest that genetic variation at multiple genetic loci is important in bone accrual in children. Moreover, the combination of genotypes as several loci may be as important as a single genotype for determining BMD and BMC.     

广东沿海地区正常人群骨密度pDEXA测量正常值调查结果

目的　通过对使用DTX 2 0 0骨密度仪进行前臂尺桡骨骨密度人群调查资料的统计分析 ,获得广东沿海地区本地人群的骨密度 (BMD)正常值。并对资料的年龄组分布特点进行分析。方法　采用美国OsteometerMediTech公司的DTX 2 0 0骨密度仪 ,对广东沿海地区的本地籍人群 (男性 2 71人 ,女性2 75人 )进行前臂尺桡骨远段的BMD检查 ,对检查对象的一般信息 :身高、体重、生活习惯、饮食习惯、既往病史、女性月经史及生育哺乳史等进行详细记录。对测量的骨矿含量 (BMC)和面平均BMD按年龄组进行平均值和标准差的计算 ,根据 2 0～ 39年龄组计算男女骨峰值。结果　①男性前臂远段骨峰值 :BMC =3. 96 0± 0 . 5 6 9,BMD =0 . 5 5 5± 0 . 0 6 0 ;女性为BMC =2 . 92 4± 0 . 35 9,BMD =0 . 4 72± 0. 0 39。男女BMD均在 30～ 39岁组达到高峰 ,但BMC达到峰值的年龄组均为 4 0～ 4 9。②各年龄组均值显示 :女性 15～ 19岁组BMD达到峰值的 91% ,而男性只达到 77% ;女性 6 0～ 6 9岁组BMD降到峰值的 72 % ,而男性降到 87% ;2 0岁以前 ,男女BMD差别较小 ;在达到峰值的年龄组 ,男女BMD差别较大 ,而BMC更为明显。③男性BMD峰值的标准差约为均值的 10 .8% ,女性约为 8 3% ;若按骨峰值降低两个标准差作为骨质疏松的判断标准 ,女性     

沈阳地区人群5254例骨密度调查研究

目的 调查沈阳地区部分人群骨密度，为骨密度正常参考值数据提供资料，为沈阳乃至全国骨质疏松预防、诊断、治疗提供科学依据。方法 应用双能X线骨密度检测仪对沈阳各区县部分人群5254例进行骨密度检测，以分析软件进行统计、比较。结果 统计出各年龄组骨密度，计算骨密度丢失率及患病率，比较城乡及不同职业间骨密度差异。结论 沈阳地区男女骨密度峰值均在26-30岁年龄组，女性50岁、男性60岁以后骨密度丢失率、患病率升高，女性66-70岁年龄骨密度均值城乡有显著差异。     

河北省农村青少年人群骨密度调查

本文对河北省农村７～１９岁青少年人群５４８５人用单光子骨矿仪测量挠骨远端１／３处骨密度，同时测量身高、体重。结果男、女性别间７～１４岁身高、７～１５岁体重与骨密度差异不显著（ｐ＞０．０５），其后男性均高于女性，差异显著（ｐ＜０．０５）；两性骨密度与年龄、身高、体重均呈明显正相关（均为ｐ＜０．００１），性别间相关系数比较，男性大于女性，差别显著（ｐ＜０．０１）；两性在青春前期和青春中期身高、体重和骨密度增长率均高于学龄期和青春后期；生活在不同地区男、女性骨密度比较，沿海区高于平原区，平原区高于山区，差别均有显著意义（均为ｐ＜０．００１）。由于青少年生长发育较快，特别在青春前期和青春中期身高、体重和骨密度增长率最快，因此应对此期青少年注意补充足够的营养物质和矿物质，尤其对经济、生活条件较差的地区更应加以关照，保障健康发育防止骨畸形和骨折发生、本调查对青少年医疗保健有指导意义。     

Relationship between bone mineral density, leptin and insulin concentration in Brazilian obese adolescents

Despite the epidemic of adolescent obesity, the effect of obesity and hormones on bone mineral accrual during growth is poorly understood. Studies using dual-energy X-ray to examine the effect of obesity on bone mass in children and adolescents have yielded conflicting results. The aim of this study was to explore the combined and independent contributions of body mass index, body composition, leptin, insulin, glucose levels and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) to bone mineral density (BMD) and bone mineral content in a group of Brazilian obese adolescents. This study included 109 post-pubescent obese adolescents. A whole-body dual-energy X-ray absorptiometry scan was performed,using a HOLOGIC QDR4200, to determine whole-body BMD and body composition. Blood samples were collected in the outpatient clinic after an overnight fast, and evaluated for fasting blood glucose and immunoreactive insulin. Leptin levels were assessed with a radioimmunoassay kit. Insulin resistance was assessed by HOMA-IR and the quantitative insulin sensitivity check index. Our results showed that insulin levels and HOMA-IR correlated negatively with BMD and a linear regression analysis showed that serum leptin is inversely associated to BMD adjusted for body mass. In conclusion, our data support the hypothesis that leptin, insulin and HOMA-IR are inversely associated with BMD and play a significant direct role in bone metabolism.     

儿童骨质密度不足相关研究概况

伴随诊断和治疗技术的发展,在儿童期发生的骨质密度减低逐渐引起了人们的重视。儿童低骨密度是由多种原因造成的,其中儿童在青春期生长高峰时,钙与维生素D摄入量不足是造成骨量减低的主要原因之一;导致骨量减低的其他临床相关因素还包括：成骨不良、佝偻病、少年类风湿、慢性关节炎,神经肌肉异常相关性骨量降低和特发性骨质疏松等疾病。为能够让临床医师早期认识与处理上述导致儿童期低骨质密度的问题,对儿童骨量降低提供有效的治疗,本文将对正常骨骼矿化过程、骨质密度测量技术,骨质降低的病理生理学机理和治疗方式选择的评估等方面展开综合性论述。