年龄、体重、体重指数对青岛市居民骨密度的影响

目的探讨年龄、体重和体重指数对骨密度的影响。方法双能骨密度仪(DEXA)测定269例50~80岁青岛常住人口腰椎前后位和髋部骨密度,记录年龄,测量身高、体重,计算出体重指数,并进行统计学分析。结果高龄、低体重和低体重指数者骨密度均较其他组低,差异有显著性。男性和女性骨密度随年龄、体重和体重指数的变化模式不同。结论年龄、体重和体重指数是影响骨密度的重要因素。年龄、体重和体重指数对男性和女性骨密度的影响结果不同。     

大豆异黄酮对大鼠骨密度及骨代谢生化指标的影响

目的 研究植物雌激素-大豆异黄酮对大鼠骨密度及骨代谢生化指标的影响。方法 将断乳Wister大鼠按体重随机分为4组，分别给予基础饲料和不同剂量的大豆异黄酮。每周称体重，调整给食量。12周后处死大鼠，取脏器称重，计算脏体比值；剥离股骨，测骨矿物质含量(BMC)、骨密度(BMD)和骨钙、骨磷的含量；对血清中骨形成生化指标碱性磷酸酶、骨钙素和骨吸收生化指标抗酒石酸酸性磷酸酶进行检测，同时测定雌激素-雌二醇(E2)的含量。结果 具有弱雌激素样作用的大豆异黄酮对实验大鼠的子宫、卵巢无刺激作用。与对照组相比，给予大豆异黄酮能提高BMC、BMD及骨钙含量，并随剂量的增加而增大。大豆异黄酮可影响骨代谢，高剂量的大豆异黄酮(41．6mg／kg)同时抑制骨形成和骨吸收，使骨转化率降低，但对骨吸收的作用大于骨形成。给予大豆异黄酮组血清雌激素水平大于对照组。结论 大豆异黄酮通过调整骨代谢生化指标的活性，提高大鼠的骨钙含量和骨密度，可预防骨质疏松的发生。     

胃大部切除术对骨密度和生化指标的影响

鉴于有人提出胃切除术后会伴有骨代谢的改变，我们研究的目的就是评定经胃大部切除术（毕Ⅱ式）治疗的溃疡病患者的骨密度和骨代谢生化指标的变化。我们选择了３０名３０～６５岁的患者并与年龄、性别相配的以常规药物治疗的消化道溃疡组患者作对照。我们发现骨密度在患者组显著低于对照组，降钙素水平患者组亦显著低于对照组。但血清钙、磷、镁、骨钙素；尿钙、磷、镁在两组间没有显著差异。胃切除术引起骨质减少的机制仍需全面阐明。我们研究的结果表明胃大部切除术后椎骨密度有显著降低。生化指标没有变化。但降钙素明显降低。骨钙素水平有下降趋势，提示成骨细胞活动性减弱。降钙素水平的下降提示骨吸收的增加，进一步提示高骨更新率可能是胃大部切除术后人群骨质减少的一个原因     

成人侏儒症患者骨密度检测结果及分析

目的 检测成人侏儒症患者腰椎、右髋、左髋骨密度值,与正常同龄人体检组相比较,探讨成人侏儒症患者与骨质疏松的相关性.方法 采用法国MEDI MINK公司生产的OSTEOCORE 3双能X线骨密度检测仪检测28例成人侏儒症患者腰椎、左髋、右髋骨密度,求出均值,以最低值作为诊断依据,并随机选出38例体检的正常同龄人与之比对.结果 患病组与对照组两组相比,年龄无差异,P=0.13＞0.005;身高有显著性差异,P=0.000＜0.005;体重有显著性差异,P=0.000＜0.005;腰椎骨密度均值有显著性差异,P=0.000＜0.005;右髋骨密度均值有显著性差异,P=0.000＜0.005;左髋骨密度均值有显著性差异,P=0.000＜ 0.005.28例侏儒症患者中骨量正常0例,占0％、骨量减少4例,占14.29％、骨质疏松24例,占85.71％、其中骨质疏松中达严重骨质疏松者12例.结论 成人侏儒症患者骨量减少合骨质疏松患病率达100％,无一例骨密度正常,要高度重视这一特殊人群的骨髂健康.     

体重体成分与骨密度的关系

为了研究体成分与骨密度（ＢＭＤ）之间的关系，因体重与ＢＭＤ显著相关，体成分各个组成相加等于体重，而体成分与ＢＭＤ的关系仍不清楚。方法随机选取２０６名１６～５２岁健康的男女性汉族人，用双能Ｘ射线吸收法（ＤＸＡ）测量ＢＭＤ与体成分，进行ＢＭＤ与体重，体成分的多元线性回归分析。结果体重，瘦组织（ＬＴＭ）与男女性的ＢＭＤ显著正相关，脂肪组织（ＦＴＭ）仅对女性全身，腰椎ＢＭＤ起显著性作用。结论影响男女性ＢＭＤ的体成分中，ＬＴＭ是主要因素，ＦＴＭ仅对女性ＢＭＤ有影响。本文较全面地研究了体成分与ＢＭＤ的关系。     

A meta-analysis of the effects of cigarette smoking on bone mineral density

To determine the magnitude and mediators of the association between cigarette smoking and bone mass in the epidemiologic literature we reviewed articles, published abstracts and conference proceedings, identified through MEDLINE, psychological abstracts, conference proceedings, and article bibliographies. We studied cross-sectional and prospective human studies that provided a quantitative measure of bone mass (X-ray, absorptiometry, or computed tomography) as a function of cigarette smoking exposure. Effects were expressed as pooled standardized mean differences for categorical comparisons (e.g. bone mass in current versus nonsmokers), and as pooled correlation coefficients for continuous comparisons (e.g., correlation of bone mass and pack-years of smoking). Effects were derived for combined bone sites (all bone sites pooled within each study) and four specific sites (hip, lumbar spine, forearm, and os calcis), and were examined overall and as a function of subject and methodologic characteristics (gender, age, body weight, menopausal status, health status). Data were pooled across 86 studies, enrolling 40, 753 subjects. Smokers had significantly reduced bone mass compared with nonsmokers (never and former smokers) at all bone sites, averaging a one-tenth standard deviation (SD) deficit for combined sites. Deficits were especially pronounced at the hip, where the bone mass of current smokers was one-third of a SD less than that of never smokers. Overall, effects were greatest in men and in the elderly, and were dosedependent. In prospective studies, smokers had greater rates of bone loss over time compared with nonsmokers. Bone mass differences remained significant after controlling for age and body weight differences between the two groups. Absolute effect sizes at most bone sites were greatest for current smokers compared with never smokers, intermediate for current smokers compared with former smokers, and lowest for former smokers compared with never smokers, suggesting that smoking cessation may have a positive influence on bone mass. Based on these data, it is estimated that smoking increases the lifetime risk of developing a vertebral fracture by 13% in women and 32% in men. At the hip, smoking is estimated to increase lifetime fracture risk by 31% in women and 40% in men. It appears that smoking has an independent, dose-dependent effect on bone loss, which increases fracture risk, and may be partially reversed by smoking cessation. Given the public health implications of smoking on bone health, it is important that this information be incorporated into smoking prevention and cessation efforts     

体重、体质指数、腰围和腰臀比对正常成人骨密度的影响

目的探讨体重、体质指数(BMI)和腰围、腰臀比(WHR)对正常成人骨密度的影响。方法采用MarcomMx8000多层螺旋CT测定560例正常成人腰椎松质骨密度,将受试者按年龄不同分为青年组、中年组和老年组,然后在同年龄组根据BMI及腰围的不同将受试者分为肥胖组和正常体重组,分析骨密度与体重、BMI、腰围及WHR的关系。结果①以BMI分组,老年肥胖组BMD高于体重正常组(P<0.05);②以腰围分组,中年女性肥胖组BMD低于非肥胖组(P<0.05);③青年组和中年组BMD与腰围及WHR呈负相关,老年组BMD与体重和BMI呈正相关与腰围和WHR不相关。结论预防骨质疏松症在中青年应提倡运动锻炼,避免肥胖,在老年人不应该过分强调降低体重减少肥胖以避免骨量的丢失。     

Influence of patient's weight on dual-photon absorptiometry and dual-energy X-ray absorptiometry measurements of bone mineral density

Lumbar spine bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) (Hologic QDR 1000) and by¹⁵³Gd dual-photon absorptiometry (DPA) (Novo Lab 22a) in 120 postmenopausal women. Though a high correlation existed between the two techniques, the ratio between DXA and DPA values was not constant. Using DXA we observed a higher dependence of BMD on weight than in the DPA measurements. To investigate the different behaviour of DXA and DPA machines with weight, we analysed the effects of increasing thickness of soft tissue equivalents on the BMD of the Hologic spine phantom and on the BMD equivalent of an aluminium standard tube. Increasing tissue-equivalent thickness caused the phantom BMD measured by DPA to decrease significantly but had not effect on the DXA measurements. The different behaviour of DPA and DXA equipment with regard to the phantoms could account for the differences observed in the relations between BMD and weight in the patients. Using multiple regression we studied the influence of weight and body mass index on the relation between BMD measured by the two techniques. The introduction of either of these variables into the regression resulted in an improvement of the prediction of the DXA values from the DPA values. However, the residual standard error of the estimate was still higher than the combined precision errors of the two methods, so that no simple relation allows a conversion of BMD_DPA into BMD_DXA. Our results confirm that BMD is positively correlated with weight in postmenopausal women; the influence of weight on BMD is blunted when the Novo Lab 22a DPA machine is used for measuring bone mineral.     

上海地区成年人上前牙区牙槽骨骨密度值测定

目的 测定上海地区成年人上前牙牙槽骨骨密度值，以确立成年人上前牙牙槽骨骨密度正常值。方法 采用法国产Digoro电脑牙片机多点测定306例18∽65岁正常成年人的上前牙牙槽骨骨密度值。结果 对1530个数据进行统计学处理，确定上前牙牙槽骨各相应点的数值范围。结论 牙槽骨骨密度值男女之间无明显差异，31∽50岁组的骨密度值最高，较51∽65岁组差异有显著性。     

环磷酰胺对大鼠骨密度和骨微结构的影响

目的：研究不同剂量环磷酰胺对雌性SD大鼠骨密度和骨微结构的影响。方法40只3月龄SD雌性大鼠随机数字表法分为环磷酰胺低剂量组、中剂量组、高剂量组和对照组,每组各10只,环磷酰胺各组分别腹腔注射不同剂量（5 mg／kg、8 mg／kg、10 mg／kg）的环磷酰胺,对照组腹腔注射等量生理盐水,每天一次,连续15天,观察大鼠骨密度及骨微结构等指标。结果不同剂量的环磷酰胺组与对照组比较,全身骨密度分别下降了9．8％、13．3％和15．6％;股骨骨小梁数目分别下降了49．8％、65．5％和72．8％;股骨骨小梁分离度则分别上升了225．2％、416．9％和577．4％。结论环磷酰胺可使大鼠骨密度降低,骨小梁数量减少,骨微结构受损,且环磷酰胺剂量越大,骨微结构受损越严重。     

Familial aggregation of bone mineral density and bone mineral content in a Chinese population

Familial aggregation of bone mineral density (BMD) and bone mineral content (BMC) has been shown in twin and familial studies, but most sample sizes were small. We here report a large familial aggregation study in a Chinese population. A total of 13,973 siblings aged 25–64 years from 3,882 families were enrolled from Anhui, China. We assessed the whole-body, hip and lumbar spine BMD and BMC by dual-energy X-ray absorptiometry (DXA). Intra-class correlation coefficients of BMD and BMC between siblings varied among different skeletal sites and between different age groups of male sib-pairs and premenopausal and postmenopausal female sib-pairs, with a range of 0.228 to 0.397. The sibling recurrence risk ratio (s) of osteoporosis was 2.6 in our population. We also evaluated the joint association of the BMD values of the first siblings and the second siblings with the risk of low BMD (defined as less than the 10th percentile of the same group population) of their younger siblings. If both the first and second siblings BMDs were in the lowest tertile, the odd ratios (ORs) of low BMD in their subsequent siblings were 8.32 [95% confidence interval (CI) 5.59–12.39)], 8.71 (95% CI 5.74–13.22) and 5.90 (95% CI 3.57–9.76) for total body, total hip and lumbar spine, respectively. This study demonstrates a significant familial aggregation of BMD and BMC in a large sample of rural Chinese adults.     

牙齿缺失与骨密度关系的研究

目的系统骨丢失与牙槽骨局部骨丢失致牙齿缺失之间的关系尚不清楚，通过检测健康藏族妇女的骨密度及其牙齿缺失状态，探讨其相关性。方法随机选择西藏拉萨40—79岁健康藏族妇女(无牙周疾病治疗史)135人，检查牙齿缺失状况确定缺牙原因。问卷调查排除系统病和服用影响骨密度和钙磷代谢药物史。同时用MetriScan TM(美国Alara公司提供)指骨骨密度仪进行骨密度测量，应用SPSS软件统计分析。结果随年龄增长，因牙周病而缺牙的人占同年龄人数的百分率逐渐升高，骨密度逐渐降低。结论骨质疏松症是牙周病的危险因子之一。     

Influence of body weight on rates of change in bone density of the spine,hip, and radius in postmenopausal women

Summary Interrelationships between percent of ideal body weight (%IBW), serum estrogen levels, and change in bone mineral density (BMD) and bone mineral content (BMC) were studied in 288 postmenopausal women aged 41–71 years who participated in a 2-year calcium supplement trial. The spine (L2–L4) and femoral neck were measured by dualphoton absorptiometry, and the radius was measured by single-photon absorptiometry. Years since menopause, calcium intake, and initial BMD or BMC were included as independent variables in two-phase regressions of BMD and BMC on %IBW. Increased %IBW protected against loss of spine BMD [regression slope estimate=0.05, 95% C.I.: (0.03, 0.26)] and BMC in women up through about 106 %IBW but not in heavier women. Increased %IBW was not significantly related to BMD or BMC at the femoral neck or radius. Women above 106%IBW had significant gains in spine and femoral neck area (P< 0.05). Serum estrone and estradiol were positively correlated with BMD and BMC at the femoral neck only.     

Bone mineral density in weight lifters

Summary The effect of intense physical training on the bone mineral content (BMC) and soft tissue composition, and the development of these values after cessation of the active career, was studied in 40 nationally or internationally ranked male weight lifters. Nineteen were active and 21 had retired from competition sports. Fifty-two age- and sexmatched nonweight lifters served as controls. The bone mineral density (BMD) in total body, spine, hip, and proximal tibial metaphysis was measured with a Lunar Dual-energy X-ray absorptiometry (DXA) apparatus and the BMD of the distal forearm was measured with single photon absorptiometry (SPA). Seventeen of the lifters had been measured earlier with SPA in the forearm and 23 in the tibial condyle during their active career in 1975. The BMD was significantly higher in the weight lifters compared with the controls (10% in the total body P<0.001, 12% in the trochanteric region P<0.001, and 13% in the lumbar spine P<0.001). All measured regions except the head showed significant higher bone mass in the weight lifters compared with the controls. In older lifters, the difference from the controls seemed to increase in total body and lumbar vertebrae (BMD), but remained unchanged in the hip. Significant correlation was found between the SPA measurements in 1975 and the corresponding measurements 15 years later in both the forearm (r=0.51, P<0.05 at the 1-cm level and r=0.87, P<0.001 at the 6-cm level) and in the tibial condyle (r=0.61, P<0.01). There was no difference in BMD for any region between active and retired weight lifters that was not explained by difference in age. The weight lifters were on average 5 cm shorter but of the same weight as the controls. In the weight lifters, the body mass index (BMI) was increased as was the lean body mass, but not the fat content.     

顺铂对雌性大鼠骨密度影响的实验研究

目的本文通过对去势雌性大鼠的动物实验研究，观察顺铂对骨代谢、骨密度的影响，并探讨其可能机制。方法将三月龄雌性SD大鼠30只，随机分为对照组和化疗组，每组15只。各组大鼠均用1％戊巴比妥钠腹腔内麻醉，行双侧卵巢切除术。术后1W开始用药，每两周用药1次，共6次。对照组腹腔内注射生理盐水1ml；化疗组腹腔内注射顺铂2mg／kg溶于1ml生理盐水中。术后13W处死各组动物，处死前用代谢笼收集24h空腹尿标本，自动生化分析仪测定尿钙浓度并计算出24h排泌量。氯胺T氧化法测尿羟脯氨酸(HOP)浓度并计算出24h排泌量；麻醉动物，开腹后下腔静脉取血离心，放免法测骨钙素(BGP)、血尿素氮(BUN)；取腰椎L4-6椎体，双能X线骨密度测量仪测腰椎骨密度。结果化疗组与对照组相比，骨密度降低，24h尿HOP及24h尿Ca定量升高，均有显著意义，血BGP无差异。结论本实验表明顺铂对大鼠的骨代谢存在直接的不良影响，使骨吸收增加，表现为松质骨骨密度降低。     

Independent effect of endogenous dehydroepiandrosterone-sulphate levels and birth weight on bone turnover parameters in young adults

Data indicate that bone turnover is higher in young adults born with a low birth weight (LBW). Moreover, several data support the presence of altered adrenal hormone production in this population. The aim of our study was to investigate whether there is any connection between altered bone homeostasis and adrenal hormone levels. Bone mineral density (BMD), serum osteocalcin (OC), and urinary deoxypyridinoline (DPD) excretion were related to dehydroepiandrosterone-sulphate (DHEAS), cortisol, estradiol, testosterone, and sex-hormone binding globulin (SHBG) levels in 47 healthy young women (of those, 33 were LBW) and 65 healthy young men (of those, 49 were LBW). The age of the subjects was 19–21 years. BMD values were normal and did not correlate with any of the factors investigated. Cortisol did not have any independent effect on bone turnover parameters in either men or women. In women, birth weight, DHEAS levels, and free estradiol index were responsible for almost 50% (corrected r² = 0.45) of serum OC variability. Independent positive associations were observed between DHEAS and OC, and between DHEAS and DPD excretion. In men, birth weight and DHEAS levels together were responsible for more than one-third (corrected r² = 0.36) of the variability of serum OC. In contrast with women, DHEAS and OC were inversely correlated in men. Our results suggest that bone turnover depends on the subjects' birth weight. Moreover, DHEAS is also an independent determinant. The effect of DHEAS on bone turnover is different in women and men. DHEAS increases bone turnover in fertile women, while it decreases this in men.     

腰椎间盘突出对绝经后妇女骨密度的影响分析

目的探讨腰椎间盘突出对绝经后妇女骨密度的影响。方法随机选择绝经后妇女进行问卷调查,内容包括身高、体重、是否有腰椎间盘突出、生活习惯、健康状况等;用双能X线骨密度仪测定腰椎、髋部骨密度,并利用SPSS 20.0统计软件对数据进行分析。结果共筛选入组582例,腰椎间盘突出组133例、腰椎间盘无突出组449例。对各因素与骨质疏松的相关性分析,腰椎间盘突出与腰椎椎体骨密度具有负相关(r=-0.094,P=0.023);两组一般资料比较,日光照射、腰椎骨密度差异比较有统计学意义(P0.05);协方差分析,腰椎间盘无突出组腰椎骨密度(0.734±0.123)g/cm~2明显高于腰椎间盘突出组腰椎骨密度(0.707±0.123)g/cm~2,差异有统计学意义(F=3.968,P=0.047),髋部骨密度差异无统计学意义(P0.05);两组骨质疏松患病率比较,腰椎间盘突出组为55.6%,腰椎间盘无突出组为43.7%,两组比较差异有统计学意义(P=0.015)。结论腰椎间盘突出能够引起腰椎骨量流失,是引起骨质疏松发生的影响因素。     

关于Ward’s三角区的探讨

目的研究Ward＇s三角区骨密度值的临床意义。方法采用美国Hologic Delphi A双能X线骨密度仪测定385名20～80岁志愿者（男230例，女155例）左股骨骨密度及113例左右股骨骨密度．观察Ward＇s三角区的变化规律及临床特点。结果①有40．4％～55．8％的青年人Ward＇s三角区的具体位置计算机很难确定，Ward＇s三角区大部分与解剖部位不相对应；②由计算机自动定位的Ward＇s三角区小方块位置取样误差比较大；③Ward＇s三角区骨密度值的精确度误差和变异系数百分比最大；④腿的位置旋转过度或旋转不足都能引起骨密度的变化；⑤正常人双腿骨密度值无显著性差异。结论Ward＇s三角区骨密度值不能用于诊断或随访。     

成都市中老年健身女性体成分指标与骨密度和骨代谢指标的相关性研究

目的探讨体重、体重指数(BMI)等体成分指标对中老年健身运动女性骨密度的影响及体成分指标与骨代谢指标、骨密度指标的关系。方法94例成都市城区健身运动女性根据BMI不同分为三组:低体重组(BMI≤20kg/m2)、正常体重组(20kg/m225kg/m2),采用Osteospace超声骨密度仪测定跟骨的BUA、SOS、STI骨密度指标;全自动生化分析仪测定血清AKP含量;应用放射免疫法测定血清hCT、BGP、IL-6、E2、TNF含量。应用方差分析和偏相关方法进行统计学处理。结果不同BMI组的体重、体重指数、瘦体重和体脂百分比差异显著,低体重组T-score与正常体重组、超重组比较有极显著差异;低体重组SOS、STI骨密度指标显著低于正常体重组;BUA、SOS、STI骨密度指标与体重、体重指数、瘦体重和体脂百分比呈正相关,与hCT、IL-6、TNF、BGP、AKP呈正相关,与E2呈负相关。低体重组骨量减少、骨质疏松发生率最高。结论体重、体重指数等体成分指标是影响中老年健身运动女性BMD的重要因素,保持体重有利于防止骨丢失和预防骨质疏松发生。     

Cortical bone senescence and mineral bone density of the humerus

Summary Study of the humeral cortex of 89 acute cadavers showed that an important factor contributing to the physiologic bone loss of aging is increasing bone porosity. Mean cortical porosity increases in both sexes with age, from 4.6% in men and 4% in women at 40 years of age to 10% and more at age 80. In the population studied, no significant difference of porosity was observed between men and women. Apparent mineral density is linked to porosity, and decreases markedly with age in women. Changes in men are lesser in magnitude and show a larger difference of density values. Correction of the apparent mineral density, by a factor reflecting the proportion of vascular and resorption spaces in the cortical bone, produces a true mineral density which does not vary significantly with age in either sex. The density values obtained for the proximal humerus differ from those in the literature which represent the femur. However, they are more readily compared with the results of clinical densitometry and may have greater clinical applications.