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.     

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。     

老年男性吸烟与骨转换标志物、骨密度和骨质疏松性骨折风险的关系

目的 调查老年男性吸烟与骨转换标志物、骨密度和骨质疏松性骨折风险的关系.方法 调查576例60～97岁老年男性吸烟等情况,按照是否吸烟分成吸烟组31例和非吸烟组545例.检测两组骨转换标志物[包括I型胶原羧基末端肽交联(CTX)、I型前胶原氨基端前肽(P1NP)和骨钙素(OC)]、骨密度[包括股骨颈骨密度(FNBMD)...     

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.     

利维爱对绝经后妇女骨密度及骨代谢指标的影响

目的了解利维爱对绝经后妇女骨密度及骨代谢指标的影响 . 方法将 123例自然绝经后妇女随机分 2组 研究组每日口服利维爱 1.25 mg+ 钙尔奇 D 600 mg, 对照组每日口服钙尔奇 D 600 mg, 观察 12个月 . 用药前后分别检测腰椎 (L 2～ 4)及股骨颈 (NK)骨密度 (BMD)骨代谢指标血清骨钙素 (BGP)和碱性磷酸酶 (AKP)及尿吡啶酚 /肌酐 (Pyr/cr)和钙 /肌酐 (Ca/Cr)比值 . 结果 (1)L 2～ 4、 NK两部位 BMD 研究组治疗后均增加 , 且前者上升有显著性差异 (P< 0.05);对照组均下降无显著性差异 (P >0.05);治疗后 2组间比较有显著性差异 (P< 0.01,P< 0.05). (2)生化指标血 BGP、 AKP及尿 Pyr/Cr、 Ca/Cr 治疗后研究组均上升有显著性差异 (P< 0.01,P< 0.05); 对照组变化无显著性差异 (P >0.05). 结论绝经后妇女每日服用 1.25 mg利维爱加钙尔奇 D可以提高骨量 ; 单用钙尔奇 D不能防止骨丢失 .     

Serum and urine markers of type I collagen metabolism in elderly women with high and low bone mineral density

The serum markers of bone formation (carboxy-terminal propeptide of type I collagen, PICP) and resorption (pyridinoline cross-links containing telopeptide of type I collagen, ICTP), as well as urinary resorption markers, pyridinoline (Pyr) and deoxypyridinoline (Dpyr), were studied in 78-year-old women with high ( n  = 18) and low ( n  = 17) bone mineral density (BMD) measured from the calcaneus and tibia. The low-BMD group had higher values for PICP ( P  = 0.025), Pyr ( P  = 0.001) and Dpyr ( P  < 0.001) than the high-BMD group. No inverse relationship between these markers and BMD was, however, observed within the study groups. ICTP, Pyr and Dpyr correlated with each other in both groups and with PICP in the high-BMD group. Higher levels of both the formation and resorption markers of type I collagen suggest an increased rate of bone turnover and remodelling in osteopenic elderly women.     

Effectiveness of raloxifene on bone mineral density and serum lipid levels in post-menopausal women with low BMD after discontinuation of hormone replacement therapy

OBJECTIVE: To evaluate the effect of raloxifene on bone mineral density (BMD) and serum lipid levels in post-menopausal women who had discontinued hormone replacement therapy (HRT). METHODS: Thirty-four post-menopausal women with low BMD who had taken 60 mg of raloxifene daily for 12 months after discontinuing HRT were evaluated retrospectively. Information about their demographics, fracture history, BMD, lipid profiles and adverse events were collected from medical records and intranet database. The outcome measures were changes in the spine (L2-L4) and femur BMD, serum lipid concentrations, fracture rate and tolerability. RESULTS: The post-menopausal women had a significant increase in their spine (L2-L4) and femur BMD from their baseline BMD [spine, 2.9 +/- 4.6% (P < 0.001); femur, 3.0 +/- 6.6% (P = 0.01)]. Serum low-density lipoprotein (LDL) cholesterol was significantly reduced by 22.6% below baseline after 12 months (P = 0.007). No fractures were observed during therapy. Raloxifene was well tolerated. The most common adverse event was hot flash, which was generally mild. CONCLUSIONS: Raloxifene increases BMD at important skeletal sites, and lowers LDL cholesterol with tolerable adverse events.     

Effects of alendronate and risedronate on bone mineral density and bone turnover markers in late postmenopausal women with osteoporosis

This study was undertaken to compare the effects of alendronate and risedronate on bone mineral density (BMD) and bone turnover markers (BTMs) in late postmenopausal women with osteoporosis. Thirty women older than 60 y of age were randomly assigned to receive alendronate 10 mg (n=16) or risedronate 5 mg (n=14) on a daily basis. The patients were followed every 3 mo for 12 mo. BMD measurements were taken at baseline and at the end of the study, and BTMs were measured at 3-mo intervals. By the end of the study, there were statistically significant increases in BMD in both groups at all sites at which they were measured (P < .001). However, these differences were not statistically significant between groups. By the end of the study, all BTMs had decreased significantly and to a similar extent in both groups. The most significant change was observed in the third month of the study. A negative correlation was noted between percentage change in bonespecific alkaline phosphatase and femoral neck BMD (r=-0.467). This study reported no difference between the 2 drugs in their effects on BMD and BTMs.     

维持性血液透析患者骨密度变化特点及影响因素分析

目的探讨维持性血液透析(MHD)患者骨密度变化的特点及其影响因素,以达到早期诊断骨质疏松的目的。方法选取72例MHD患者和76例健康者(对照组),利用双能X射线(DEXA)骨密度仪检测其腰椎和髋部的骨密度值,分析MHD患者骨密度的异常情况及骨代谢生化指标的变化特点,进而探索影响骨密度的相关因素。结果 MHD患者腰椎和髋关节的骨密度明显减少,以老年女性降低最为显著,骨质疏松的发生率明显上升(P0.05)。血清检测结果显示碱性磷酸酶(AKP)、甲状旁腺素(iPTH)、磷(P)、骨钙素(OC)、1型前胶原氨基端伸展肽(P1NP)和β-1型胶原羧基末端肽(β-CTX)水平明显上升;而25-羟基维生素D(Vit D)和血钙(Ca)水平明显下降。相关性分析结果显示,骨密度与体质量指数(BMI)和血Ca呈正相关;与年龄、透析龄及AKP、OC呈负相关。结论 MHD患者易出现骨质疏松现象,其中性别、年龄、透析龄、BMI及AKP、Ca和OC均是影响骨密度的因素之一。     

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.     

恶性肿瘤患者骨密度改变的研究

目的了解恶性肿瘤患者骨密度的改变及其主要影响因素;初步探讨骨显像与骨密度改变的关系。方法对恶性肿瘤患者77例及相对年龄段的同性别对照组48例分别进行腰椎2～4(L2～4)及股骨上端骨密度测定。均行99mTc-MDP放射性核素全身骨显像。结果77例患者L2～4、股骨颈、Wards区骨密度值均明显低于同年龄对照组。但在有、无骨转移组之间无明显差异(P>0.05);而降低的程度与有否接受化疗有关。骨显像显示L2～4异常放射性分布浓聚者中57.1%见相应部位骨密度增高。结论恶性肿瘤患者常有骨密度减低,化疗可能是重要的影响因素;骨密度测定和核素骨显像联合诊断是观察骨代谢改变的敏感性指标。     

中药骨康对去势大鼠血清骨钙素及离体骨密度的影响

目的探讨中药骨康对绝经后骨质疏松大鼠模型血清骨钙素的影响。方法采用雌性SD大鼠,运用随机对照分组的原则,分别分为正常对照组、模型组、中药骨康组及尼尔雌醇组,去双侧卵巢后造绝经后骨质疏松大鼠模型,造模3个月后,分别采用生理盐水、中药骨康及尼尔雌醇对其进行灌胃,灌胃3个月后采用摘眼球取血,离心分离血清,放免分析法测定其血清骨钙素含量,并行离体右胫骨双能X线扫描。结果中药骨康组大鼠血清骨钙素水平明显高于模型组及尼尔雌醇组,两者相比有显著性差异,P<0.05;骨康治疗组大鼠离体骨密度显著高于模型组,两者相比P<0.05。结论中药骨康能显著提高模型大鼠血清骨钙素水平,并能显著提高其离体骨骨密度,表明其具有促进去势模型大鼠骨形成的作用。     

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。     

Graves病患者治疗前后骨密度及骨代谢指标的临床观察

目的了解甲状腺机能亢进患者治疗前骨代谢生化指标、骨密度(BMD)的变化,观察甲状腺机能亢进患者治疗后甲状腺功能恢复正常时骨代谢情况。方法选择未治疗的Graves病(GD)患者27例(治疗组),采用双能X线吸收法(DEXA)测定其治疗前后BMD、血钙(Ca)、磷(P)、碱性磷酸酶(ALP)、血清骨钙素(BGP)、1型胶原交联羧基末端肽(1CTP)、1型前胶原羧基末端前肽(P1CP)、甲状旁腺激素(PTH)。并选择与患者年龄、性别和女性月经状态相匹配的健康志愿者30例作为对照组。结果GD患者治疗前ALP、BGP、1CTP、P1CP显著高于治疗后及对照组,BMD于治疗前显著低于治疗后及正常对照组,治疗组治疗前后不同部位BMD的测定值分别为,腰椎L2~L4(1.027±0.094)g/cm2vs(1.140±0.072)g/cm2,股骨颈(0.803±0.161)g/cm2vs(0.929±0.127)g/cm2,Ward三角(0.669±0.088)g/cm2vs(0.742±0.112)g/cm2,股骨粗隆(0.698±0.113)g/cm2vs(0.774)±0.097)g/cm2。血Ca、P、PTH治疗前后及与对照组之间差异无统计学意义。结论甲状腺机能亢进治疗前破骨细胞功能增强,BMD减低,同时伴有成骨细胞活性增加。甲状腺功能恢复正常后,骨矿含量增加。     

哺乳早期妇女骨量变化的研究

目的观察哺乳早期(3个月)产妇骨密度的变化。方法40例正常产妇按哺乳频率、是否补充钙剂、饮食习惯分组,检测产后3个月腰椎(L2～4)及股骨近端(股骨颈、转子、Ward's区)BMD的变化(以产后3d骨密度作基线)。结果产后3个月L2～4、股骨颈、转子骨密度的变化呈下降趋势,而Ward's区骨密度呈上升趋势,但均无显著性,分组后亦无显著性差异。结论哺乳早期哺乳频率、钙摄入量及产妇饮食习惯与骨密度变化无关。     

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.     

男性阻塞性睡眠呼吸暂停低通气综合征对2型糖尿病患者骨代谢及骨密度的影响

目的 探讨男性阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对2型糖尿病（T2DM）患者血糖、骨代谢及骨密度（BMD）的影响。方法 收集2016年5月至2019年4月就诊于甘肃省人民医院的T2DM男性患者,根据多导睡眠监测仪（PSG）中的睡眠呼吸暂停指数（AHI）分为单纯T2DM组（对照组）、T2DM合并轻度OSAHS组（轻度组）、T2DM合并中重度OSAHS组（重度组）,测定血清钙（Ca）、磷（P）、维生素D（VitD）、骨钙素（OSTE）和其β 胶原特殊序列（β CTX）的浓度, 同时测定平均血糖水平（MBG）、糖化血红蛋白（HbA1c）,应用美国双能X线骨密度仪测定受试者腰椎 (L1 4) 及左侧股骨(LF)骨密度（BMD）。分别比较3组血糖、骨代谢指标、骨密度指标,并分析AHI与上述指标的相关性。 结果 3组P、OSTE、β CTX、及L1 4 BMD差异无统计学意义（P＞0.05）;与对照组比较, 轻、重度组MBG、HbA1c增高,VitD、Ca及LF BMD降低（P＜0.05）;重度组VitD、Ca、MBG、HbA1c与轻度组比较,差异有统计学意义（P＜0.05）。相关性分析表明OSAHS合并T2DM患者AHI与BMI、MBG、β CTX呈正相关（r=0.607, 0.208, 0.169,P=0.000, 0.014, 0.046）;与VitD呈负相关(r=-0.276, P=0.001)。结论 OSAHS可能会进一步加剧T2DM患者糖代谢和骨代谢紊乱,且随着OSAHS的病情进展逐渐加重。     

非那雄胺对老年良性前列腺增生患者骨代谢及骨密度的影响分析

目的 探讨非那雄胺对老年良性前列腺增生患者骨代谢指标及骨密度的影响.方法 回顾性分析我科住院老年良性前列腺增生患者的临床资料,按是否服用非那雄胺分为非那雄胺组及未服用非那雄胺组(对照组).其中非那雄胺组168例,对照组176例.采集两组患者下述临床资料:身高,体质量,计算体质量指数(BMI),血清钙(Ca),血清磷(P),甲状旁腺激素(PTH),25羟维生素D3(25(OH) VD3),骨代谢指标包括:总骨1型前胶原氨基端延长肽(TP1 NP)、Ⅰ型胶原交联羧基末端肽(β-CTX)、骨钙素(OC).骨密度(g/cm2)包括:腰椎(L1～4),股骨颈,股骨大粗隆,股骨全部.结果 ①与对照组比较,非那雄胺组在骨代谢指标,骨密度方面差异无统计学意义(P＞0.05).②非那雄胺组中,按年龄分组,各亚组中骨代谢指标、骨密度差异无统计学意义(P＞0.05).③非那雄胺组中,按应用非那雄胺时间分组,各亚组中骨代谢指标、骨密度差异无统计学意义(P＞0.05).结论 非那雄胺对于老年良性前列腺增生患者骨代谢及骨密度影响与对照组比较差异无统计学意义,且高龄患者及长期服用非那雄胺对骨代谢及骨密度亦没有影响.