围绝经期女性血清雌二醇及卵泡刺激素变化规律及其与腰椎、髋部和股骨颈骨密度的关系

目的探索围绝经期女性血清雌二醇(E2)、卵泡刺激素(FSH)变化规律与其腰椎、髋部、股骨颈骨密度(BMD)的关系。方法选取2014年1月-2015年1月在该院进行体检的围绝经期妇女440例为研究对象,分为绝经前组(220例)和绝经后组(220例)。测定两组血清E2、FSH水平及其腰椎、髋部、股骨颈BMD值,并进行组间比较。结果绝经后组妇女血清E2与绝经前组比较明显减少,而血清FSH与绝经前组比较明显增加,差异均有统计学意义(P0.05)。绝经后组妇女腰椎、髋部、股骨颈BMD值与绝经前组比较均有明显减少,组间差异均有统计学意义(P0.05)。绝经前低骨量组和绝经后低骨量组血清E2水平均较正常骨量组明显减少,而血清FSH水平均较正常骨量组明显增加,差异均有统计学意义(P0.05)。血清E2水平与腰椎BMD、髋部BMD、股骨颈BMD均呈正相关关系(P0.05);血清FSH水平与腰椎BMD、髋部BMD、股骨颈BMD均呈负相关关系(P0.05)。结论绝经后女性BMD明显减少,雌激素水平变化可能影响骨代谢,应引起临床的高度关注。     

骨标志物与骨质疏松症相关性研究

目的 探讨绝经后女性骨标志物与骨质疏松症的相关性,为临床预防绝经后骨质疏松症的发生提供参考.方法 采用双能X线骨密度（BMD）仪分别对160例绝经前和绝经后女性进行BMD测定,按BMD结果分为BMD正常组、BMD减少组和骨质疏松组,分别检测β胶原特殊序列（β-crosslaps）、总骨Ⅰ型前胶原氨基酸延长链（P1NP）、骨钙素N端片段（N-MID）三种骨标志物,并分析三种骨标志物与骨质疏松症的关系.结果 BMD正常组92例,BMD减少组38例,骨质疏松组30例.三组β-crosslaps、P1NP依次升高,差异有统计学意义（P＜0.05）.BMD减少组N-MID高于BMD正常组和骨质疏松组,骨质疏松组高于BMD正常组,差异有统计学意义（P＜0.05）.BMD正常组BMD高于BMD减少组和骨质疏松组,差异有统计学意义（P＜0.05）,BMD减少组和骨质疏松组BMD比较差异无统计学意义（P＞0.05）.β-crosslaps、P1NP、N-MID与BMD呈负相关（r=-0.412,-0.320,-0.3421,P＜ 0.05）.结论 绝经后女性三种骨标志物与骨质疏松症存在密切关系,监测血清骨标志物,有助于早期诊断骨质疏松症.     

2型糖尿病老年男性患者骨密度变化研究

目的研究2型糖尿病老年男性患者的骨矿面密度（bone mineral density,BMD）变化,探讨影响其骨密度的可能因素。方法应用双能x线骨密度仪测定60例老年男性2型糖尿病患者的腰椎和股骨颈骨密度,并检测血清和尿液中骨代谢及血糖相关的生化指标,分析影响患者骨密度的可能因素。结果依据患者腰椎或股骨颈的骨密度值,骨质疏松的检出率为20％,骨量减少的检出率为53．3％。相关分析显示,年龄、体重、HbAlc均是与腰椎或股骨的BMD相关的变量,其中体重与腰椎的BMD相关性最高（r=0．254,P〈0．01）,HbAlc与股骨的BMD相关性最好（r=-0．224,P〈0．01）。结论老年男性2型糖尿病患者的BMD与年龄、体重、HbAlc相关。     

绝经后女性骨标志物与骨质疏松症的相关性研究

目的:探讨绝经后女性骨代谢标志物与骨质疏松之间的关系.方法:双能X线骨密度仪测定患者股骨的骨密度(BMD),计算其BMD与正常年轻人的骨峰值比值(以t值表示),并按照骨密度值将120例患者分为63例非骨质疏松组和57例骨质疏松组.选用瑞士罗氏诊断公司COBAS6000全自动电化学发光免疫分析仪,测定骨代谢标志物总骨I型前胶原N端肽(PINP)、血清骨钙素(N-MID)和β胶原特殊序列(β-crosslaps)的水平.结果:PINP、N-MID和β-crosslaps水平骨质疏松组均高于非骨质疏松组;两组患者的BMD、PINP、N-MID和β-crosslaps水平之间均具有统计学差异(P＜0.05).结论:绝经后女性的骨代谢标志物与骨质疏松的发生关系密切,血清中P1NP、N-MID、B-Crosslaps可作为诊断绝经后妇女骨质疏松症的理想生化指标.     

绝经后女性血清脂肪因子瘦素、抵抗素、内脂素及Apelin与骨转换生化指标的关系

目的探讨绝经后女性血清脂肪因子瘦素(Leptin)、抵抗素(Resistin)、内脂素(Visfatin)及Apelin与骨转换生化指标的关系。方法酶联免疫吸附试验测定287名40～80岁健康绝经后女性血清Leptin、Resistin、Visfatin和Ape-lin,以及血清骨特异性碱性磷酸酶(Bonealk aline phosphatase,BAP)和Ⅰ型胶原交联氨基末端肽(cross-linked N-telopep-tide of type I collagen,NTx);用双能X线骨密度扫描仪(dual energy X-ray absorptiometry,DEXA)测定总体、腰椎正位、左前臂、总髋部骨密度(bone mineral density,BMD)以及体脂、瘦体质量;以方差分析、直线相关(Pearson)分析它们之间的关系。结果BAP与总体BMD、腰椎BMD、髋部总体BMD、前臂BMD均呈负相关(r=-0.210、-0.236、-0.223、-0.226,P0.05),校正年龄和BMI后,相关性都依然存在(r=-0.168、-0.187、-0.169、-0.175,P0.05)。NTx与总体BMD、腰椎BMD、髋部总体BMD、前臂BMD均呈负相关(r=-0.238、-0.232、-0.239、-0.221,P0.05),校正年龄和BMI后,相关性依然存在(r=-0.201、-0.189、-0.193、-0.185,P0.05)。Leptin、Resistin、Visfatin、Aplein与BAP、NTx相关差异均无统计学意义。绝经后骨质疏松女性与健康对照组间血清Leptin、Resistin、Visfatin、Apelin水平差异无统计学意义(P0.05)。结论Leptin、Resistin、Visfatin及Apelin不是骨代谢的关键调控因子。     

骨密度检测对老年女性骨折风险的预测价值

目的探讨骨密度(BMD)检测对老年女性骨折风险的预测价值。方法采用整群抽样的方法对上海市虹桥街道所辖户籍≥60岁的女性居民进行抽样,采用骨密度检测仪测定BMD值,抽取调查对象的空腹静脉血3.0 m L,测定其钙(Ca)、磷(P)、碱性磷酸酶(ALP)含量等钙磷代谢指标,采用电化学发光法检测其中骨代谢指标的含量,包括骨钙素(BGP)、Ⅰ型胶原吡啶交联终肽(β-CTx)、抗酒石酸酸性磷酸酶(TRAP)、脱氧吡啶啉(DPD)。对不同BMD值调查对象的钙磷代谢和骨代谢指标进行分析。结果共对1 890名上海市虹桥街道所辖户籍≥60岁的老年女性居民进行调查,平均年龄为(68.1±6.9)岁。BMD值正常组408人,BMD T值为(-0.73±0.19);骨质减少组964例,T值为(-1.73±0.32);骨质疏松组518例,T值为(-2.94±0.42);3组人群的BMD值差异有统计学意义(P0.05)。骨质疏松组、骨质减少组女性血清中Ca、P、ALP的水平均低于正常组,且骨质疏松组女性血清中Ca、P、ALP的水平低于骨质减少组,差异均有统计学意义(均P0.05)。骨质疏松组、骨质减少组老年女性血清中BGP的含量低于正常组,β-CTx、TRAP、DPD的含量高于正常组,且骨质疏松组血清中BGP的含量低于骨质减少组,β-CTx、TRAP、DPD的含量高于骨质减少组,差异均有统计学意义(均P0.05)。结论老年女性BMD值检测可客观反映其钙磷代谢、骨代谢异常程度,是预测远期骨折风险的可靠指标。     

男性吸烟与骨密度及骨生化指标关系

目的探讨男性吸烟与骨密度及骨生化指标关系。方法用DXA仪测定腰椎及髋部骨密（BMD），用ELISA测定389例20～80岁健康男性血清骨特异性碱性磷酸酶（sBAP）和I型胶原氨基末端肽（sNTX）。结果（1）各部位BMD均在20岁～年龄组最高，30岁之后随年龄增加而缓慢下降；40—60岁各年龄组之间的BMD差异无统计学意义。（2）除腰椎侧位BMD外，吸烟组其它各部位BMD显著低于非吸烟组；吸烟组的BAP显著高于非吸烟组，2组之间的sNTX差异无统计学意义。（3）校正年龄与BMI后，烟龄与腰椎正位，髋部总体，股骨颈及ward＇s区BMD均呈负相关（P〈0．05）。每日吸烟量与腰椎正位及Ward＇s区BMD呈负相关（P〈0．05）。结论男性随年龄增长骨量丢失。男性吸烟者骨生化指标与骨转换水平增高，骨量丢失加速。吸烟等生活方式增高骨转换水平，影响骨转换的增龄性变化并加速骨量的丢失。吸烟是骨质疏松的一个危险因素。预防骨质疏松症（OP）应提倡戒烟。     

绝经后骨质疏松补肾健脾化瘀治疗的临床研究

目的观察补肾健脾化瘀治疗对绝经后骨质疏松骨量、骨代谢标志物以及疼痛程度的影响。方法选择2014年10月-2015年10月于一汽总医院骨质疏松诊疗中心就诊的绝经10年内骨质疏松患者158例,采用随机数字表法将患者分为补肾健脾化瘀组88例和对照组70例。于实验开始及6个月后检测腰椎和股骨颈骨密度(BMD),检测尿钙/肌酐(Ca/Cr)、尿羟脯氨酸/肌酐(HYP/Cr)、骨碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶(TRACP),并分别于实验开始前、1个月、2个月、4个月、6个月及结束后2周时测定疼痛强度。结果 1补肾健脾化瘀组实验结束时,腰椎L1-4 BMD、股骨颈BMD均明显提高(P0.05)。对照组两部位的BMD比较无统计学差异(P0.05)。2补肾健脾化瘀组尿Ca/Cr、尿HYP/Cr、BALP、TRACP均较治疗前降低(P0.05),而对照组无明显变化(P0.05)。31个月后,补肾健脾化瘀组疼痛评分已明显下降(P0.05),在2个月、4个月及结束时疼痛评分持续下降,且停药2周后疼痛强度无明显加重。对照组疼痛程度与实验开始时比较无明显变化(P0.05)。结论补肾健脾活血化瘀治疗可通过调节骨转换水平提高BMD,改善骨质疏松疼痛,延缓或阻断绝经后骨的流失。     

围绝经期妇女骨质疏松患者血清铁蛋白与骨密度及骨转换生化标志物的关系

目的探讨围绝经期妇女骨质疏松患者血清铁蛋白与骨密度及骨转换生化标志物的相关性。方法选取2015年5月-2017年10月绍兴第二医院门诊确诊的围绝经期妇女160例,其中骨质疏松者75例为骨质疏松组,未出现骨质疏松者85例为对照组。采用化学发光免疫分析仪检测两组血清铁蛋白表达水平,采用全身数字化双能X线骨密度仪检测两组妇女腰椎(L1～L4)及股骨颈骨密度,采用酶联免疫吸附(ELISA)法检测两组妇女血清骨转换生化标志物骨碱性磷酸酶(B-ALP)、骨钙素(OC)、I型前胶原氨基端延长肽(PINP),采用Pearson法分析围绝经期妇女骨质疏松患者血清铁蛋白表达水平与骨密度及骨转换生化标志物的相关性。结果骨质疏松组妇女血清铁蛋白、OC和PINP表达水平显著高于对照组妇女,腰椎(L1～L4)和股骨颈骨密度显著低于对照组妇女,差异均有统计学意义(P0.05),B-ALP表达与对照组妇女差异无统计学意义(P0.05)。骨质疏松组患者血清铁蛋白表达水平与腰椎(L1～L4)及股骨颈骨密度呈负相关(r=-0.435、-0.512,P0.05),与OC和PINP表达水平呈正相关(r=0.573、0.584,P0.05),与B-ALP表达水平无相关性(r=-0.301,P 0.05)。结论血清铁蛋白在围绝经期妇女骨质疏松患者中表达明显升高,且其表达水平与骨密度及骨转换生化标志物密切相关,提示血清铁蛋白可作为围绝经期妇女骨质疏松病情评估的潜在生物学指标。     

联合补充不同剂量钙、镁、铜、锌和维生素D对中老年妇女骨质疏松症的防治效果

目的观察联合补充钙、镁、锌、铜及维生素D对中老年妇女骨密度和骨钙索的影响，以及改善骨症状的效果。方法依据人选和排除标准，在上海地区筛选出中老年妇女230人，随机分成干预组和对照组，各组再分为未绝经与绝经组。干预组A：未绝经妇女75名；对照组A：未绝经妇女40名；干预组B：已绝经妇女78名；对照组B：已绝经妇女37名。干预组每日服用2片钙尔奇添佳片（每片含钙273．5mg、VitD1．62μg、镁99．7mg、锌3．08mg、铜0．51mg），干预6个月后再进一步分成低剂量亚组和高剂量亚组，每日服用2或3片钙尔奇添佳片，再干预6个月，总计干预12个月。所有入选者在研究前后各阶段检测腰椎骨密度（BMD）及血清骨钙素（BGP），并进行24小时膳食回顾调查和记录骨症状改善情况。结果（1）骨密度：研究6个月后，干预组腰椎骨密度值较前无显著差异（P〉0．05）。研究12个月后，未绝经干预组骨密度显著增加，未绝经对照组腰椎骨密度则呈显著性下降，但已绝经干预组和对照组的骨密度研究前后无显著变化（P〉0．05）。不同剂量干预亚组骨密度间无显著差异（P〉0．05）。（2）骨钙素：研究6及12个月后各组骨钙素水平均明显降低（P〈0．05）；但干预组血清骨钙素水平均明显高于对照组，差异有显著性（P〈0．05）。不同剂量干预亚组的血清骨钙素浓度间无显著差异（P〉0．05）。（3）骨症状：干预后能明显改善局部关节痛和腰背痛等骨症状。结论联合补充钙、镁、锌、铜及维生素D可明显增加未绝经妇女的骨密度和骨钙索，有效改善骨症状；并可明显改善已绝经妇女骨钙素及骨症状，但骨密度改善不明显。低剂量亚组与高剂量亚组的骨质疏松防治效果问无显著性差异。建议中老年妇女尽早补充与骨营养有关的营养素以防治骨质丢失。     

Reduced spinal and femoral bone mass and deranged bone mineral metabolism in chronic alcoholics.

Prevalence and factors which may influence the development of osteoporosis have been assessed in 32 chronic alcoholic males by measuring the bone mineral density (BMD) of the lumbar spine and femoral neck by dual photon absorptiometry. Serum bone Gla-protein, as an index of bone formation, 25-hydroxyvitamin D, testosterone and cortisol levels were also measured. Eleven patients (34%) had osteoporosis. In seven the lumbar BMD was below the fracture threshold. Lumbar and femoral neck age-matched BMD were below mean normal values in 20 and in 23 patients, respectively. Moreover, the age-matched BMD was significantly lower in the femoral neck (91.7 +/- 14.4%) than in the lumbar spine (100.1 +/- 17.1%) (P < 0.001). Duration of alcoholism was significantly higher in patients with age-matched BMD below 100% than in those with age-matched BMD above 100%. Bone GLA-protein and 25- hydroxyvitamin D were below normal levels in 67% and 56% of patients, respectively. Serum testosterone was normal in all but two patients, and cortisol was within normal values in all patients tested. In addition a direct correlation was found between the days of abstinence before the study and serum levels of bone GLA-protein (r = 0.64, P < 0.001). In conclusion, chronic alcoholics frequently have bone loss of the lumbar spine and femoral neck related with the duration of alcohol intake. The correlation between bone-GLA protein levels and the days of abstinence suggests that alcohol directly depresses bone formation. Likewise, the low levels of vitamin D also support that this deficiency may contribute to the development of osteopenia in chronic alcoholism.     

Calcium Intake, Vitamin D and Bone Health Status of Post-menopausal Chinese Women in Kuala Lumpur

Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide β cross link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high levels of CTX- β. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as < 50 nmol/l). Mean total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p< 0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p< 0.001) and femoral neck (r=0.295, p< 0.001). CTX-β was negatively correlated with BMD at the spine (r= -0.235, p< 0.001), whereas P1NP (r=-0.215, p< 0.001) and osteocalcin (r=-0.265, p< 0.001) were both negatively correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion, this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status and low bone mass and elevated biochemical markers of bone turnover.     

运动疗法对防治绝经后妇女骨质疏松症的疗效分析及对骨密度的影响

目的探究运动疗法对防治绝经后妇女骨质疏松症的疗效分析及对骨密度的影响。方法选取2016年9月-2019年1月内该院收治的164例绝经后骨质疏松症患者为研究对象,根据随机数字表法分为观察组和对照组,每组82例。两组患者均进行常规治疗,其中观察组进行为期1年的运动锻炼作为辅助治疗,1年后比较两组患者的骨质疏松情况以及骨密度情况。结果经过为期1年的治疗后,两组患者的骨质疏松症有所改善,骨密度有所提高,其中观察组血钙(Ca)明显高于对照组(P<0.05),而观察组血磷(P)、尿Ca与肌酐比值(Cr)、血碱性磷酸酶(ALP)明显低于对照组(P<0.05)。性激素水平比较上,观察组的雌二醇(E2)、睾酮(T)高于对照组(P<0.05),而卵泡刺激素(FSH)则低于对照组(P<0.05)。观察组的BMD也高于对照组(P<0.05)。结论运动疗法可以提高患者骨密度情况,改善妇女雌激素分泌,对于防治骨质疏松有很好的疗效。     

Nutritional Status in Chinese Patients with Obesity Following Sleeve Gastrectomy/Roux-en-Y Gastric Bypass: A Retrospective Multicenter Cohort Study

Metabolic surgery (MS) is one of the most effective therapies for treating obesity. Due to the lack of multicenter cohort research on nutritional evaluations after surgery in Chinese patients, we explored the changes in nutritional status following MS in Chinese patients. This was a retrospective study of patients (n = 903) who underwent sleeve gastrectomy (SG) (n = 640) or Roux-en-Y gastric bypass (RYGB) (n = 263) for obesity at five different hospitals in China between 17 February 2011, and 20 December 2019. Major nutrients were evaluated at baseline and 1, 3, 6, and 12 months postoperatively. Hb levels decreased, and anemia prevalence increased at 12 months after MS in the premenopausal female group. Moreover, patients with preoperative anemia had an increased risk of postoperative anemia. The ferritin levels (p < 0.001) decreased and iron deficiency increased (p < 0.001) at 12 months after MS among premenopausal females. No significant changes in folate deficiency and vitamin B12 deficiency were found throughout the study. The bone mineral density (BMD) of the femoral neck, lumbar spine, and total hip significantly decreased from baseline to 12 months after MS; however, no new patients developed osteopenia or osteoporosis after MS. Based on 12 months of follow-up, premenopausal females presented a high incidence of anemia after MS. Although we found no differences in osteopenia and osteoporosis prevalence after MS, the BMD did decrease significantly, which suggests that nutrient supplements and long-term follow-up are especially necessary postoperation.     

Low bone mass in premenopausal chronic dieting obese women

BACKGROUND: Obese premenopausal women are thought to be at low risk for osteoporosis due to increased body weight and effects of estrogen on weight-bearing bone. OBJECTIVE: To examine the effect of restrained eating on obese women, we examined bone mineral density (BMD) and content (BMC) of the spine and femur in obese women who were restrained eaters, with emphasis on the relationship between BMC and determinants of bone mass, and current eating behaviors, dietary intake, physical activity, and indices of calcium regulation, bone metabolism, stress and inflammation. DESIGN: A total of 78 obese, Caucasian, female, restrained eaters, ages 30-45 y, were enrolled in a weight lose program. Height, weight, bone turnover markers, serum parathyroid hormone (PTH), cortisol, c-reactive protein (CRP), dietary intake, eating behaviors, physical activity, and BMD and BMC were measured. SETTING: This study was conducted at the University of California, in Davis, CA, USA. RESULTS: In all, 31% of women had osteopenia or osteoporosis (OSTEO). In the OSTEO group, 87.5% of women had osteoporosis or osteopenia of the lumbar spine and 12.5% of the women had osteoporosis or osteopenia in femur. A significant positive correlation between BMC and energy expenditure (r=0.256), and a significant negative correlation between BMC and number of times on a weight loss diet (r=-0.250) and cognitive restraint (r=-0.239) were observed. No significant differences were observed between OSTEO women and nonosteoporotic women for current eating behaviors, dietary intake, physical activity habits, bone turnover, calcium regulation, stress, or inflammation. CONCLUSIONS: Obese restrained eaters are at risk for low bone mass. Prior dieting may be responsible. Chronic dieters should be encouraged to decrease their dietary restraint, develop healthy eating habits and increase physical activity.     

股骨远端皮质厚度预测老年男性骨量变化的效果评价

目的探讨股骨远端皮质厚度与骨量变化的关系,评价股骨远端皮质厚度预测骨质疏松症和骨量变化的能力。方法选取沈阳医学院附属中心医院接受膝关节前后位摄影与双能X线吸收检测法(DXA)检查的男性骨折患者87例。在膝关节正位片上测量股骨远端皮质厚度。骨量变化利用DXA测定,根据T评分分为骨质疏松、骨量减少、骨质正常。结果本研究评估了87例患者,不同组患者(骨质疏松、骨量减少、骨质正常)骨皮质厚度之间差异有统计学意义(F=17.77,P<0.001);股骨远端皮质厚度与其T评分正相关(r=0.510,P<0.0001)。股骨远端皮质厚度预测骨质疏松的ROC曲线下面积为0.803(0.679~0.903),灵敏度为78.6%,特异度为81.3%;预测骨质改变的ROC曲线下面积为0.821(0.736?0.906),灵敏度和特异度分别为86.0%和80.0%。结论测量股骨远端皮质厚度是一种快速可靠的评估骨质量的方法,可作为骨量减少和骨质疏松的有效筛查工具。     

Salivary testosterone is associated with higher lumbar bone mass in premenopausal healthy women with normal levels of serum testosterone

The relationships among lumbar and femoral bone mineral density (BMD) and different forms of testosterone -total, salivary testosterone and free testosterone index (FTI) calculated with the sex hormone binding globulin (SHBG)-, body mass index (BMI) and body fat distribution (waist-to-hip ratio and breast-to-hip ratio) were analysed in a cross-sectional study with 66 Spanish premenopausal healthy women aged 42 years and with normal levels of serum testosterone. BMD was measured using dual-energy X-ray absorptiometry (Hologic QDR 1000 ^®), and salivary and blood samples were obtained during early follicular phase. In a multiple stepwise regression analysis, lumbar BMD was positively predicted by salivary testosterone and negatively by SHBG adjusted by BMI (R ² = 0.20; p < 0.02). The most femoral BMDs were negatively predicted by SHBG and positively by breast-to-hip ratio (R ² = 0.22–0.33, according to the site measured), but neck BMD was not predicted by any variable. When FTI was entered into the regression model instead of SHBG, it was not an independent predictor of BMD. The waist-to-hip ratio was positively correlated with several femoral BMD sites, but breast-to-hip ratio was better predictor. After adjusting by SHBG, the BMI was only predictor for intertrochanter BMD. All women with elevated salivary testosterone (n = 12) had higher lumbar BMD than those with normal value (1.120 ± 0.112 vs. 1.026 ± 0.118; p < 0.01) without differences in other confounding variables. As a conclusion, in premenopausal healthy women of the same age with normal levels of serum testosterone, low levels of SHBG and high levels of salivary testosterone are associated with higher lumbar BMD, whereas low levels of SHBG together with higher breast-to-hip ratio are associated with higher femoral BMD.     

Effect of a Nutritional Supplementation on Bone Health in Chilean Elderly Subjects with Femoral Osteoporosis

Objective: To study the effects of a special nutritional supplement on bone mineral density and bone turnover markers in Chilean elderly subjects with femoral osteoporosis.

Setting: Public primary health care clinics in Chile.

Subjects: Free living elderly subjects with femoral osteoporosis.

Interventions: Subjects were randomized to receive the usual nutritional supplement provided by the Chilean Ministry of Health or a special nutritional supplement providing, among other nutrients, 90 mg isoflavones, 800 mg calcium, 400 IU vitamin D, 60 ug vitamin K and 31 g proteins per day.

Measures of Outcome: At baseline, and after six and twelve months of supplementation, body composition, bone mineral density, serum 25 OH vitamin D, intact parathyroid hormone (iPTH), osteocalcin, decarboxylated osteocalcin, urinary aminoterminal telopeptide of type I collagen (NTX), deoxypyridoline cross links (Dpd) and equol were measured. Every month, urinary daidzein was measured in a morning urine sample.

Results: No differences between treatment groups were observed in body composition or bone mineral density changes. The group receiving the special supplement had a significant increase in serum 25 OH vitamin D and a significant decrease in serum iPTH and decarboxylated osteocalcin. No association between daidzein or equol excretion and changes in bone mineralization was observed.

Conclusions: A special supplement delivered to elderly subjects with osteoporosis improved serum vitamin D and reduced serum iPTH and undercarboxylated osteocalcin levels but did not affect BMD.     

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.