绝经年限、体质量和人体质量指数与绝经后妇女的骨密度变化

背景：绝经后妇女易于发生骨质疏松，不同年龄和体质量的人群，其骨量丢失的规律不同。目的：分析年龄、绝经年限、绝经年龄、身高、体质量及人体质量指数对绝经后妇女骨密度的影响。设计：以绝经妇女为研究对象，随机抽样检测。单位：一所省级中医药研究院药品临床研究基地，一所大学医院骨科及一所大学骨伤系。对象：2000-09／2003-08福州地区自然绝经后妇女603例。方法：采用随机抽样方法，记录患者年龄、绝经年限、绝经年龄、身高、体质量及人体质量指数，采用双能X射线骨密度仪检测腰椎和股骨颈、大转子及Ward’s区骨密度，用SPSS软件相关回归分析。主要观察指标：年龄、绝经年限、绝经年龄、身高、体质量和人体质量指数与骨密度的相关性及回归方程。结果：绝经后妇女的年龄、绝经年限、体质量和人体质量指数与腰椎、股骨颈、大转子及Ward’s区骨密度的相关性十分显著；低体质量组骨密度明显低于超体质量组(P&;lt;0．01)；影响腰椎、大转子骨密度的主要因素为年龄和体质量，影响股骨颈骨密度的重要因素为绝经年限和体质量。影响腰椎骨密度的因素依次为年龄、体质量和绝经年龄，回归方程：y=0．927-0．0093X1+0．0037X2+0．004X3，影响股骨颈骨密度的因素依次有绝经年限、体质量和绝经年龄，回归方程：y=0．687-0．0081X1+0．0048X2-0．0034X3，影响大转子骨密度的因素依次有年龄、体质量和绝经年限，回归方程：y=0．591—0．0038X1+0．0042X2-0．0024X3．影响Ward’s区骨密度的因素依次有年龄、人体质量指数和绝经年限，回归方程：y=0．686-0．0072X1+0．0136X2-0．0046X3。结论：绝经后女性随着年龄的增大，其腰椎和髋部的骨密度呈下降趋势，对于体瘦者，患骨质疏松的危险性要大于正常体质量组及肥胖组。     

绝经后骨丢失的初步探讨及体重指数对骨密度的影响

目的　探讨绝经后妇女不同年龄及不同绝经年限骨丢失的特点及体重指数对骨密度的影响。方法　对３６２ 例绝经后妇女（ 均为自然绝经） 分别超声测定右下肢胫骨中点骨密度。结果　①绝经后骨密度在４５ ～５０ 岁时最高,５０ 岁以后随年龄的增长明显下降,７０ 岁以后趋于平稳。②骨密度在绝经后１ ～４ 年内下降幅度较小,５ ～７ 年下降幅度较大,７ ～１０ 年较平稳,１０～２０ 年再次下降,２０ 年以后下降幅度较小。③当体重指数＜ ３０ 时,骨密度随体重指数的增加而上升,＞ ３０ 时,骨密度下降。结论　绝经后妇女骨密度随年龄的增加而下降,与绝经年限呈非线性相关,呈两次下降,适当的体重对绝经后妇女的骨丢失有保护作用。     

太原地区251例男性健康体检者腰椎骨密度与年龄、体质量指数和血脂四项相关性的研究

目的探讨太原地区男性健康人群腰椎骨密度与血脂代谢、年龄、体质量指数(BMI)的相关性。方法采用美国Hologic公司生产的双能X线骨密度仪(DXA)测量251例男性健康体检者的正位腰椎(L1~4)处骨密度(BMD)并将其分为骨质疏松组(224例)及非骨质疏松组(27例),记录被检者的一般情况并计算BMI,分别测量总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C);采用两组间各指标进行比较,并进行相关性、偏相关性和Logistic回归性分析。结果骨质疏松组的BMI较非骨质疏松组低,差异有统计学意义(P=0.002<0.05);骨密度与BMI、TC、HDL-C相关(P<0.05);控制年龄、BMI后,骨密度仍与TC相关(P=0.002<0.05);Logistic回归分析结果显示,BMI是骨质疏松的保护因素,TC可能是骨质疏松的危险因素。结论男性BMI的增加可能会减少骨质疏松的发生,对高血脂患者进行降脂治疗可能会降低骨质疏松发病的风险。     

人工绝经后妇女的骨密度分析

目的探讨人工绝经后妇女的骨密度变化。方法随机抽查35例人工绝经后妇女的桡骨骨密度,并以35例同年龄健康人作对照。结果发现人工绝经后妇女较同龄健康对照组骨密度显著降低,且骨质疏松发生率高于同年龄对照组。结论人工绝经可以引起妇女骨质疏松。     

自然绝经和手术绝经对妇女骨密度的影响

随着生活水平提高，老年人口比率不断增加，也即绝经后妇女比率增加，加之因各种原因，妇女接受手术切除全子宫及双侧附件机会也增加，由此而对妇女产生了一些不良影响，如心血管疾病增加及更年期综合征等。本文目的在于通过观察妇女自然绝经及手术绝经后骨密度的变化，以期为绝经妇女骨质疏松的防治提供一定的依据。1资料和方法1．1研究对象：自然绝经妇女8例，年龄49～59岁，绝经年限3～9年；全子宫及双附件切除妇女（手术绝经组）8例，年龄48～59岁（均为绝经前施行手术，全部为子宫良性疾患），手术年限3～8年；未绝经妇女（对照组）9例…     

体重指数与骨密度的关系

目的分析体重指数(BMI)与骨密度的关系.方法对2395例腰椎前后位和髋部骨密度检查结果的T值与体重指数进行统计学相关回归分析.结果无论总体分析或按年龄组分析都显示骨密度T值与体重指数呈线性正相关.低体重指数者(BMI≤20)骨密度T值低于较高体重指数者(BMI>20),差异具有显著性.骨密度T值随体重指数变化在髋部较脊柱更明显.结论体重指数与骨密度T值呈正相关,低体重指数与骨质疏松的发生有关.     

绝经后妇女体质量指数与腰椎、髋关节骨质疏松相关性探讨

目的了解体质量指数与绝经后妇女腰椎、髋关节骨质疏松发生率的关系。方法利用双能X线骨密度测量仪对绝经后妇女行腰椎、髋关节骨密度检查,同时行生化检查,排除继发性骨质疏松可能后,随机抽样215例进行分析。其中BMI≤20 kg/m2者（Ⅰ组）105例,BMI〉25 kg/m2者（Ⅱ组）10例。结果Ⅰ组的髋关节骨质疏松患病率（98.1%）明显高于腰椎（30.5%）（P〈0.01）,而Ⅱ组的腰椎骨质疏松患病率（91.8%）明显高于髋关节（54.6%）（P〈0.01）。结论体质量指数大者腰椎易发生骨质疏松症,而体质量指数小者髋关节易发生骨质疏松症。     

广东省自然绝经后妇女137人体力活动与桡骨骨密度、皮质结构和骨代谢指标的相关性

目的本研究通过抽样调查我国广东省自然绝经妇女的体力活动水平,探讨绝经后女性日常体力活动与桡骨骨密度、皮质结构和相关骨代谢指标的关系。方法以单纯随机抽样的方法,抽取江门市12家工厂和企事业单位自然绝经的女性职工137人作为研究对象,采用标准化的MOSPA(TheMONICAOptionalStudyOfPhysicalActivity)体力活动问卷评价其体力活动水平,并测量有关桡骨皮质骨结构指标和相关骨代谢指标。结果在校正年龄、BMI、血清雌激素及膳食钙和维生素D摄入水平等因素后,高体力活动组女性的桡骨骨密度和骨皮质指数均高于低体力活动组(F=9.382,P=0.003;F=5.487,P=0.021),而其骨髓腔宽度则低于低体力活动组(F=7.713,P=0.08),但两组间的血清钙、磷、碱性磷酸酶(AKP)、抗酒石酸盐酸性磷酸酶(TRAP)以及空腹尿钙和肌酐比均无显著性差异(F=0.161,P=0.709;F=0.168,P=0.682;F=0.196,P=0.659;F=1.835,P=0.172;F=0.162,P=0.708)。与低体力活动组相比,高体力活动组的抗酒石酸盐酸性磷酸酶有下降趋势。结论绝经后妇女体力活动与桡骨骨密度、骨皮质厚度呈正相关关系。     

提前绝经妇女8个部位的骨密度变化

目的探讨提前绝经对骨密度的影响.方法选择2001-01/2003-01在广西壮族自治区人民医院进行健康体检的南宁市机关工作人员及离退休人员165人.提前绝经的妇女83人（早绝经组）,自然绝经妇女82人（对照组）,记录一般资料,采用法国Challenger双能X射线骨密度仪检测受试者腰椎：L2,L3,L4正位,左髋部：股骨颈、Ward三角、大转子,左前臂：超远端、远端的骨密度,并将两组一般情况、骨密度、骨质疏松的患病率进行分析比较.结果纳入165人均进入结果分析.[1]股骨颈骨密度比较：早绝经组低于对照组[（0.764&;#177;0.115,0.799&;#177;0.118）g/cm^2,（P＞0.05）].[2]L2骨密度比较：早绝经组明显低于对照组[（0.701&;#177;0.154,0.760&;#177;0.138）g/cm^2,（P＜0.05）].[3]骨质疏松患病率比较：提前绝经组明显高于对照组[（67.1%,52.4%）,（P＜0.05）].结论提前绝经妇女骨密度低于自然绝经妇女,其骨质疏松的发病机率明显增高.     

绝经后妇女髋部和腰椎骨密度变化及骨质疏松发生特点比较

绝经后骨质疏松是严重危害老年妇女健康的疾病,是骨折发生的重要危险因素。人群调查结果表明,骨量在人体不同部位的分布以及随年龄丢失率并不相同,而不同部位骨折的发生对生活质量和健康的影响也各有差异。因此,了解绝经后妇女骨折易发部位髋部及腰椎骨密度变化和骨质疏松发生特点,以及髋部和腰椎骨质疏松的发生是否具有一致性,对骨质疏松的防治具有重要的参考价值。     

Metacarpal bone mineral density,body mass index and lifestyle among postmenopausal Japanese women: relationship of body mass index,physical activity,calcium intake,alcohol and smoking to bone mineral density: the Hizen-Oshima study

The present study was designed to investigate the influence of modifiable risk factors (body weight and lifestyle) for bone loss on bone mineral density (BMD). We examined age-specific changes in metacarpal BMD, and its associations with body mass index and lifestyle among 532 community-dwelling postmenopausal Japanese women. Measurements of the second metacarpal BMD were obtained from the hand radiographs using computer-assisted radiographic absorptiometry. Body height and weight were measured, and body mass index (BMI) was calculated. Physical activity index was calculated using validated questionnaire. Daily calcium intake and amount of ingested alcohol were estimated by semiquantitative food frequency questionnaire. Current smoking status was obtained by questionnaire. Metacarpal BMD decreased significantly with increasing age. Simple correlation analysis indicated that metacarpal BMD correlated significantly with BMI and physical activity index. On the other hand, metacarpal BMD did not correlate with calcium intake and alcohol drinking. Metacarpal BMD in current smokers was not different from that in nonsmokers. Multiple regression analysis showed that increasing age was associated with decreased metacarpal BMD and greater BMI increased metacarpal BMD. However, physical activity, calcium intake, alcohol drinking and current smoking were not significant determinants of metacarpal BMD. Our findings suggest that maintenance of adequate body mass (prevention for leanness) is important for prevention of postmenopausal bone loss.     

全身振动对绝经后妇女骨量和骨代谢的影响

目的:寻找一种新型的、安全有效的防治绝经后骨质疏松的办法。方法:对北京市罗庄里小区28例49—65岁绝经后妇女进行问卷调查、腰椎骨密度(BMD)、双侧股骨上端BMD,护骨素(OPG)、抗酒石酸酸性磷酸酶(TRAP)和骨特异性磷酸酶(BALP)等测定。随机分为实验组和对照组,实验组采用振动干预,对照组无任何干预。振动方案为:频率30—45Hz、20min/次,3次/周,连续3个月。结果:在实验前和实验后,组间对比BMD均无明显变化。组内对比,实验组腰椎和股骨上端BMD较实验前无明显改变(P=0.397);而对照组左侧股骨上端BMD和双侧股骨BMD均值均较实验前降低0.01g/cm2(P<0.05);实验组与对照组血清TRAP、BALP、OPG在振动干预结束后较实验前均无明显变化。两组血清TRAP、OPG在实验前后分别进行组间对比也无明显变化(P>0.05);而实验前,实验组BALP明显高于对照组5.61μg/L(P<0.05),但3个月后,差异扩大到6.42μg/L(P<0.01),但两组的变化值间没有明显差异(P>0.05)。结论:振动方案对绝经后女性血清BALP、TRAP、OPG无明显影响,但可延缓股骨上端骨丢失。     

Relationship of serum leptin with age, body weight, body mass index, and bone mineral density in healthy mainland Chinese women

BACKGROUND: Serum leptin concentration is associated with age, fat and bone mineral density (BMD), and there are ethnic differences in physique and BMD values. The relationship between serum leptin concentration and BMD in Chinese women is presently unknown. We examined the relationship of serum leptin concentration with age, body weight, BMI and BMD in mainland Chinese women. METHODS: Serum leptin concentration in a population of 676 Chinese females, aged 20-80 years (45.4+/-14.8 years, mean+/-S.D.), was measured using an enzyme-linked immunosorbent assay (ELISA). BMD values were measured by dual-energy X-ray absorptiometry (DXA) at a number of sites: the posteroanterior lumbar spine (PA, L1-L4), lateral lumbar spine (Lat, L2-L4), hip (including the femoral neck (FN) and total hip (T-hip)), and forearm (one-third region (RU1/3) and total region (RUT)). The relationship between changes in serum leptin concentration with age, body weight, height, body mass index (BMI) and BMD values at six sites were analyzed using 10 different regression models, and the models giving the best fit were selected. RESULTS: The cubic regression model best described the changes in serum leptin concentration with age (R(2)=0.048, p<0.001) and body weight (R(2)=0.352, p<0.001), while the quadratic regression model was best for serum leptin concentration changes with BMI (R(2)=0.410, p<0.001); serum leptin concentration was not correlated with height. Serum leptin concentration was significantly higher in postmenopausal than premenopausal women (p<0.001). Serum leptin concentration was correlated with Lat BMD (R(2)=0.012, p<0.018), FN BMD (R(2)=0.006, p<0.041) and T-hip BMD (R(2)=0.013, p<0.004) in the whole population. In premenopausal women, leptin was positively associated with BMD except for Lat (R(2)=0.029-0.055, p<0.008); in postmenopausal women, leptin was also positively associated with AP, FN, T-hip BMD (R(2)=0.026-0.042, p<0.007). However, after adjusting for BMI not for body weight, there was no association between serum leptin concentration and age. Meanwhile, after adjustment for age, body weight and BMI, there was no association between serum leptin concentration and BMD values in premenopausal and postmenopausal women. CONCLUSIONS: Age-related changes in serum leptin concentration is dependent on BMI, but not a direct determinant of BMD in Chinese females.     

老年妇女体重指数与骨密度和骨超声传导速度的相关性研究

目的　研究体重指数 (BMI)对老年妇女骨密度 (BMD)和骨强度的影响 ,为骨质疏松症 (OP)的预防提供科学依据。方法　采用双能X线骨密度仪和定量骨超声仪 ,测量 319例老年妇女不同骨骼部位的BMD和胫骨超声传导速度 (SOS) ,并按BMI不同分为低体重组 (BMI <2 0 )、正常体重组 (BMI =2 0～ 2 4)和肥胖组 (BMI >2 4)进行分析和比较。结果　除腰椎侧位外 ,老年妇女各部位BMD和胫骨SOS均与BMI呈正相关 (r=0 .2 6 7～ 0 .446和r =0 .16 2 ,P <0 .0 0 1和P =0 .0 0 4) ;正常体重组各部位BMD和胫骨SOS均高于低体重组对应部位 (P <0 .0 5～P <0 .0 0 1) ,而肥胖组均高于低体重组和正常体重组对应部位 (P <0 .0 0 1和P <0 .0 5～P<0 .0 0 1) ;除腰椎侧位 3组间差异无显著性外 ,老年妇女各部位OP的患病率 :低体重组 >正常体重组 >肥胖组。结论　BMI高者可能通过雌激素和负重等作用 ,延缓老年妇女BMD和骨强度下降 ,但对腰椎侧位影响小。     

运动对绝经后女性骨密度的影响

目的：观察运动对绝经后女性骨密度的影响。方法：绝经后女性106名分为运动组37例和对照组69例。运动组进行广场舞、爬山、慢跑等运动干预,对照组未进行任何干预。采用双能X线吸收仪测试其全身及各部位骨矿含量（BMC）和骨密度（BMD）,并进行比较。结果：运动干预8个月后,运动组全身BMD和BMC值均较干预前及对照组明显增加（P＜0．05）,而对照组全身BMD和BMC值均较8个月前下降,但差异无统计学意义。运动组胸椎的BMD、BMC和盆骨的BMC均较干预前及对照组明显增加（P＜0．05）,而腰椎的BMD、BMC和盆骨的BMD干预后差异无统计学意义;对照组干预后腰椎、盆骨的BMD、BMC均较8个月前明显下降（P＜0．05）,而胸椎的BMD、BMC 8个月前后差异无统计学意义。运动组上肢优势侧BMD、BMC和下肢双侧BMD、BMC均较干预前及对照组明显增加（ P＜0．05）,而上肢非优势侧BMD、BMC干预前后差异无统计学意义;对照组上肢非优势侧BMD、BMC均较8个月前及上肢优势侧BMD明显下降（P＜0．05）,而上肢优势侧BMC和下肢双侧BMD、BMC 8个月前后差异无统计学意义。结论：常规运动可显著提高绝经后女性胸椎 BM D和BM C ,而只能维持其腰椎和盆骨的BM D、BM C;上下肢、优势侧与非优势侧活动不均衡可影响相关部位 BM D和BM C的变化。     

骨量下降期成年人骨密度与体质量指数的相关性

目的:通过对骨量下降期成年人的跟骨进行骨密度的测试,探讨骨量下降期成年人骨密度与体质量指数的关系。方法:实验于2005-02/05在苏州市体育科学研究所进行测试,随机选取苏州市骨量下降期40～65岁成年912人作为受试对象,其中男517人,女395人。记录受试者的性别、出生年月,分别测试身高、体质量、体质量指数;采用sonost-2000超声骨密度仪测试跟骨骨密度,算出跟骨骨质量指数;测量不同体质量指数组间超声参数和骨质疏松发生率;并进行体质量指数与各指标的相关性分析。结果:受试对象912人全部进入结果分析。①体质量指数与各指标的相关性分析:体质量指数越高与超声波衰减系数和骨质指数相关性越高(r=0.573和0.525,P<0.01),体质量指数与骨密度和骨强度呈显著性正相关。②不同体质量指数组间骨质疏松率的比较:根据体质量指数测量结果分为≤18.50kg/m2组,18.50～24.9kg/m2组和≥25.0kg/m2组。结果表明,体质量指数≤18.5kg/m2组骨质疏松发生率为12.5%,18.50～24.9kg/m2组骨质疏松发生率为5.45%,≥25.0kg/m2组骨质疏松发生率为3.89%。结论:①体质量指数与骨密度和骨强度呈正相关。体质量指数越大,骨密度和骨强度越高,即骨承受和抵抗外力的能力强,骨质疏松发生率低。②保持适当的体质量指数有利于防止骨质疏松的发生,低体质量指数是发生骨质疏松的危险因素之一。     

绝经后妇女椎体骨骼大小对骨密度和诊断骨质疏松的影响

目的：探讨绝经后妇女椎体骨骼大小对骨密度（BMD）和诊断骨质疏松（OP）的影响。方法：采用QDR－4500A型扇形束双能X线吸收法骨密度仪，测量1081例年龄42－96岁健康绝经妇女腰椎妇女腰椎正位投射骨面积（BA）、骨矿含量（BMC）、面积骨密度（ABMD）及腰椎侧位面积骨密度和体积骨密度（VBMD）。结果：BA与骨矿含量（r=0.606)和面积骨密度（r=0.270,P=0.000)呈正相关，与体积骨密度相关无显著性意义（r=-0.055,P=0.101).BA每增加1cm^2，骨矿含量和面积骨密度分别相应增加6．29％和1．28％。大BA组与中等BA组及中等BA组与小BA组比较，妇女的身高、体重、骨矿含量、面积骨密度和OP检出率的差异均具有显著性的意义（P＝0．000）。腰椎正位和侧位的OP检出率，大BA组分别为24．9％和39．9％，中等BA组分别为36．4％和54．5％，小BA组分别为55．2％和70．9％。各组之间体积骨密度的OP检出率的差异无显著性的意义。多元线性回归分析结果显示，影响骨骼大小和骨密度的主要因素为身高和体重。结论：绝经后妇女腰椎较大者面积骨密度较高和OP检出率较低，椎体较小者面积骨密度较低和OP检出率较高。腰椎体积骨密度不随骨骼大小而改变。腰椎侧位骨密度检测是诊断OP的敏感部位。     

Reproductive factors affecting the bone mineral density in postmenopausal women

Osteoporosis has been defined as a metabolic bone disease characterized by a loss of bone mineral density (BMD) greater than 2.5 standard deviations below young adult peak bone mass or the presence of fracture. By considering that some factors related to female reproductive system might influence the ultimate risk of osteoporosis, we aimed to investigate if a relationship exists between the present BMD of postmenopausal women with their past and present reproductive characteristics. The present study focused on how BMD could be affected by the following factors in postmenopausal women, such as age at menarche, age at first pregnancy, the number of pregnancies and total breast-feeding time. We reviewed detailed demographic history of 303 postmenopausal women. According to the results of the present study, a negative correlation was found between the number of parities and BMD. The BMD values decreased as the number of pregnancies increased. When the BMD values for lumbar vertebrae 2 and Ward's triangle were investigated, it was observed that a significant difference exists between the women with no child birth and those with more than five parities. There was a significant relationship between age at first pregnancy and BMD values at the lumbar vertebrae 2 and Ward's triangle. Women who had five or more abortions were found to have significantly lower spine BMD values compared to women who had no abortions or women who had one or two abortions. These findings indicate that the increased risk of osteoporosis is associated with the increased number of pregnancies and abortions and higher age at first pregnancy.