Serum osteopontin levels in relation to bone mineral density and bone turnover markers in postmenopausal women

Osteopontin (OPN) is an extracellular matrix protein that is expressed in bone cells such as osteoblast and osteocytes and associated with bone turnover and bone mineral density (BMD) in postmenopausal women. Here, we aimed to investigate the relationship between circulating OPN levels and BMD in postmenopausal women in Southern China. A total of 362 postmenopausal women were consecutively recruited into this study from 2011–2013. Serum levels of OPN, receptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL), and bone turnover markers were analyzed. BMD was measured by dual energy X-ray absorptiometry. Osteoporosis and osteopenia were diagnosed according to the World Health Organization criteria. Serum OPN levels were remarkably higher in the osteoporotic group than those in the osteopenic and normal groups (all p?r?=??0.25, p?=?0.004; r?=??0.66, p?r?=??0.28, p?=?0.001; respectively) and positively associated with type I procollagen amino-terminal propeptide (PINP), carboxy-terminal cross-linking telopeptide of type I collagen (CTX), and RANKL (r?=?0.20, p?=?0.020; r?=?0.17, p?=?0.036; r?=?0.19, p?=?0.028, respectively) in the osteoporotic group. In multiple regression analyses, lumbar spine BMD, PTH and RANKL were the predictors for serum OPN levels. In conclusion, OPN serum levels are negatively related to BMD and positively correlated with bone turnover levels in this group of Chinese postmenopausal women.     

Association between increased serum osteoprotegerin levels and improvement in bone mineral density after parathyroidectomy in hemodialysis patients

Secondary hyperparathyroidism (SHPT) is a common complication in chronic renal disease. Osteoprotegerin (OPG), an extracellular cytokine receptor secreted by osteoblasts, can promote bone formation by inhibiting the function of osteoclasts. Hemodialysis (HD) patients have elevated serum OPG levels. OPG secretion can be suppressed with high parathyroid hormone (PTH) levels. HD patients with refractory SHPT can benefit from parathyroidectomy (PTX) treatment, but the changes of serum OPG, bone turnover markers and bone mineral density (BMD) following PTX in HD patients remain unclear. In this study, patients on maintenance HD who received PTX for refractory SHPT (n = 28) were prospectively followed for 1 year. Serum intact PTH (iPTH), alkaline phosphatase (Alk-P), and OPG were measured serially; BMD was measured pre-PTX and at 1 year after PTX. After PTX, serum iPTH levels reduced profoundly. Serum Alk-P levels increased rapidly, peaking at 2 weeks post-PTX, while serum OPG levels gradually increased at 2 weeks after PTX and peaked at 2 months. BMD improved in both femoral neck (FN; cancellous and cortical bone) and lumbar spine (LS; cancellous bone). Higher baseline iPTH levels were associated with greater FN and LS BMD improvements at one year after PTX. The increment of serum OPG was correlated with the increase in LS BMD, implying that inhibition of osteoclastic bone resorption may improve BMD within the first year after PTX. These findings suggest that PTX removes the suppressive effects of high PTH on OPG secretion, resulting in the increased serum OPG levels that may contribute to BMD improvement.     

Osteoprotegerin serum levels in women: correlation with age,bone mass,bone turnover and fracture status

Pre-clinical data have shown that osteoprotegerin (OPG) inhibits osteoclast function and therefore plays an important role in bone remodelling. This study aimed to evaluate the clinical value of serum OPG. Do higher OPG serum levels reflect decreased bone resorption and perhaps higher bone mass in women? Serum OPG levels were measured in 177 healthy women (aged 17-85 years) and in 48 untreated patients (mean age 71 +/- 5) with established osteoporosis, and related to age, bone mass, markers of bone turnover and, in the case of patients with osteoporosis, to pre-existing vertebral fractures. In healthy women OPG levels showed a positive correlation with age (r = 0.25, p < 0.001) but not to bone mass or markers of bone turnover. In women with osteoporosis, however, there was a strong relationship between serum OPG and markers of bone turnover (serum c-terminal crosslinked telopeptides of thpe I collagen (sCTX): r = +0.82, p < 0.0001; osteocalcin (OC): r = +0.69, p < 0.0001), with patients who had higher levels of bone-turnover markers showing higher serum levels of OPG. After adjustment for bone mass and bone markers, patients with pre-existing vertebral fractures had significantly lower serum OPG levels than patients without fractures (57 +/- 8 vs. 97 +/- 10 pg/ml, [mean +/- SE], p < 0.01). The age-dependent increase of OPG as an antiresorptive factor may reflect an insufficient paracrine mechanism of bone cells to compensate for bone loss in older age. In patients with osteoporosis, however, OPG correlated strongly with markers of bone turnover; this may point toward a higher level of RANKL/OPG expression in these patients. Finally, low OPG serum levels seem to be associated with vertebral fractures. We hypothesise that low OPG levels in preset conditions of bone turnover may indicate a higher risk of fracture in patients with osteoporosis.     

骨转换指标和骨密度预测骨折危险性的可行性

背景:骨密度虽然可以诊断骨质疏松,但不能及时反映受试者正在发生的骨代谢情况:骨转换指标虽然不能诊断骨质疏松,但它可以及时反映受试个体正在发生的骨转换速率.目的:概述骨转换指标和骨密度预测骨质疏松症的骨折危险性,从理论上分析,骨折术后愈合与否的预测方法的可行性.方法:以bone tunrnover,biochemical marker,osteoporosis为检索词,检索Pubmed数据库(1999-01/2009-01);以骨转换,骨代谢,生化标志物,骨密度,骨质疏松,骨折为检索词,检索CNKI数据库(1999-01/2009-01).文献检索语种限制为英文和中文.纳入与骨转换指标和骨密度预测骨折危险性的研究紧密相关的文章;排除重复文献.结果与结论:计算机初检得到631篇文献,根据纳入排除标准,对其中31篇文献进行分析.骨质疏松症是老年人发病及死亡的主要原因之一,早期预测骨质疏松症的骨折危险性意义重大.文章介绍了长期制动后的骨代谢机制、骨生化标志物种类、骨密度测量、多细胞基本单位和OPG-RANKL-RANK系统在骨重建中的作用;重点介绍了国内外学者运用骨转换指标和骨密度预测骨质疏松症和长期制动后的骨折危险性,从理论上分析骨折术后愈合与否的预测方法的可行性.     

在糖尿病肾病过程中血清骨保护素及骨密度的变化

背景:目前人们对糖尿病肾病过程中所致肾性骨病骨保护素的关系仍不清楚.目的:探索2型糖尿病肾病过程中患者骨密度、血清骨保护素水平的变化及其间的相关性.方法:选择2型糖尿病患者104例,根据肾小球滤过率将患者分为5组:单纯糖尿病组、肾脏轻,中,重度损伤组、肾衰竭组.选择健康体检者20名为对照组.采用双抗体夹心酶联免疫吸附法(ELISA)测定受试者血清骨保护素水平.采用全自动生化分析仪检测血清钙、磷、碱性磷酸酶、肌酐、尿素氮及糖化血红蛋白.采用双能X射线骨密度仪测定正位L_(2～4)的骨密度.观察受试者骨密度、骨保护素水平及其与各指标的多元回归相关分析.结果与结论:糖尿病肾病患者血清骨保护素水平明显高于健康对照人群(P<0.05),肾脏轻,中,重度损伤组、肾衰竭组患者骨密度明显低于健康对照人群(P<0.05,P<0.01,P<0.001).总体来说,肾功能越差,骨保护素水平越高,骨密度越低.糖尿病肾病患者骨保护素水平与骨密度呈负相关(R=-0.497,P<0.01),与糖尿病病程(r=0.566,P<0.01)、血清肌酐水平(r=0.772,P<0.01)、尿素氮水平(r=0.708,P<0.01)、磷水平(r=0.329,P<0.01)、全段甲状旁腺激素水平(r=0.702,P<0.01)呈正相关,与血清钙水平呈负相关(r=-0.505,P<0.01).提示糖尿病肾病过程中随肾脏功能的恶化,骨保护素水平升高,骨密度降低,骨保护素水平与骨密度呈负相关,与糖尿病病程、血清肌酐水平、尿素氮水平、磷水平、全段甲状旁腺激素水平呈正相关,与血清钙水平呈负相关.     

老年男性代谢综合征患者血睾酮水平与骨密度及骨转换指标的相关性研究

目的分析老年男性代谢综合征(MS)患者血睾酮(T)水平与骨密度(BMD)及骨转换指标之间的相互关系。方法收集60～90岁老年男性111例,分为MS组(61例)和非MS组(50例)。测定T、N-MID骨钙素(N-MID-OC)、总I型胶原氨基端延长肽(PINP)、血清β-胶原特殊系列(β-CTX)水平,同时使用双能X线骨密度测量仪测量左前臂、左髋部及腰椎的BMD,分析血清T水平与BMD及骨转换指标的相关性。结果 MS组的T、N-MID-OC、PINP、腰椎、髋骨及桡骨BMD水平均低于非MS组(P<0.05),β-CTX高于非MS组(P<0.05),且随着MS组分的增加,血T、N-MID-OC、PINP水平及腰椎、髋部、桡骨BMD平逐渐下降,β-CTX逐渐增高,差异有统计学意义(P<0.05)。相关性分析表明:血清T与N-MID-OC、PINP及腰椎、髋部、桡骨BMD呈正相关,与β-CTX水平呈负相关(P<0.05)。结论老年男性MS患者中血T水平与BMD及骨转换指标密切相关,低T水平可作为老年男性骨质疏松(OP)的预测因子。     

The roles of bone mineral density, bone turnover, and other properties in reducing fracture risk during antiresorptive therapy

Osteoporosis is a skeletal disorder characterized by compromised bone strength and increased risk of fracture. Properties related to bone strength include rate of bone turnover, bone mineral density, geometry, microarchitecture, and mean degree of mineralization. These properties (with or without bone density) are sometimes collectively referred to as bone quality. Antiresorptive agents may reduce fracture risk by several separate but interrelated effects on these individual properties. For example, antiresorptive agents have been reported to reduce bone turnover, stabilize or increase bone density, preserve or improve microarchitecture, reduce the number or size of resorption sites, and improve mineralization. Although changes in bone architecture and mineralization are not currently measurable in clinical practice, bone turnover is assessed easily in vivo and affects the other bone properties. Moreover, antiresorptive therapies that produce larger decreases in bone turnover markers together with larger increases in bone mineral density are associated with greater reductions in fracture risk, especially at sites primarily composed of cortical bone such as the hip. Reductions in fracture risk are the most convincing evidence of good bone quality. Data from well-designed randomized clinical trials with up to 10 years of continuous antiresorptive therapy have shown that certain antiresorptive agents effectively reduce fracture risk and (together with extensive preclinical data) suggest no deleterious effects on bone quality.     

Relationship between bone mineral density and biochemical markers of bone turnover in hemodialysis patients

End-stage renal disease is closely associated with changes in bone and mineral metabolism. In recent times, osteoporosis has become important among hemodialysis (HD) patients. In this study, the investigators sought to evaluate the relationship between bone mineral density (BMD) and biochemical markers of bone turnover among HD patients. A total of 70 uremic patients on a maintenance HD program for at least 1 y were enrolled in the study. All patients were treated with conventional bicarbonated HD for 5 h through the use of low-flux hollow-fiber dialyzers. Bone densitometry was measured by dual energy x-ray absorptiometry in the lumbar spine (LS) and the femoral neck (FN). BMD was classified according to World Health Organization criteria on the basis of BMD T scores. Biochemical bone turnover markers such as calcium, phosphorus, ionized calcium, intact parathyroid hormone, alkaline phosphatase, plasma bicarbonate, blood pH, serum albumin, and hematocrit levels were measured before the HD session in the morning. Male patients (n=37; 52.9%; mean age, 46.2+/-17.0 y) were assigned to a single study group, and female patients (n=33; 47.1%; mean age, 44.0+/-13.1 y) to another. Mean duration of HD treatment was 33.7+/-28.5 mo in females and 33.0+/-26.0 mo in males. Among all patients, BMD T scores in the osteopenia/osteoporosis range were observed at the LS in 58 patients (82.8%) and at the FN in 45 patients (64.3%). According to BMD measurements in FN T score, 10% of patients (n=7) were osteoporotic, 54.3% (n=38), osteopenic, and 35.7% (n=25), normal. On the other hand, in LS T score, the results were 47.1% (n=33) osteoporotic, 35.7% (n=25), osteopenic, and 17.1% (n=12), normal. No statistically significant association was found in osteopenia/osteoporosis between sexes according to FN and LS T score (P=.542, P=.267, respectively). No significant relationship was noted between BMD and biochemical markers of bone turnover. A positive correlation was found between FN T scores of BMD and age (r=.413, P=.000). BMD T scores within the range of scores for osteopenia/osteoporosis were observed in 78.5% of patients at the LS and in 58.5% of patients at the FN. The investigators concluded that no correlation could be found between markers of bone turnover and bone mass measurements in both skeletal regions. LS T score results were worse than FN T score results. Elevated alkaline phosphastase levels combined with high intact parathyroid hormone levels are predictive of renal osteodystrophy but not of adynamic bone disease/osteoporosis.     

Biochemical markers of bone turnover and bone mineral density in patients with beta-thalassaemia major

In this study, bone formation markers (bone-specific alkaline phosphatase and osteocalcin) and bone resorption markers (pyridinoline and deoxypyridinoline) were analysed. Bone formation, as evidenced by the levels of serum alkaline phosphatase and osteocalcin, did not appear to be impaired, while bone resorption was grossly increased in all patient groups. The decrease of bone mineral density values was more prominent in the lumbar spine, thus making this site particularly interesting for such studies. The patients had significantly lower femoral neck and lumbar spine bone mineral density when compared with control (all p <0.001). Our conclusion is that, in spite of the severe bone destruction that occurs in thalassaemia major, the fact that bone formation remains intact calls for a more intensive treatment.     

辛伐他汀对糖尿病性骨质疏松患者骨密度和骨转换的影响

INTRODUCrION Many basic and clinical experiments showed that drugs of statinsmight stimulate proliferation and differentiation of osteoblast andmight be used as an effective drug to treat osteoporosis. We usedsimvastatin (one kind of drugs of statins) to treat cases with dia-betic osteoporosis for 3 months, observed and compared each indexbefore and after treatment in order to observe its effects on boneformation.     

糖皮质激素性骨质疏松骨保护素表达与骨密度的相关性

目的:探讨糖皮质激素性骨质疏松大鼠骨保护素在骨骼局部的表达,及其对骨密度变化的影响。方法:实验于2005-01/2006-03在解放军总医院骨科实验室完成。选择6月龄雄性Wistar大鼠48只,随机数字表法分为实验组和对照组,各24只。实验组大鼠给予地塞米松1mg/kg肌肉注射,1次/d;对照组大鼠给予等量生理盐水肌注。两组大鼠给药后2,4,8,12周各处死6只,取松质骨(腰椎)和皮质骨(股骨干),进行骨密度值测量、骨组织形态学观察及骨保护素免疫组织化学染色,并进行图像处理和统计分析。结果:纳入动物48只,均进入结果分析。①实验组大鼠腰椎骨密度给药后2,4,8,12周与对照组相比均明显下降[分别为(0.175±0.013),(0.212±0.018)g/cm2;(0.152±0.021),(0.211±0.019)g/cm2;(0.129±0.014),(0.213±0.015)g/cm2;(0.113±0.016),(0.212±0.015)g/cm2,P<0.01],给药后12周较2周下降更为显著(P<0.01);股骨干骨密度给药后2周无明显差异(P>0.05),给药后4周开始下降[分别为(0.226±0.013),(0.244±0.015)g/cm2,P<0.05],给药后8,12周均明显下降[分别为(0.204±0.014),(0.238±0.015)g/cm2;(0.186±0.016),(0.240±0.013)g/cm2,P<0.01]。②实验组骨小梁排列稀疏,数目减少,小梁明显变细、间距加宽,股骨干中段骨皮质厚度变薄,12周多视野计数可见破骨细胞增多(P<0.01)。③实验组给药后2周腰椎的骨保护素组织化学染色明显减低,4周股骨干内亦明显减低,并且随着给药时间的延长逐渐减低。结论:糖皮质激素抑制骨骼局部骨保护素表达,并且与局部破骨细胞的增多、骨密度降低密切相关,继发了渐进性骨质丢失,可能参与并促进了骨质疏松的形成。     

2型糖尿病患者骨转换标志物与骨密度的相关性研究

目的探讨骨转换标志物在2型糖尿病合并骨质疏松患者中的临床应用价值及与不同部位骨密度的相关关系。方法选择我院64例2型糖尿病成年男性患者为病例组,同期收集20例健康成年男性为对照组,用双能X线吸收测定仪检测受试者正位腰椎（L1-L4）、右侧髋部（股骨颈、大转子、ward’s三角）的骨密度,并依据WHO骨质疏松症诊断标准将病例组分为骨质疏松组、骨量减少组、骨量正常组。同时检测血清骨钙素（osteocalcin,OC）、总Ⅰ型前胶原氨基端延长肽（procollagen type Ⅰ N—terminal propeptide,PINP）、Ⅰ型胶原羧基端肽β特殊序列（β—carboxy—terminal collagen crosslinks,β—CTX）、血钙（calcium,Ca）、血磷（phosphorus,P）、甲状旁腺素（parathyroid hormone,PTH）、25羟维生素D3[25-hydroxy vitamin D3,25（OH）D3]、空腹血糖（fasting blood—glucose,FBG）、糖化血红蛋白（hemoglobin AlC,HbAlC）、碱性磷酸酶（alkaline phosphatase,ALP）以及血清肌酐（serum creatinine,SCr）等临床化学指标,对检测结果进行统计学分析。结果各组间年龄、体重指数差异均无统计学意义（P均〉0．05）。骨量减少组及骨质疏松组的脊椎骨密度值、髋部骨密度值均显著低于健康对照组,且差异均有统计学意义（P均〈0．05）;骨量减少组与健康对照组相比,SCr、FBG、HbAlC和β—CTX均升高,差异均有统计学意义（P均〈0．05）;骨质疏松组与健康对照组相比,SCr、ALP、FBG、HbAlC、PINP、β—CTX、PTH结果均升高,且差异具有统计学意义（P均〈0．05）;骨量减少组和骨质疏松组的25（OH）D,均明显降低,与健康对照组相比差异均有统计学意义（P均〈0．05）。相关性分析结果表明,PINP、β—CTX与大转子、股骨全部的骨密度均呈负相关（P均〈0．05）。结论骨转换标志物与骨密度联合检测能更早反映糖尿病患?     

糖皮质激素性骨质疏松骨保护素表达与骨密度的相关性

目的：探讨糖皮质激素性骨质疏松大鼠骨保护素在骨骼局部的表达，及其对骨密度变化的影响。 方法：实验于2005-01／2006—03在解放军总医院骨科实验室完成。选择6月龄雄性Wistar大鼠48只，随机数字表法分为实验组和对照组，各24只。实验组大鼠给予地塞米松1mg／kg肌肉注射，1次／d；对照组大鼠给予等量生理盐水肌注。两组大鼠给药后2，4，8，12周各处死6只，取松质骨（腰椎）和皮质骨（股骨干），进行骨密度值测量、骨组织形态学观察及骨保护素免疫组织化学染色，并进行图像处理和统计分析。 结果：纳入动物48只，均进入结果分析。①实验组大鼠腰椎骨密度给药后2，4，8，12周与对照组相比均明显下降分别为（0．175&;#177;0．013），（0．212&;#177;0．018）g／cm^2；（0．152&;#177;0．021），（0．211&;#177;-0．019）g／cm^2；（0．129&;#177;0．014），（0．213&;#177;0．015）g／cm^2；（0．113&;#177;0．016），（0．212&;#177;0．015）g／cm^2，P〈0．01]，给药后12周较2周下降更为显著（P〈0．01）；股骨干骨密度给药后2周无明显差异（P〉0．05），给药后4周开始下降[分别为（0．226&;#177;0．013），（0．244&;#177;0．015）g／cm^2,P〈0．05]，给药后8，12周均明显下降[分别为（0.204&;#177;0．014），（0.238&;#177;0．015）g／cm^2；（0．186&;#177;0．016），（0．240&;#177;0．013）g／cm^2，P〈0、01]。②实验组骨小梁排列稀疏，数目减少，小梁明显变细、间距加宽，股骨干中段骨皮质厚度变薄，12周多视野计数可见破骨细胞增多（P〈0．01）。③实验组给药后2周腰椎的骨保护素组织化学染色明显减低4周股骨干内亦明显减低，并且随着给药时间的延长逐渐减低。 结论：糖皮质激素抑制骨骼局部骨保护素表达，并且与局部破骨细胞的增多、骨密度降低密切相关，继发了渐进性骨质丢失，可能参与并促进了骨质疏松的形成。     

Biomarkers of bone turnover and bone mineral density in hyperprolactinemic amenorrheic women.

We tested the hypothesis that biomarkers of bone resorption are increased in hyperprolactinemic amenorrheic patients with estrogen (E) deficiency, augmenting the possible risk of developing osteoporosis. Fifty hyperprolactinemic patients with amenorrhea of more than 12 months and with low serum E2, as well as 30 healthy fertile women (controls), matched for age and body mass index, participated in this study. Bromocriptine was administered orally to hyperprolactinemic patients and blood and urine samples were collected before and 12 weeks after treatment. Serum osteocalcin (OC) and bone-specific alkaline phosphatase (B-ALP), reflecting bone formation, and urinary deoxypridinoline (D-Pyr) and N-telopeptide of type 1 collagen (NTX) excretion, reflecting bone resorption, were measured using direct immunoassays. Hyperprolactinemic patients had higher (p < 0.0005) levels of all the biomarkers compared to control values: (OC, 22+/-1.2 [SE] vs. 14+/-.99 ng/ml (+57 %); B-ALP, 14.2+/-0.7 vs. 7.5+/-0.8 ng/ml (+89 %); D-Pyr, 8.8+/-0.6 vs. 3.2+/-0.3 nmol/mmol creatinine (+175%) and NTX, 65+/-5.1 vs. 25+/-3.2 nmol bone collagen equivalent (BCE)/mmol creatinine (+160%)). These results were associated with significantly decreased lumbar spine bone mineral density (LS-BMD), measured by dual energy X-ray absorptiometry (DEXA). Treatment of hyperprolactinemia with bromocriptine restored normal values of bone formation and resorption markers. In conclusion, hyperprolactinemia with estrogen deficiency exhibits a significant increase of bone resorption which is associated with a significant decrease of LS-BMD. These changes may subject the patient to the possible risk of developing osteoporosis.     

血液透析患者血清瘦素水平与骨密度和骨代谢的关系研究

目的观察血液透析患者体内血清瘦素水平与骨密度、骨代谢指标之间的关系。方法94名血液透析患者均采用双能X射线骨密度仪检测计算股骨颈和腰椎骨的骨密度。采用酶联免疫法测定血清瘦素,放射免疫检定法测定甲状旁腺素（PTH）,酶联免疫吸附法测定Ⅰ型胶原羧基端肽β特殊序列（β-CTX）,采用全自动生化分析仪检测骨特异性碱性磷酸酶（BAP）。结果女性患者的血清瘦素明显高于男性患者（t=2.44,P＜0.05）,且女性患者血清瘦素和PTH、β-CTX、BAP均呈负相关（r分别=-0.58、-0.23、-0.37,P均＜0.05）,男性患者血清瘦素和PTH、β-CTX呈负相关（r分别=-0.41、-0.45,P均＜0.05）。所有患者的血清瘦素与骨密度相关性不明显（r分别=0.06、0.06,P均＞0.05）。结论血液透析患者女性的血清瘦素水平明显高于男性,女性患者血清瘦素与骨代谢呈负相关;男性患者中血清瘦素与骨代谢中的骨吸收负相关,而与骨形成无关。所有患者的血清瘦素与骨密度相关性均不明显。     

大段同种异体骨移植后骨密度变化与骨折的关系

目的:探讨大段同种异体骨移植后的骨密度变化及骨折发生的规律和特征。方法:对1985-01/2001-01解放军第四军医大学西京医院骨科48例四肢骨肿瘤切除,行大段同种异体骨移植患者,每6个月测定异体骨和对侧相应部位正常骨骼骨密度并进行比较。结果:异体骨和对侧相应部位正常骨骼骨密度术后12个月分别为(1.12±0.12)g/cm和1.13±0.10)g/cm,两者间的差异无显著性意2(2义(t=1.48,P>0.05);手术18个月后分别为(1.04±0.11)g/cm和2(1.10±0.10)g/cm,两者间的差异有显著性意义t=2.42,P<0.05);2(手术30个月后分别为(0.91±0.10)g/cm和(1.11±0.11)g/cm,两者22间的差异有非常显著性意义(t=3.78,P<0.01)。结论:异体骨移植后骨密度降低,是由免疫反应和爬行替代修复造成,多发生在植入术18个月后,异体骨移植后骨密度降低与骨折发生密切相关。提示:异体骨骨折多发生在植入术18个月后,降低免疫反应和加速爬行替代,坚强、持久内固定,术后延迟内固定物取出,适当控制患肢活动量等,均能有效预防异体骨骨折。     

退行性膝关节骨关节病患者的骨强度与骨密度的相关性研究

目的退行性膝关节骨关节病患者的骨强度与骨密度的相关性。方法组和对照组的患者均进行胫骨超声速率(SOS)和髋部骨密度(BMD)的测定。依据髋部BMD,再将研究组分为单纯退行性膝关节骨关节病组和合并骨质疏松症组。结果组和研究组的胫骨SOS和髋部BMD呈正相关,对照组的胫骨SOS和髋部BMD相关系数显著地高于研究组的相关系数,单纯组的相关系数没有显著性意义。结论退行性骨关节病患者的骨强度与骨密度呈正相关,但相关性较低,所以胫骨超声速率(SOS)测定仅能反映骨强度的情况,不能反映骨密度的情况。     

Menstrual status and bone mineral density among female athletes

The present study investigated the relationship between menstrual status and bone mineral density (BMD). Sixty-three elite female athletes competing at the regional level participated. Self-reported menstrual status, stress during the past 6 months, dietary intake of calcium, blood samples for hormonal study, mid-thigh skinfold thickness, triceps, iliac crest, spine and femoral neck BMD were determined. It was found that more than half of the athletes were eumenorrheic while almost half were menstrually dysfunctional. The bone mineral density at the lumbar spine and the femoral neck were within normal ranges. Menstrual dysfunction in female athletes was related to a low BMD at the lumbar spine but not at the femoral neck. Delayed menarche and menstrual dysfunction during the first 2 years after menarche were related to current menstrual dysfunction, but low percent body fat was not related to menstrual dysfunction. This study suggests that exercise in elite female athletes might be an underlying cause of menstrual dysfunction and that there is a relationship between lumbar spine BMD and menstrual dysfunction. The assessment of menstrual history and percent body fat could be used as a screening tool for menstrual dysfunction.     

Association of immune function with bone mineral density and biochemical markers of bone turnover in patients with anklylosing spondylitis

The lymphocyte-osteoclast interaction has recently been described. The aim of this study was to investigate the possible relationship between ankylosing spondylitis (AS) and bone metabolism. Bone metabolism was evaluated in the blood of 49 patients with AS by means of biochemical markers and bone mineral density (BMD) with a Lunar device. Bone formation markers, bone specific alkaline phosphatase (BALP), osteocalcin (BGP), bone resorption markers, pyridinoline (Pyd), deoxypyridinoline (Dpyd) and lymphocyte surface markers (CD3, CD19, CD4, CD8, CD16+56) were analysed with ELISA and flow-cytometry methods. The patients had significantly lower femoral neck and trochanter BMD than the controls. Dpyd concentrations were negatively correlated to CD3+% and CD3-/CD16+56% cells. Neither mineral nor hormone levels were significantly correlated with absolute T scores of BMD of the hip sites. BALP and BGP were negatively correlated to BMD when expressed as T scores. We conclude that AS is related to accelerated osteoclastic activity. Many lymphokines and growth factors produced by lymphocytes can influence osteoclastogenesis and probably play a role in rheumatologic/inflammatory disorders.