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1.
Hong-Wen Deng Jian Li Jin-Long Li M. Johnson G. Gong R. R. Recker 《Osteoporosis international》1999,9(6):499-507
Much work has been done on the association between vitamin D receptor (VDR) genotypes and bone mineral density (BMD). Despite
considerable effort, the results are inconsistent. While the VDR association remains unresolved, studies have expanded to
other candidate genes (i.e., estrogen receptor (ER) genotypes), also yielding inconsistent results. A few studies have suggested
that interaction effects between VDR and ER genotypes significantly affect BMD. We assessed associations of BMD with VDR BsmI genotypes, and ER XbaI and PvuII polymorphisms (denoted as ERX and ERP respectively) with spine, femoral neck, distal radius BMD, and with total body bone
mineral content (tbBMC) in 108 US Mid-western postmenopausal Caucasian women. We statistically controlled for confounding
factors such as height, weight, etc., in the analysis. No significant association was detected for ER genotypes with spine
and radius BMD, or for VDR genotypes with femoral neck and radius BMD and tbBMC. No significant interaction between VDR and
ER genotypes was detected in our sample. However, the VDR genotypes are significantly (p = 0.004) associated with *5.8% spine BMD variation. Both ERX and ERP genotypes are significantly (p = 0.02) associated with *3.5% femoral neck BMD variation. ERX genotypes are significantly (p = 0.03) associated with *2.4% tbBMC variation. However, if the data were analyzed by simple ANOVA as in some previous studies,
without adjusting statistically for confounding factors, all the significant results we found here would have gone undetected.
Our findings suggest that: (1) VDR and ER genotypes may have different effects on BMD at different sites and on tbBMC; and
(2) if significant factors influencing bone are not appropriately controlled, true significant associations can easily be
missed. These findings may offer a partial explanation for some of the earlier inconsistent results of association studies
on BMD with VDR and ER genotypes.
Received: 4 August 1998 / Accepted: 2 November 1998 相似文献
2.
A. Tenenhouse L. Joseph N. Kreiger S. Poliquin T. M. Murray L. Blondeau C. Berger D. A. Hanley J. C. Prior 《Osteoporosis international》2000,11(10):897-904
The Canadian Multicentre Osteoporosis Study (CaMos) is a prospective cohort study which will measure the incidence and prevalence
of osteoporosis and fractures, and the effect of putative risk factors, in a random sample of 10 061 women and men aged ≥25
years recruited in approximately equal numbers in nine centers across Canada. In this paper we report the results of studies
to establish peak bone mass (PBM) which would be appropriate reference data for use in Canada. These reference data are used
to estimate the prevalence of osteoporosis and osteopenia in Canadian women and men aged ≥50 years. Participants were recruited
via randomly selected household telephone listings. Bone mineral density (BMD) of the lumbar spine and femoral neck were measured
by dual-energy X-ray absorptiometry using Hologic QDR 1000 or 2000 or Lunar DPX densitometers. BMD results for lumbar spine
and femoral neck were converted to a Hologic base. BMD of the lumbar spine in 578 women and 467 men was constant to age 39
years giving a PBM of 1.042 ± 0.121 g/cm2 for women and 1.058 ± 0.127 g/cm2 for men. BMD at the femoral neck declined from age 29 years. The mean femoral neck BMD between 25 and 29 years was taken
as PBM and was found to be 0.857 ± 0.125 g/cm2 for women and 0.910 ± 0.125 g/cm2 for men. Prevalence of osteoporosis, as defined by WHO criteria, in Canadian women aged ≥50 years was 12.1% at the lumbar
spine and 7.9% at the femoral neck with a combined prevalence of 15.8%. In men it was 2.9% at the lumbar spine and 4.8% at
the femoral neck with a combined prevalence of 6.6%.
Received: 23 April 1999 / Accepted: 14 April 2000 相似文献
3.
Bone Mineral Density and Vertebral Fractures in Men 总被引:1,自引:0,他引:1
E. Legrand D. Chappard C. Pascaretti M. Duquenne C. Rondeau Y. Simon V. Rohmer M.-F. Basle M. Audran 《Osteoporosis international》1999,10(4):265-270
In women, many studies indicate that the risk of vertebral fragility fractures increases as bone mineral density (BMD) declines.
In contrast, few studies are available for BMD and vertebral fractures in men. It is uncertain that the strength of the relationship
between BMD and fractures is similar in magnitude in middle-aged men and in postmenopausal women. In the present study, 200
men (mean age 54.7 years) with lumbar osteopenia (T-score <−1.5) were recruited to examine the relationships between spine BMD and hip BMD and the associations of BMD with vertebral
fractures. Lumbar BMD was assessed from L2 to L4, in the anteroposterior view, using dual-energy X-ray densitometry. At the
upper left femur, hip BMD was measured at five regions of interest: femoral neck, trochanter, intertrochanter, Ward’s triangle
and total hip. Spinal radiographs were analyzed independently by two trained investigators and vertebral fracture was defined
as a reduction of at least 20% in the anterior, middle or posterior vertebral height. Spinal radiographs evidenced at least
one vertebral crush fracture in 119 patients (59.5%). The results of logistic regression showed that age, femoral and spine
BMDs were significant predictors of the presence of a vertebral fracture. Odds ratios for a decrease of 1 standard deviation
ranged from 1.8 (1.3–2.8) for spine BMD to 2.3 (1.5–3.6) for total hip BMD. For multiple fractures odds ratios ranged from
1.7 (1.1–2.5) for spine BMD to 2.6 (1.7–4.3) for total hip BMD. In all models, odds ratios were higher for hip BMD than for
spine BMD, particularly in younger men, under 50 years. A T-score <−2.5 in the femur (total femoral site) was associated with a 2.7-fold increase in the risk of vertebral fracture while
a T-score <−2.5 in the spine was associated with only a 2-fold increase in risk. This study confirms the strong association of
age and BMD with vertebral fractures in middle-aged men, shows that the femoral area is the best site of BMD measurement and
suggests that a low femoral BMD could be considered as an index of severity in young men with lumbar osteopenia.
Received: 27 October 1998 / Accepted: 22 February 1999 相似文献
4.
Bone Density in an Immigrant Population from Southeast Asia 总被引:9,自引:0,他引:9
M. A. Marquez L. J. Melton III J. M. Muhs C. S. Crowson A. Tosomeen M. K. O’Connor W. M. O’Fallon B. L. Riggs 《Osteoporosis international》2001,12(7):595-604
The epidemiology of bone loss in populations of Asian heritage is still poorly known. This study compared the skeletal status
of a convenience sample of 396 Southeast Asian immigrants (172 Vietnamese, 171 Cambodians and 53 Laotians) residing in Rochester,
Minnesota in 1997 with 684 white subjects previously recruited from an age-stratified random sample of community residents.
Areal bone mineral density (BMD, g/cm2) and volumetric bone mineral apparent density (BMAD, g/cm3) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 instrument for the white population and the
QDR 4500 for Southeast Asian subjects; the machines were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was
7% higher in white than Southeast Asian women ( p < 0.001), and similar results were observed for the femoral neck; lumbar spine BMD was 12% higher in white than nonwhite
men ( p < 0.001). Race-specific discrepancies were reduced by calculating BMAD: for premenopausal women, lumbar spine and femoral
neck differences between whites and Southeast Asians were eliminated; for postmenopausal women the lumbar spine differences
persisted ( p < 0.0001), while femoral neck BMAD was actually higher for Southeast Asians. There were no race-specific differences in femoral
neck BMAD among men of any age ( p= 0.312), but lumbar spine BMAD was less for younger ( p= 0.042) but not older ( p= 0.693) Southeast Asian men. There were differences among the Southeast Asian subgroups, but no clear pattern emerged. Predictors
of lumbar spine BMAD in Southeast Asian women were age ( p < 0.001), weight ( p= 0.015) and gravidity ( p= 0.037). Even after adjusting for bone size using BMAD, 32% and 9% of Southeast Asian women and men, respectively, would
be considered to have osteoporosis at the femoral neck and 25% and 4%, respectively, at the lumbar spine. These findings indicate
a need for culturally sensitive educational interventions for Southeast Asians and for physicians to pursue diagnosis and
treatment to prevent osteoporosis-related disabilities in this population.
Received: 12 October 2000 / Accepted: 15 February 2001 相似文献
5.
The aim of this study was to determine possible associations between bone mineral density (BMD), 25-hydroxyvitamin D (25(OH)D)
and intact parathyroid hormone (PTH). In a retrospective study we examined the case notes of free-living postmenopausal women
living in our city (34° S). We also report a low prevalence of vitamin D deficiency (25(OH)D <25 nmol/l, 5.6%) and of secondary
hyperparathyroidism (intact PTH >65 pg/ml, 7.5%). Age was correlated with BMD at the lumbar spine (r=−0.25, p = 0.00038) and femoral neck (r=−0.252, p = 0.0003). Body mass index (BMI) was correlated with BMD at the femoral neck (r= 0.177, p = 0.021) but not at the lumbar spine. 25(OH)D was positively correlated with BMD at the femoral neck (r = 0.149, p=0.036) but not at the lumbar spine. PTH was positively correlated with age (r= 0.279, p = 0.012) and negatively correlated with 25(OH)D (r=−0.322, p = 0.0036). PTH was also negatively correlated with BMD at the lumbar spine (r=−0.258, p=0.02) and the femoral neck (r=−0.282, p = 0.011). Forward stepwise multiple regression showed that BMI, age and 25(OH)D made significant contributions to BMD at
the femoral neck. PTH also showed a significant contribution to BMD at both sites. In conclusion, weak correlations found
between PTH and 25(OH)D and BMD suggest these biochemical variables, among other factors, contribute to lumbar spine and femoral
neck BMD.
Received: 19 February 2000 / Accepted: 20 June 2000 相似文献
6.
M. Blum S. S. Harris A. Must S. M. Phillips W. M. Rand B. Dawson-Hughes 《Osteoporosis international》2002,13(8):663-668
Subjects exposed to environmental tobacco smoke have been found to be at increased risk for several health problems. Whether
exposure to passive tobacco smoke is associated with reduced bone mineral density (BMD) is unknown. In order to examine this,
we measured BMD in 154 healthy premenopausal women (age range 40–45 years). BMD of the total hip, femoral neck, lumbar spine
and total body was measured by dual-energy X-ray absorptiometry (DXA). Data were collected on exposure to household tobacco
smoke from age 10 years to the present as well as on other lifestyle factors related to bone mass. We found that 67.5% of
the subjects had a history of household tobacco smoke exposure. Subjects exposed to household tobacco smoke had a mean adjusted
BMD that was significantly lower at the total hip (p= 0.021) and femoral neck (p= 0.018) compared with subjects who were not exposed. In addition, duration of household tobacco smoke exposure was negatively
associated with BMD at the total hip (p = 0.010), femoral neck (p= 0.004), lumbar spine (p = 0.037) and total body (p = 0.031). Subjects exposed to household tobacco smoke for 15 years or more had mean adjusted BMD that was 4% lower at the
total body, and more than 8% lower at the total hip, femoral neck and lumbar spine, compared with subjects who were not exposed.
In conclusion, household tobacco smoke exposure during adolescence and young adulthood was found to be negatively associated
with BMD at the total hip and femoral neck, and duration of exposure was negatively associated with BMD at the total hip,
femoral neck, lumbar spine and total body in premenopausal women.
Received: 17 December 2001 / Accepted: 16 February 2002 相似文献
7.
The aim of this study was to assess a dry calcaneal quantitative ultrasound (QUS) device by examining: (i) short- and long-term
precision; (ii) the ability of the ultrasound parameters to identify women with vertebral fractures; (iii) age- and menopause-related
bone loss; (iv) applicability of the WHO criteria in scan interpretation. The study group consisted of 422 healthy women with
no risk factors associated with osteoporosis (227 premenopausal and 195 postmenopausal) and 93 women with one or more vertebral
fractures. All women had calcaneal QUS and bone mineral density (BMD) measurements of the lumbar spine and hip performed.
Broadband ultrasound attenuation (BUA) and speed of sound (SOS) measurements in the heel were combined and expressed as estimated
heel BMD. Short-term precision studies yielded coefficient of variations of 0.3% for SOS, 4% for BUA and 3.3% for estimated
heel BMD. Standardized short-term precision values were approximately 0.2 SD. Long-term standardized precision errors ranged
from 0.17 to 0.38 SD. All the QUS and BMD measurement parameters showed significant negative relationships with age in the
postmenopausal group. Annual losses were 0.35 dB/MHz per year for BUA, 0.56 m/s per year for SOS and 0.002 g/cm2 per year for estimated heel BMD. All the QUS and BMD parameters were able to discriminate between healthy postmenopausal
women and women with vertebral fracture. Age-adjusted odds ratios for each SD decline in QUS measurements were 3.63, 5.25
and 4.79 for BUA, SOS and estimated heel BMD respectively. Corresponding odds ratios for BMD at the lumbar spine, femoral
neck and total hip were 2.39, 2.51 and 2.95 respectively. When the QUS and BMD parameters were expressed as T-scores, estimated heel BMD showed the least age-related decline, while femoral neck BMD displayed the greatest decrease with
age. The mean T-score and prevalence of osteoporosis (T<−2.5) for a Caucasian woman aged 60–65 years were −1.35 and 21% respectively for the lumbar spine compared with −0.59 and
2% for estimated heel BMD. In conclusion, this study revealed that contact ultrasound can detect age- and menopause-related
influences on bone status and was able to discriminate between healthy individuals and women with vertebral fracture. However,
the widely accepted threshold of a T-score of less than −2.5 for the definition of osteoporosis may need modifying for the interpretation of QUS scans.
Received: 8 February 1999 / Accepted: 5 May 1999 相似文献
8.
Polymorphism at an Sp1 Binding Site of COL1A1 and Bone Mineral Density in Premenopausal Female Twins and Elderly Fracture Patients 总被引:3,自引:0,他引:3
F. G. Hustmyer G. Liu C. C. Johnston J. Christian M. Peacock 《Osteoporosis international》1999,9(4):346-350
Polymorphism at an Sp1 binding site in the COL1A1 gene has been reported to be associated with bone mineral density (BMD)
and osteoporotic vertebral fracture. We therefore examined for associations and linkage of the Sp1 polymorphism in the COL1A1
gene and BMD at the lumbar spine and femoral neck in 38 monozygotic (MZ) and 40 dizygotic (DZ) twin pairs of white adult women.
All twins were premenopausal with an age range of 21–49 years. Sp1 genotypes of 56 patients with idiopathic osteoporotic vertebral
fracture were examined for a preponderance of either genotype relative to our normal healthy twin subjects. In the twin sample
no significant association was found between Sp1 genotypes and BMD at the spine and femoral neck. No linkage of Sp1 genotype
and BMD at the spine or femoral neck was observed in DZ twins discordant for genotype. Frequencies of Sp1 genotypes were similar
in our healthy (twin) and fracture population samples. In conclusion, in our American sample of premenopausal twins we found
no association or linkage of the Sp1 polymorphism at the COL1A1 gene and BMD at the lumbar spine and femoral neck, and no
over-representation of any Sp1 genotype was observed in our sample of patients with osteoporotic vertebral fracture. Taken
together these results indicate that the Sp1 polymorphism is not related to BMD in our American sample, and contrasts with
the findings in a British population.
Received: 16 November 1997 / Accepted: 12 June 1998 相似文献
9.
H.-Y. ChenChen W.-C. Chen W.-C. Chen F.-J. Tsai C.-H. Tsai C.-W. Li 《Osteoporosis international》2001,12(12):1036-1041
Osteoporosis is a common disorder with a strong genetic component. Our aim was to evaluate the correlation of the vitamin
D receptor gene intron 8 BsmI polymorphism with bone mineral density (BMD) and their relationship to osteoporosis. We determined the vitamin D receptor
gene intron 8 BsmI polymorphism using polymerase chain reaction-based restriction analysis in 171 postmenopausal Chinese women in Taiwan. The
polymorphism was detected using the restriction enzyme BsmI, where the B allele indicated absence of the cuttable site and the b allele its presence. BMD of the lumbar spine and proximal
femur were measured using dual-energy X-ray absorptiometry. The allelic frequencies for postmenopausal Chinese women in Taiwan
were 12.3% for B and 87.7% for b in BsmI restriction fragment length polymorphisms. The prevalence of each genotype in the study population was: 6.4% BB, 11.7% Bb
and 81.9% bb. The three genotypic groups differed significantly in BMD at the lumbar spine and the femoral neck. These differences
corresponded to significant gene-dose effects at the lumbar spine and femoral neck (p<0.001 for both sites). The relative risk for the development of osteoporosis was about 2–3 times as great as that predicted
by the differences between genotypes in BMD, and remained significant even after adjustment for age, height and weight. The
vitamin D receptor gene intron 8 BsmI polymorphism is associated with reduced BMD and predisposes women to osteoporosis.
Received: 21 February 2001 / Accepted: 31 May 2001 相似文献
10.
G. Leidig-Bruckner B. Limberg D. Felsenberg T. Bruckner S. Holder A. Kather J. Miksch C. Wüster R. Ziegler C. Scheidt-Nave 《Osteoporosis international》2000,11(2):102-119
Morphometric methods have been developed for standardized assessment of vertebral deformities in clinical and epidemiologic
studies of spinal osteoporosis. However, vertebral deformity may be caused by a variety of other conditions. To examine the
validity of morphometrically assessed vertebral deformities as an index of osteoporotic vertebral fractures, we developed
an algorithm for radiological differential classification (RDC) based on a combination of quantitative and qualitative assessment
of lateral spinal radiographs. Radiographs were obtained in a population of 50- to 80-year-old German women (n= 283) and men (n = 297) surveyed in the context of the European Vertebral Osteoporosis Study (EVOS). Morphometric methods (Eastell 3 SD and
4 SD criteria, McCloskey) were validated against RDC and against bone mineral density (BMD) at the femur and the lumbar spine.
According to RDC 36 persons (6.2%) had at least one osteoporotic vertebral fracture; among 516 (88.9%) nonosteoporotics 154
had severe spondylosis, 132 had other spinal disease and 219 had normal findings; 14 persons (2.4%) could not be unequivocally
classified. The prevalence of morphometrically assessed vertebral deformities ranged from 7.3% to 19.2% in women and from
3.5% to 16.6% in men, depending on the stringency of the morphometric criteria. The agreement between RDC and morphometric
methods was poor. In men, 62–86% of cases with vertebral deformities were classified as nonosteoporotic (severe spondylosis
or other spinal disease) by RDC, compared with 31–68% in women. Among these, most had wedge deformities of the thoracic spine.
On the other hand, up to 80% of osteoporotic vertebral fractures in men and up to 48% in women were missed by morphometry,
in particular endplate fractures at the lumbar spine. In the group with osteoporotic vertebral fractures by RDC the proportion
of persons with osteoporosis according to the WHO criteria (T-score <−2.5 SD) was 90.0% in women and 86.6% in men, compared with 67.9–85.0% in women and 20.8–50.0% in men with vertebral
deformities by various methods. Although vertebral deformities by most definitions were significantly and inversely related
to BMD as a continuous variable in both sexes [OR; 95% CI ranged between (1.70; 1.07–2.70) and (3.69; 1.33–10.25)], a much
stronger association existed between BMD and osteoporotic fractures defined by RDC [OR; 95% CI between (4.85; 2.30–10.24)
and (15.40; 4.65–51.02)]. In the nonosteoporotic group individuals with severe spondylosis had significantly higher BMD values
at the femoral neck (p <0.01) and lumbar spine (p <0.0004) compared with the normal group. On the basis of internal (RDC) and external (BMD) validation, we conclude that assessment
of vertebral osteoporotic fracture by quantitative methods alone will result in considerable misclassification, especially
in men. Criteria for differential diagnosis as used within RDC can be helpful for a standardized subclassification of vertebral
deformities in studies of spinal osteoporosis.
Received: 5 February 1999 / Accepted: 24 June 1999 相似文献
11.
The Effects of Lifestyle, Dietary Dairy Intake and Diabetes on Bone Density and Vertebral Deformity Prevalence: The EVOS Study 总被引:9,自引:0,他引:9
M. Lunt P. Masaryk C. Scheidt-Nave J. Nijs G. Poor H. Pols J. A. Falch G. Hammermeister D. M. Reid L. Benevolenskaya K. Weber J. Cannata T. W. O”Neill D. Felsenberg A. J. Silman J. Reeve 《Osteoporosis international》2001,12(8):688-698
The risk of low and moderate energy fracture is related to bone mineral density (BMD). Yet it is uncertain whether the epidemiologic
determinants of fracture risk are the same as for low bone density. The European Vertebral Osteoporosis Study was a population-based
prevalence study of vertebral deformity in 36 age-stratified population samples aged 50–80 years. In nearly 4000 subjects
(13 centers), BMD measurements were also made at the spine, femoral neck and femoral trochanter. To investigate whether effects
of reported physical activity on spine deformity risk were mediated through BMD, we modeled these and other risk factor data
with BMD as the dependent variate after adjusting for age, center, sex and body mass index (BMI). The significant determinants
of vertebral deformity risk were also entered into logistic models of deformity risk that included BMD measurements as covariates.
Both current and lifetime physical activity were positively associated with BMD. This effect was stronger with hip BMD than
with spine BMD. Lifetime smoking exposure was associated with reduced BMD. Type 2 diabetes mellitus was associated with increased
BMD. Weak positive associations were found between consumption of dairy products and BMD at the three measured sites and these
were strengthened by an interaction with measures of physical activity in men. Physical activity in women had the largest
beneficial effect in lean women and in women exposed to hormone replacement therapy. When fracture risk was modeled with BMD
as a covariate, the lifestyle and dietary determinants became less strongly related to vertebral deformity risk, suggesting
that BMD may have acted as an intermediary variable. However, heavy physical activity in men still increased spine deformity
risk after adjusting for BMD. It is concluded that physical activity in both genders and milk consumption in young women might
protect against vertebral deformities in later life through their effects on bone density. The adverse effect of smoking on
BMD was confirmed. Heavy physical activity in men might increase spine deformity risk even when BMD is normal.
Received: 29 June 2000 / Accepted: 5 January 2001 相似文献
12.
J. R. Guthrie P. R. Ebeling J. L. Hopper E. Barrett-Connor L. Dennerstein E. C. Dudley H. G. Burger J. D. Wark 《Osteoporosis international》1998,8(3):282-290
Two hundred and twenty-four women (74 pre-, 90 peri-, 60 post-menopausal), aged 46–59 years, from a population-based cohort
participated in a longitudinal study of bone mineral density (BMD). BMD was measured by dual-energy X-ray absorptiometry (DXA)
at the lumbar spine and femoral neck and the time between bone scans was on average 25 (range 14–41) months. The aim of the
study was to assess changes in BMD in relation to changes in normal menopausal status. During the study period women who were
between 3 and 12 months past their last menstrual period (n= 22, late perimenopausal) at the time of the second bone scan had a mean (SE) annual change in BMD of 70.9% (0.4%) at the
lumbar spine and 70.7% (0.6%) at the femoral neck (both p50.05 compared with women who remained premenopausal). In the women who became postmenopausal (n= 42) the mean annual changes in BMD were 72.5% (0.2%) at the lumbar spine and 71.7% (0.2%) at the femoral neck (both p50.0005), and in the women who remained postmenopausal (n= 60) they were 70.7% (0.2%) per year and 70.5% (0.3%) per year respectively (both p50.05), compared with women who remained premenopausal. In the 1–3 years after the final menstrual period (FMP) there was
greater bone loss from the lumbar spine than the femoral neck (p50.05). In women who were menstruating at the time of the second bone scan and whose FMP could be dated prospectively (n= 35), higher baseline oestradiol levels were associated with less lumbar spine bone loss (p50.005). In the women who remained postmenopausal there was an association between baseline body mass index (BMI) and percentage
change per year in femoral neck BMD (p50.05), such that women with higher BMI had less bone loss. In conclusion, during the time of transition from peri- to post-menopause,
women had accelerated BMD loss at both the hip and spine.
Received: 23 June 1997 / Accepted: 5 November 1997 相似文献
13.
Regular Physical Exercise and Bone Mineral Density: A Four-Year Controlled Randomized Trial in Middle-aged Men. The DNASCO Study 总被引:3,自引:0,他引:3
J. Huuskonen S. B. Väisänen H. Kröger J. S. Jurvelin E. Alhava R. Rauramaa 《Osteoporosis international》2001,12(5):349-355
The aim of the study was to investigate the effects of regular aerobic exercise training on bone mineral density (BMD) in
middle-aged men. A population based sample of 140 men (53–62 years) was randomly assigned into the exercise and reference
groups. BMD and apparent volumetric BMD (BMDvol) of the proximal femur and lumbar spine (dual-energy X-ray absorptiometry, DXA) and anthropomorphic measurements were performed
at the randomization and 2 and up to 4 years later. The participation rate was 97% and 94% at the second and third BMD measurements,
respectively. As another indication of excellent adherence and compliance, the cardiorespiratory fitness (aerobic threshold)
increased by 13% in the exercise group. The 2% decrease in the reference group is regarded as an age-related change in cardiorespiratory
fitness. Regardless of the group, there was no association between the increase in aerobic threshold and change in BMD. In
the entire group, age-related bone loss was seen in the femoral neck BMD and BMDvol (p<0.01). BMD and BMDvol values increased with age in L2–L4 (p<0.004). An increased rate of bone loss at the femoral neck was observed in men with a low energy-adjusted calcium intake
(p = 0.003). Men who increased their alcohol intake during the intervention showed a decrease in the rate of bone loss at the
femoral neck (p = 0.040). A decrease in body height associated with decreased total femoral BMD (r= 0.19, p = 0.04) and the change in body height was a predictor of bone loss in the femoral neck (β= 0.201). Long-term regular aerobic
physical activity in middle-aged men had no effect on the age-related loss of femoral BMD. On the other hand, possible structural
alterations, which are also essential for the mechanical strength of bone, can not be detected by the DXA measurements used
in this study. The increase seen in lumbar BMD reflects age-related changes in the spine, thus making it an unreliable site
for BMD follow-up in men.
Received: August 2000 / Accepted: November 2000 相似文献
14.
Determinants of Bone Loss in Elderly Men and Women: A Prospective Population-Based Study 总被引:19,自引:10,他引:9
E. Dennison R. Eastell C. H. D. Fall S. Kellingray P. J. Wood C. Cooper 《Osteoporosis international》1999,10(5):384-391
While several studies have described the rate and pattern of involutional bone loss in women, far less information is available
for men. Furthermore, the roles of lifestyle and body build in determining bone loss rate in both sexes have been largely
extrapolated from cross-sectional studies. We addressed this issue in a population-based longitudinal study which sought to
ascertain rates of bone loss at the femoral neck and lumbar spine in a cohort of men and women aged 60–75 years at baseline,
and to relate this loss to anthropometric and lifestyle variables. We additionally investigated the capacity of biochemical
markers of bone turnover to predict bone loss rates in these subjects. Women lost bone at all sites; this ranged from 0.20%/year
at the lumbar spine to 1.43%/year at the femoral trochanteric region. By contrast, men lost only 0.20%/year at the trochanteric
region, and gained at the lumbar spine (0.33%/year) and at Ward’s triangle (0.27%/year) over the 4-year period. Anthropometric
measurements were associated with bone loss in both sexes; lower baseline body mass index (BMI) and a greater rate of loss
of adiposity over the follow-up period were both associated with greater bone loss at all proximal femoral sites. These attained
statistical significance after Bonferroni correction at the total proximal femur among both men (r= 0.29), p<0.01) and women (r= 0.31, p<0.05). Lifestyle factors associated with lower rates of bone loss (after adjustment for BMI) included alcohol consumption
at the femoral neck among women (p= 0.007) and physical activity at the lumbar spine among men (p = 0.05). Serum parathyroid hormone, 25-hydroxyvitamin D and biochemical markers of bone turnover did not predict bone loss
after adjustment for adiposity.
Received: 8 December 1998 / Accepted: 8 April 1999 相似文献
15.
S. M. F. Pluijm M. G. Dik C. Jonker D. J. H. Deeg D. J. H. Deeg G. J. van Kamp P. Lips P. Lips 《Osteoporosis international》2002,13(9):701-709
The aim of this study was to examine whether the presence of apolipoprotein E ε4 (ApoE ε4) is associated with a lower bone
mineral density (BMD), lower quantitative ultrasound (QUS) measurements, higher bone turnover and fracture risk, and whether
these relations are modified by gender and age. A total of 1406 elderly men and women (≥65 years) of the Longitudinal Aging
Study Amsterdam (LASA) participated in this study. In all participants, QUS measurements were assessed, as well as serum osteocalcin
(OC) and urine deoxypyridinolin (DPD/Cr urine). Follow-up of fractures was done each three months. In a subsample (n = 604), total body bone mineral content (BMC) and BMD of the hip and lumbar spine were measured. In addition, prevalent vertebral
deformities were identified on radiographs. In women, the presence of ApoE ε4 was associated with significantly lower femoral
neck BMD (g/cm2; mean ± SEM; ε4+, 0.64 ± 0.01 vs. ε4−, 0.67 ± 0.01; p= 0.04), lower trochanter BMD (g/cm2; mean ± SEM; ε4+, 0.58 ± 0.01 vs. ε4–, 0.61 ± 0.01; p= 0.01) and lower total body BMC (g; mean ± SEM; ε4+, 1787 ± 40.0 vs. ε4–, 1863 ± 23.8; p= 0.04). Women with ApoE ε4 also had a higher risk of severe vertebral deformities (OR=2.78; 95%CI: 1.21–6.34). In men, the
associations between ApoE status and both hip BMD and QUS depended on age. Only among the younger men (65–69 years) was the
presence of ApoE ε4 associated with lower BMD values. Bone markers and fractures were not associated with ApoE ε4 in either
women, or men. In conclusion, this large community-based study confirms the importance of ApoE ε4 as a possible genetic risk
factor related to BMD and vertebral deformities and demonstrates that its effect is gender related, and depends on age in
men only.
Received: 6 July 2001 / Accepted: 2 April 2002 相似文献
16.
Variations in Bone Density among Persons of African Heritage 总被引:3,自引:0,他引:3
L. J. Melton III M. A. Marquez S. J. Achenbach A. Tefferi M. K. O’Connor W. M. O’Fallon B. L. Riggs 《Osteoporosis international》2002,13(7):551-559
The epidemiology of bone loss in populations of African heritage is still poorly known. We compared a convenience sample
of 47 African-American (AA) residents of Rochester, Minnesota (32 women, 15 men) and 66 recent immigrants from Somalia (all
women) with 684 white subjects (349 women, 335 men) previously recruited from an age-stratified random sample of community
residents. Areal bone mineral density (BMD, g/cm2) and volumetric bone mineral apparent density (BMAD, g/cm3) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 for white subjects and the QDR 4500 for the
others; the instruments were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was 18% higher in AA (p<0.001) and 4% lower in Somali (p= 0.147) than white women. Femoral neck BMD was 27% higher in AA women but also 11% greater in Somali women (both p<0.001) compared with whites. Lumbar spine BMD was 6% higher (p= 0.132) and femoral neck BMD 21% higher (p<0.001) in AA than white men. No Somali men were studied. After correcting for bone size differences, both lumbar spine (p<0.01) and femoral neck BMAD (p<0.001) were greater for Somali than white women, but the difference between Somali and AA women persisted. Lumbar spine and
femoral neck BMAD values also remained significantly greater for AA women (both p<0.001) and men (p<0.05; p<0.001) compared with whites. Weight was associated with BMAD at both skeletal sites in all groups, but adjustment for differences
in weight did not reduce the discrepancy in BMAD values between Somali and AA women or between the latter group and whites.
This heterogeneity among different ethnic groups of African heritage may provide an opportunity for research to better explain
race-specific differences in bone metabolism.
Received: 4 September 2001 / Accepted: 11 January 2002 相似文献
17.
Digital X-ray radiogrammetry (DXR) is a technique that uses automated image analysis of standard hand radiographs to estimate
bone mineral density (DXR-BMD). Previous studies have shown that DXR-BMD measurements have high precision, are strongly correlated
with forearm BMD and are lower in individuals with prevalent fractures. To determine whether DXR-BMD measurements predict
wrist, hip and vertebral fracture risk we conducted a case–cohort study within a prospective study of 9704 community-dwelling
elderly women (the Study of Osteoporotic Fractures). We compared DXR-BMD, and BMD of the radius (proximal and distal), calcaneus,
femoral neck and posteroanterior lumbar spine in women who subsequently suffered a wrist (n= 192), hip (n= 195), or vertebral fracture (n= 193) with randomly selected controls from the same cohort (n= 392–398). DXR-BMD was estimated from hand radiographs acquired at the baseline visit. The radiographs were digitized and
the Pronosco X-posure System was used to compute DXR-BMD from the second through fourth metacarpals. Wrist fractures were
confirmed by radiographic reports and hip fractures were confirmed by radiographs. Vertebral fractures were defined using
morphometric analysis of lateral spine radiographs acquired at baseline and an average of 3.7 years later. Age-adjusted odds
ratio (OR, vertebral fracture) or relative hazard (RH, wrist and hip fracture) for a 1 SD decrease in BMD were computed. All
BMD measurements were similar for prediction of wrist (RH = 1.5–2.1) and vertebral fracture (OR = 1.8–2.5). Femoral neck BMD
best predicted hip fracture (RH = 3.0), while the relative hazards for all other BMD measurements were similar (RH = 1.5–1.9).
These prospective data indicate that DXR-BMD performs as well as other peripheral BMD measurements for prediction of wrist,
hip and vertebral fractures. Therefore, DXR-BMD may be useful for prediction of fracture risk in clinical settings where hip
BMD is not available.
Received: 27 April 2001 / Accepted: 10 October 2001 相似文献
18.
Vertebral Deformities and Low Bone Mineral Density in Adults with Cystic Fibrosis: A Cross-sectional Study 总被引:5,自引:0,他引:5
S. L. Elkin A. Fairney S. Burnett M. Kemp P. Kyd J. Burgess J. E. Compston M. E. Hodson 《Osteoporosis international》2001,12(5):366-372
Patients with cystic fibrosis (CF) have low bone mineral density (BMD). The clinical relevance of this is not clearly established.
The aim of this study was to determine the prevalence of low BMD and vertebral deformities in CF adults with varied disease
severity. One hundred and seven patients (58 men) aged 18–60 years underwent dual-energy X-ray absorptiometry scanning of
the lumbar spine and hip, radiology of the spine and biochemical studies. Thirty-eight percent had a Z-score of <−1, with 13% having Z-scores <−2. Seventeen percent had evidence of vertebral deformity on radiography, mostly in the thoracic spine. Thirty-five
percent reported past fractures, of which 9% were rib fractures. Percent predicted forced expiratory volume in 1 second (FEV1)
and the amount of daily physical activity were positively related to BMD. The number of intravenous antibiotic courses in
the previous 5 years was negatively related to BMD. Patients with a history of rib fracture and CF-related diabetes had significantly
lower femoral neck BMD (p<0.02). The median serum 25-hydroxyvitamin D was 28 nmol/l, with 36% of patients having levels below 25 nmol/l despite vitamin
D supplementation. Forty-four percent had raised levels of urinary pyridinium crosslinks (NTx). In conclusion, fragility fractures
and hypovitaminosis D occur commonly in adult patients with CF. Low BMD occurs in patients with more severe disease and significantly
relates to FEV1, infective exacerbations and daily energy expended in physical activity.
Received: 27 June 2000 / Accepted: 1 December 2000 相似文献
19.
A. Monegal M. Navasa N. Guañabens P. Peris F. Pons M. J. Martinez de Osaba J. Ordi A. Rimola J. Rodés J. Muñoz-Gómez 《Osteoporosis international》2001,12(6):484-492
After liver transplantation there is a high incidence of fractures, with important rates of bone loss during the first months.
However, the long-term evolution of bone mass and metabolism parameters have been scarcely studied. In order to determine
the incidence and risk factors involved in the development of skeletal fractures and to analyze the long-term evolution of
bone mass, bone turnover and hormonal status after liver transplantation, a 3-year prospective study was performed in 45 patients
following liver transplantation. Serum osteocalcin, parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH D) and testosterone
levels (men), and bone mass at the lumbar spine and femur were measured before and sequentially at different time points during
3 years. Spinal X-rays were obtained during the first year. Histomorphometric analysis of bone biopsies obtained in 24 patients
within the first 12 hours after surgery and 6 months after transplantation was performed. Fifteen patients (33%) developed
fractures after liver transplantation, and pre- transplant risk factors for fractures were age and low bone mass (odd”s ratio
for osteoporosis, 95% confidence interval: 5.69, 1.32–24.53). Serum PTH, osteocalcin, 25-OH D, testosterone and creatinine
levels increased after transplantation. Moreover, PTH correlated with creatinine and osteocalcin values. Bone mass decreased
during the first 6 months and reached baseline values at the lumbar spine the second year, with posterior significant recovery
at the femoral neck. Long term evolution of femoral neck BMD correlated with PTH levels. Six months after transplantation
bone histomorphometric data showed an increase in bone formation parameters. After liver transplantation there is a high incidence
of fractures, specially in elderly patients and those with osteoporosis. Bone mass decreased in the short-term period and
improved, initially at the lumbar spine and later at the femur, according to histomorphometric evidences of an increase in
bone formation. The increase in creatinine values induces a secondary hyperparathyroidism that influences the changes in femoral
bone mass. Treatment of osteoporosis shortly after liver transplantation may be important in the prevention of bone fractures,
particularly in patients with low bone mass.
Received: June 2000 / Accepted: November 2000 相似文献
20.
E. Jódar M. Begoña López L. García D. Rigopoulou G. Martínez F. Hawkins 《Osteoporosis international》1998,8(4):311-316
The effects of suppressive doses of levothyroxine (LT4) on bone mass are controversial. Our aim was to evaluate the effects on axial and appendicular bone mineral density (BMD)
and bone metabolism of long-term LT4 suppressive therapy in women by means of cross-sectional and longitudinal studies, and also to assess the potential influence
of menopausal status and LT4 dose. Seventy-six women (aged 47 + 13 years, 37 pre- and 39 postmenopausal) on suppressive therapy (67 + 34 months duration,
mean LT4 dose 168 + 41 mg/day) from our Thyroid Cancer Unit without previous hyperthyroidism or concomitant hypoparathyroidism were
studied. Serum TSH, T3 free T4, calcium, phosphorus, alkaline phosphatase, BGP, iPTH and urinary calcium (uCA) were measured. BMD was measured by dual-energy
X-ray absorptiometry (DXA) at lumbar spine, femoral neck, Ward's triangle, ultradistal and distal third radius and expressed
as a Z-score. In a subset of 27 women aged 46 + 15 years (14 pre- and 13 postmenopausal) a second densitometry scan was performed
27 + 5 months later. Patients on suppressive therapy showed a small reduction in BMD at the distal third radius (Z-score: 70.77 + 0.98; 95% confidence interval: 71.11, 70.44) without differences between pre- and postmenopausal women. Significant
relations with the regimen of suppressive therapy and bone turnover markers were detected except at the lumbar spine. In the
longitudinal study a significant although mild reduction in femoral neck BMD was found that correlated with prior T3 and iPTH. In conclusion, our data show a small detrimental effect of cautious LT4 suppressive therapy on bone mass assessed by DXA; it remains to be established whether this increases the prevalence of fractures.
Received: 30 June 1997 / Accepted: 7 November 1997 相似文献