骨矿含量和骨密度的测量

骨矿含量和骨密度的测量秦林林，陈金标中日友好医院临床医学研究所同位素室（１０００２９）骨质疏松症是一种以低骨量（ｌｏｗｂｏｎｅｍａｓｓ）和骨组织微结构破坏为特征导致骨脆性增加和容易发生骨折的全身性疾病［１］，大量的研究表明，骨矿含量（ＢＭＣ）和骨密度...     

整月龄胎儿骨矿含量的研究

用单光子吸收测定仪对４４例整月龄正常胎儿股骨中段的骨矿含量进行测定。结果表明：骨矿含量、骨宽度和骨密度随胎龄的增加而增加。ＢＭＣ、ＢＭＣ／ＢＷ在４－７月胎龄为加速增长期，７月龄以后为迟缓增长期；ＢＷ在４－５胎胎龄增长速度快，５月胎龄以后较慢、但仍以相对稳定的速度增长。     

高冲击运动时不同着陆姿势对骨密度和骨矿含量的影响

目的研究不同类型高冲击运动对于骨密度(bone mineral density,BMD)和骨矿含量(bone mineral content,BMC)的影响。方法招募39名志愿者,其中伞兵、篮球运动员和作为对照组的普通大学生各13名,将其分成两组(第1组:20~22岁;第2组:23~25岁),分别测量跟骨、第1~5跖骨、髋关节和腰椎(L1~4)BMD和BMC。结果篮球运动员跟骨、第1、2跖骨、总腰椎和髋部BMC显著大于伞兵和对照组;篮球运动员在腰椎、髋关节和股骨颈处BMD也显著大于其他组;伞兵和对照组在测量部位的BMD和BMC无显著性差异。结论 BMC与BMD并非总是正比于平时运动时的垂直地面反作用力。相比跳伞训练,篮球运动能更好提高BMC和BMD,这种变载荷运动作为训练方法,更有利于降低骨质疏松性骨折的风险。     

广西河池地区仫佬族7～15岁正常儿童青少年跟骨超声骨密度及其影响因素

目的:了解仫佬族学生超声骨密度的变化规律及其影响因素.方法:按年龄进行分组,以1岁作为1个年龄段.采用定量超声技术(QUS)测定长居广西河池市罗城县四把镇的956名(男465,女491)7～15岁正常儿童的跟骨QUS参数超声振幅衰减系数(BUA),同时测量受检者身高和体质量.结果:7～15岁仫佬族男、女学生BUA值随年龄的增长而增加.男、女生各年龄段的BUA值差异无统计学意义,同性别相邻的2个年龄组间无统计学意义,同年龄不同性别间亦无统计学意义.7～15岁男、女生BUA与年龄、身高、体质量和BMI均呈正相关(P＜0.01),年龄、身高和体质量是超声骨密度参数的主要决定因素.结论:年龄、身高和体质量是影响儿童青少年骨密度的重要因素;本研究获得仫佬族学生定量超声BUA正常参考值,为仫佬族儿童少年骨质疏松症诊疗提供依据,为指导和改善仫佬族学生钙营养提供依据.     

绝经后女性骨密度与雌激素水平、免疫细胞因子和骨代谢指标的相关性研究

目的:分析绝经后女性骨密度变化及其与雌激素水平、免疫细胞因子和血清骨代谢指标的相关性。方法:将135 名绝经后女性根据其腰椎骨密度(BMD)分为骨质疏松(OP)组(54 例)、骨量减少组(43 例)及正常组(38 例)。测定三组研究对象血清雌二醇(E2)、骨源性碱性磷酸酶(BALP)、骨钙素(BGP)、抗酒石酸酸性磷酸酶-5b(TRAP-5b)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β1)水平,并分析其与BMD 的相关性。结果:与正常组比,OP 组和骨量减少组血清E2、TGF-β1、IL-10 水平均显著降低(P<0.05),血清BALP、BGP、TRAP-5b、IL-6 及TNF-β水平均显著升高(P<0.05);与骨量减少组比,OP 组的血清E2 水平更低,血清BALP、BGP、TRAP-5b、IL-6 及TNF-β水平均更高,差异有统计学意义(P<0.05)。E2、TGF-β1、IL-10 与BMD 呈正相关(P<0.05);BALP、BGP、TRAP-5b、IL-6 及TNF-α均与BMD 呈负相关(P<0.05)。低血清E2 水平和高血清BALP、BGP、TRAP-5b、IL-6、TNF-α水平是绝经后女性BMD 降低的独立影响因素(P<0.05)。结论:绝经后女性E2 水平降低,引起骨重建失衡及骨免疫炎症反应,该变化与BMD 降低有关。     

2型糖尿病男性患者骨代谢指标与骨密度的相关性研究

目的：探讨2型糖尿病男性患者骨密度与骨代谢生化指标间的关系。方法：选取我科2014年1月至2015年12月入院的2型糖尿病男性患者102例,采用双能X线骨密度仪,测定腰椎(L2~L4)、股骨上端[包括股骨颈(Neck)、华氏三角(Ward)及股骨粗隆(Troch)]和全身的骨密度(bone mineral density, BMD)值;根据T值将这些患者分为骨量正常组(44例)、骨量减少组(36例)和骨质疏松组(29例),采用酶联免疫法测定各组碱性磷酸酶(alkaline phosphatase,ALP)、N-端中段骨钙素(N-MID-OT)、总Ⅰ型胶原氨基端延长肽(type 1 amino-terminal propeptide,tP1NP)和β胶原特殊序列(β-CTX)的浓度,比较三组骨代谢指标的变化,并对BMD与各项骨代谢指标进行相关性分析。结果：随着骨密度的降低,骨代谢指标的水平逐渐增高,其中,N-MID-OT和β-CTX的水平在三组间的差异皆有统计学意义(P<0.05);tP1NP在骨质疏松组和其余两组有统计学差异(P<0.05);ALP在三组间无统计学差异(P>0.05)。骨量减少组中,N-MID-OT与Neck、Troch及全身的BMD呈负相关(r=?0.754,?0.663,?0.743;P<0.05),β-CTX与Ward的BMD呈负相关(r=?0.273;P<0.05);骨质疏松组中, N-MID-OT与所有部位的BMD呈负相关(r=?0.736,?0.562,?0.715,?0.521,?0.436;P<0.05),β-CTX与Neck、Ward及全身的BMD呈负相关(r=?0.532,?0.614,?0.764;P<0.05)。结论：2型糖尿病男性患者骨密度与骨代谢指标呈负相关,两者联合评估有助于早期预防骨质疏松。     

男性骨量减少者与骨质疏松者的体重指数与腰椎平均骨密度的相关性研究

从2003年8月~2005年12月因骨关节疼痛在四川大学华西医院康复科就诊的男性患者中,选取40岁以上且无腰椎骨质增生,T值-1者为研究对象,共566例,年龄40~93岁,平均62.93±13.50岁。测定L2-4正位骨密度,记录其年龄、身高、体重、糖尿病患病情况、运动和吸烟习惯等基线资料,并计算体重指数。按T值大小分骨量减少组和骨质疏松组。结果显示:两组基线资料中,BMI及运动状况比较,差异有统计学意义(P0.05),骨质疏松组的BMI大于骨量减少组,但参加运动者较少;多元线性回归分析表明:BMI每增加1 kg/m2,腰椎平均BMD将下降0.003 g/cm2(P=0.002);年龄与腰椎平均BMD呈负相关(B=-0.001,P=0.035);参加运动情况为正相关(P=0.000);而吸烟情况对腰椎平均BMD的影响无统计学意义(P=0.837)。提示BMI增加,即脂肪含量增加,会引起骨量减少及骨质疏松患者腰椎平均BMD的下降。有研究报道只有通过增加肌肉含量提高BMI者,才能预防骨质疏松,因此我们认为日后研究BMI与BMD相关性时,需考虑研究对象的肌肉含量。     

胫骨密质骨相对钙含量沿径向分布的研究

本文应用离子探针技术研究了成年牛和人胫骨骨干密质骨中相对钙含量沿径向的分布,发现径向内外侧的相对钙含量大于中间部位,得到相对钙含量的分布曲线,它的分布规律对于胫骨中不同的微观几何结构是相同的,并对这种分布规律形成的原因和对密质骨力学性质的影响进行了初步的分析。     

男性吸烟与骨密度及骨生化指标关系的调查与分析

目的研究男性吸烟与骨密度及骨生化指标关系的调查与分析遥方法选择2012 年1 月~2016 年1 月某社区的500 例 吸烟男性为观察组,另外选择500 例不吸烟的男性作为对照组,比较两组研究对象的骨代谢及骨生化指标,分析吸烟对上述两 种因素造成的影响遥结果观察组各部位骨密度均显著低于对照组（约0.05）,观察组sBAP和年龄明显高于对照组（约0.05）,但 25-羟基总维生素D则显著低于对照组（约0.05）,差异有统计学意义遥结论男性随着年龄的增长骨量会逐渐丢失,而吸烟会造 成男性骨生化指标和骨转换水平升高,加速骨量的丢失,所以吸烟是造成骨质疏松的危险因素之一,要预防骨质疏松的发生应 当提倡戒烟     

LRP5, low-density-lipoprotein-receptor-related protein 5, is a determinant for bone mineral density

Osteoporosis is a multifactorial trait with low bone mineral density (BMD). We report results of an association study between BMD and nine candidate genes (TGFB1, TGFBR2, SMAD2, SMAD3, SMAD4, IFNB1, IFNAR1, FOS and LRP5), as well as of a case-control study of osteoporosis. Samples for the former association study included 481 general Japanese women. Among the nine candidate genes examined, only LRP5 showed a significant association with BMD. We identified a strong linkage disequilibrium (LD) block within LRP5. Of five LPR5 single nucleotide polymorphisms (SNPs) that are located in the LD block, three gave relatively significant results: Women with the C/C genotype at the c.2220C>T SNP site had higher adjusted BMD (AdjBMD) value compared to those with C/T and T/T (p=0.022); and likewise, G/G at IVS17–30G>A and C/C women at c.3989C>T showed higher AdjBMD than those with G/A or A/A (p=0.039) and with C/T or T/T (p=0.053), respectively. The case-control study in another series of samples consisting of 126 osteoporotic patients and 131 normal controls also gave a significant difference in allele frequency at c.2220C>T (²=6.737, p=0.009). These results suggest that LRP5 is a BMD determinant and also contributes to a risk of osteoporosis.     

Forty mouse strain survey of voluntary calcium intake, blood calcium, and bone mineral content

We measured voluntary calcium intake, blood calcium, and bone mineral content of male and female mice from 40 inbred strains. Calcium intakes were assessed using 48-h two-bottle tests with a choice between water and one of the following: water, 7.5, 25, and 75 mM CaCl(2), then 7.5, 25, and 75 mM calcium lactate (CaLa). Intakes were affected by strain, sex, anion, and concentration. In 11 strains females consumed more calcium than did males and in the remaining 29 strains there were no sex differences. Nine strains drank more CaLa than CaCl(2) whereas only one strain (JF1/Ms) drank more CaCl(2) than CaLa. Some strains had consistently high calcium intakes and preferred all calcium solutions relative to water (e.g., PWK/PhJ, BTBR T(+)tf/J, JF1/Ms). Others had consistently low calcium intakes and avoided all calcium solutions relative to water (e.g., KK/H1J, C57BL/10J, CE/J, C58/J). After behavioral tests, blood was sampled and assayed for pH, ionized calcium concentration, and plasma total calcium concentration. Bone mineral density and content were assessed by DEXA. There were no significant correlations between any of these physiological measures and calcium intake. However, strains of mice that had the highest calcium intakes generally fell at the extremes of the physiological distributions. We conclude that the avidity for calcium is determined by different genetic architecture and thus different physiological mechanisms in different strains.     

Endogenous factors affecting bone mineral content in post-menopausal women

Eighty-eight healthy post-menopausal women were divided into two groups, one of 35 subjects who had undergone menopause up to 9 years previously and the second of 53 subjects who were 10 or more years post-menopausal. In each individual we related the bone mineral content (BMC), measured by single photon absorptiometry in the distal forearm, to anthropometric variables and urinary oestrogen excretion. There was a positive association between BMC and both urinary oestrogen excretion and anthropometric variables, but this was statistically significant only in the older women. As expected, BMC in the distal forearm decreased with advancing age, the fall being greatest in the first 9 years after the menopause. We concluded that although a single measurement of urinary oestrogen and anthropometric variables does not provide enough information to predict an individual's BMC, the values obtained may prove of use, along with a single BMC determination, in helping to predict the rate of bone loss.     

Adrenocortical steroids, bone mineral content and endometrial condition in post-menopausal women

In 23 post-menopausal women, serum levels of cortisol, unconjugated dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS), testosterone, unconjugated and total oestrone and prolactin were measured before and during an ACTH test. Significant positive correlations were found between basal levels of DHA and DHAS; DHA and unconjugated oestrone; DHA and total oestrone; testosterone and total oestrone and between unconjugated and total oestrone. ACTH significantly raised the levels of the steroids but not of prolactin. Significant positive correlations were found between basal levels and ACTH induced increments in DHA; between basal DHAS and increments in DHA and between increments in DHA and DHAS. A significant negative correlation was found between basal levels and increments in cortisol. No significant correlations were found between other combinations of hormone basal levels and/or increments. Significant positive correlations were found between basal levels of DHAS and the DHA response to ACTH respectively, and trabecular bone mineral content of the distal forearm. A significant correlation was also found between bone mineral content and pre-cancerous/cancerous state of the uterine epithelium. The results are a further support to the concept of a link between adrenal androgens and bone mineral density, and do also indicate a relation to endometrial pathology. The lack of correlation between cortisol and other steroids indicate different regulatory mechanisms. Prolactin does not seem to be involved in the regulation of the adrenal androgen synthesis.     

Serum leptin levels,bone mineral density and osteoblast alkaline phosphatase activity in elderly men and women

Although primarily secreted by adipose cells, leptin, a polypeptide hormone that influences body weight, satiety and lipid metabolism, and its receptor are also expressed in human osteoblasts. Leptin plays a role in the central, hypothalamic modulation of bone formation, as well as locally within the skeleton by enhancing differentiation of bone marrow stroma into osteoblasts and inhibiting its differentiation into osteoclasts and adipocytes. The purpose of this investigation was to compare serum leptin values in 100 postmenopausal women (age 62-97) and 31 men (age 72-92) to bone mineral density (BMD) measurements made by dual X-ray absorptiometry and additionally to biochemical markers of bone resorption and formation, including crosslinked collagen N-telopeptides (NTx), aminoterminal extension procollagen propeptides (PINP) and bone-specific alkaline phosphatase (bAP). The circulating level of leptin directly correlated with body mass index (BMI) (r=0.61-0.78, P<0.001) and was modestly, but significantly and positively associated with bAP activity (r=0.24-0.33, P<0.01) in the sera of men and women after adjustment for BMD, age and BMI. The association of circulating leptin levels with bAP, a specific marker of osteoblast activity suggests that leptin levels influence osteoblast activity in vivo in elderly women and men.     

Calcitonin and lumbar bone mineral content during oestrogen-progestogen administration in post-menopausal women

It now appears to be accepted that oestrogens and progestogens can help to prevent post-menopausal bone loss. This study accordingly evaluated vertebral bone mineral content (BMC) patterns and changes in calcitonin (CT) secretion in 12 women who had been ovariectomized in the previous 6 mth and in 12 others who had had a natural menopause, all of whom received oestrogen-progestogen replacement therapy for 12 mth. We also studied 12 oophorectomized and 21 normal-menopause women who did not receive any treatment and hence constituted the corresponding control groups.

A significant difference was found between the lumbar BMC in the treated women and the controls. Moreover, the CT levels rose significantly after replacement therapy in both the oophorectomized and the natural-menopause subjects. It was concluded that combined oestrogen-progestogen treatment can prevent post-menopausal bone loss and increase CT secretion.     

Reduced bone mineral density and low parathyroid hormone levels in patients with the adult form of hypophosphatasia

Summary Hypophosphatasia is a heritable metabolic bone disease with characteristically reduced levels of alkaline phosphatase (ALP) in the blood, liver, kidney and bone. ALP levels are normal in the intestine and placenta. About 300 patients have been reported so far in the literature. Three kindreds with 52 known subjects are described here, whereby 12 subjects could be examined osteologically. Four subjects were patients and had clinical signs of the disease: spontaneous fractures of the metatarsals or femora and low ALP serum levels ranging between 8 and 23 U/1 (normal range 40–170 U/1). Four other members without fractures had reduced ALP levels; they might be carriers of the disease and develop symptoms later in life. The four remaining subjects had normal ALP levels and no signs of the disease. Serum levels of intact parathyroid hormone (iPTH) were found to be in the lower normal range and serum calcium levels in the upper normal range. There was a significant (P<0.05) negative correlation between iPTH and serum calcium levels (r=–0.78). Urinary calcium excretion was increased in 3 subjects with fractures. 25-OH-D₃ levels were increased in 6 of 8 subjects without any treatment. The bone mineral density (BMD) was measured using dual X-ray absorptiometry of the lumbar spine, representing mainly trabecular bone, and single-photon absorptiometry of the forearm, measuring mainly cortical bone. Z-scores of the spinal bone mass ranged between 0.38 and –1.95 SD; Z-scores of the forearm bone mass ranged between 0.53 and –2.47 SD with the lowest values in patients with fractures. There was a significant (P<0.05) correlation between serum ALP levels and forearm BMD (r=0.83). We conclude from these data that patients with the adult form of hypophosphatasia have decreased forearm and subnormal spinal bone mass, as well as reduced serum levels of iPTH.Abbreviations BMD bone mineral density - ALP alkaline phosphatase - iPTH intact parathyroid hormone - 25-OHD₃ 25-hydroxyvitamin D₃ - SD standard deviation - PEA phosphoethanolamine - PPi inorganic pyrophosphate - PLP pyridoxal-5-phosphate - cDNA clonal desoxyribonucleic acid - U/S Ca²⁺ urinary/serum calcium - DXA dual X-ray absorptiometry - DPA dual photon absorptiometry - SPAD bone density of distal forearm measured by single photon absorptiometry - SPAP bone density of proximal forearm measured by single photon absorptiometry     

Effect of natural early menopause on bone mineral density

OBJECTIVES: Early menopause (EM) is included among the risk factors for osteoporosis. Several studies have shown that women with early menopause have lower bone mineral density (BMD) than those with normal expected age of menopause. The aim of our cross-sectional study was to investigate the effects of time of menopause on vertebral bone mass in healthy postmenopausal women and to evaluate if early menopause is a risk factor for lower vertebral BMD. METHOD: We studied 782 who had never received drugs acting on bone mass. The study population was divided into three groups: women with early, normal (NM), and late (LM) menopause. Our study population was further categorized in 5-year age segments between 45 and >75. RESULTS: The three groups examined did not differ for age, age at menarche, body mass index (BMI), and vertebral BMD, while there were significant differences in age at menopause and years since menopause. Our study showed that women with EM presented significantly lower vertebral BMD than NM and LM in 50-54 age segments. Beyond 55 years, EM, NM, and LM women had no differences in lumbar BMD values. CONCLUSIONS: In conclusion, controversial data demonstrated that the absolute amount of bone loss is greater after early menopause than after normal or late menopause, even if a slight effect of early menopause on bone mass cannot be excluded.     

丙戊酸对癫痫儿童骨密度的影响及VitD防治作用

目的观察丙戊酸对癫痫儿童骨密度的影响及VitD的预防作用。方法 6-14岁癫痫儿童63例,分两组,一组以单药丙戊酸治疗,另一组以丙戊酸+VitD治疗,应用CT分别测量两组治疗前及治疗后6个月第四腰椎及股骨颈骨密质和骨松质的骨密度值。结果丙戊酸治疗组和丙戊酸+VitD治疗组治疗前骨松质、骨密质的骨密度无明显差异。在第4腰椎和股骨颈,丙戊酸治疗组疗后6个月骨松质的骨密度明显低于疗前,差异有明显意义;丙戊酸+VitD治疗组疗后6个月骨松质的骨密度与治疗前无明显差异。丙戊酸+VitD治疗组治疗6个月后第四腰椎骨松质的骨密度变化率显著低于丙戊酸治疗组,添加VitD能提高骨松质的骨密度。结论丙戊酸可致癫痫儿童的骨松质密度明显降低。VitD对此副作用有预防作用。     

Meta-analysis of genome-wide linkage studies for bone mineral density

Genome-wide linkage studies have shown several chromosome loci that may harbor genes that regulate bone mineral density (BMD), but results have been inconsistent. A meta-analysis was performed to assess evidence for linkage of BMD across whole genome scan studies. Eleven whole-genome scans of BMD or osteoporosis containing 3,097 families with 12,685 individuals were included in this genome scan meta-analysis (GSMA). For each study, 120 genomic bins of ~30 cM were defined and ranked according to maximum evidence for linkage within each bin. Bin ranks were weighted and summed across all studies. The summed rank for each bin was assessed empirically for significance using permutation methods. A total of seven bins lie above the 95% confidence level (P=0.05) and one bin was above the 99% confidence level (P=0.01) in the GSMA of eleven linkage studies: bins 16.1 (16pter-16p12.3, Psumrnk <0.01), 3.3 (3p22.2-3p14.1), 1.1 (1pter-1p36.22), 18.2 (18p11.23-18q12.2), 6.3 (6p21.1-6q15), 20.1 (20pter-20p12.3), and 18.1 (18pter-18p11.23). GSMA was performed with seven studies with linkage scores of LOD >1–1.85 for sensitivity test, confirming the linkage on chromosome 16p and 3p and revealing evidence of new linkage in bins 10.2 (10p14-10q11.21) and 22.2 (22q12.3-22pter). In conclusion, the meta-analysis of whole-genome linkage studies of BMD has shown chromosome 16pter-16p12.3 to have the greatest evidence of linkage as well as revealing evidence of linkage in chromosomes 1p, 3p, 6, 10, 18, 20p, and 22q across studies. This data may provide a basis with which to carry out targeted linkage and candidate gene studies particularly in these regions.