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1.
T. Andrew Y. T. Mak P. Reed A. J. MacGregor T. D. Spector 《Osteoporosis international》2002,13(9):745-754
In this confirmatory candidate gene study, we investigated possible linkage and association for bone density, heel ultrasound
and bone turnover with the osteocalcin gene using the nearby (50–180kb) microsatellite marker D1S3737. Non-identical twin
sisters aged 18–75 years at first interview were recruited for the study from the St Thomas’ UK Adult Twin Registry with 1366
women being genotyped for marker D1S3737. Linkage, allelic association and joint linkage and association tests were carried
out using quantitative transmission disequilibrium tests (QTDT), along with post-hoc multivariate tests of linkage and association.
Phenotypes tested were bone mineral density (BMD) at the spine, left forearm and left total hip; quantitative ultrasound measurements
of the heel including velocity of ultrasound (VOS) and broadband ultrasound attenuation (BUA); and bone turnover markers,
urine deoxypyridinoline (DPD), serum osteocalcin, bone specific and total alkaline phosphatase (ALP). BMD and ultrasound variables
showed evidence of pleiotropic linkage (p= 0.05) and association (p= 0.02) with the marker in postmenopausal women. Bone markers showed little or no evidence of linkage and association for
any age group. Evidence for pleiotropic linkage appeared to be strongest for BUA and spine BMD in postmenopausal women. The
univariate test statistic for BUA was χ2
1=12.8 (p= 0.0003), equivalent to a LOD score of 2.8. DPD showed borderline evidence of linkage to the marker for women of all ages.
Multivariate model-fitting showed allele 10 to be negatively associated with BMD, VOS and BUA via a common pathway, suggesting
the putative functional polymorphism affects both bone content and structure through shared underlying metabolic pathways.
It is likely that the alleles are in linkage disequilibrium with functional polymorphism(s) in or nearby the osteocalcin gene,
which may contribute to the onset of osteoporosis.
Received: 24 January 2002 / Accepted: 25 April 2002 相似文献
2.
C. Maayan E. Bar-On A. J. Foldes B. Gesundheit R. Dresner Pollak 《Osteoporosis international》2002,13(5):429-433
Familial dysautonomia (FD) patients suffer from multiple fractures and have reduced bone pain, which defers the diagnosis.
The pathogenesis of bone fragility in FD is unknown. This study aimed to characterize bone mineral metabolism and density
in FD. Seventy-nine FD patients aged 8 months to 48 years (mean age 13.9 ± 10.4 years, median 12.3) were studied. Clinical
data included weight, height, bone age, weekly physical activity and history of fractures. Bone mineral density (BMD) of the
lumbar spine (n= 43), femoral neck (n= 26), total hip (n= 22) and whole body (n= 15) were determined by dual-energy X-ray absorptiometry. Serum 25-hydroxyvitamin D3, osteocalcin, bone alkaline phosphatase (B-ALP), parathyroid hormone and urinary N-telopeptide cross-linked type 1 collagen
(NTx) were determined in 68 patients and age- and sex-matched controls. Forty-two of 79 patients (53%) sustained 75 fractures.
Twenty-four of 43 patients had a spine Z-score <–2.0, and 13 of 26 had a femoral neck Z-score <–2.0. Mean femoral neck BMD Z-score was lower in patients with fractures compared with those without (–2.5 ± 0.9 vs –1.5 ± 1.0, p= 0.01). Mean body mass index (BMI) was 16 kg/m2 in prepubertal patients and 18.4 kg/m2 in postpubertal patients. Bone age was significantly lower than chronological age (75.5 vs 99.3 months in prepubertal patients,
p<0.001; 151 vs 174 in post-pubertal patients, p<0.05). NTx and osteocalcin levels were higher in FD patients compared with controls (400 ± 338 vs 303 ± 308, BCE/mM creatinine
p<0.02; 90 ± 59.5 vs 61.8 ± 36.9 ng/ml, p<0.001, respectively). B-ALP was lower in FD patients compared with controls (44.66 ± 21.8 vs 55.36 ± 36.6 ng/ml, p<0.04). Mean spine Z-score was significantly lower in physically inactive compared with active patients (–3.00 ± 1.70 vs –1.77 ± 1.3, respectively,
p= 0.05). We conclude that fractures in FD patients are associated with reduced BMD. FD patients have increased NTx and osteocalcin.
Contributing factors include reduced BMI, failure to thrive and reduced physical activity. Preventive therapy and early diagnosis
are essential.
Received: 21 May 2001 / Accepted: 27 November 2001 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.
S. Bertelloni G. I. Baroncelli M. C. Sorrentino S. Costa R. Battini G. Saggese 《Calcified tissue international》1997,61(1):1-5
The effect of peripheral androgen hypersensitivity on bone mineral density (BMD) was investigated in a group of adolescent
women with idiopathic hirsutism (n= 17; mean age 17.0 ± 1.7 years). The effect of long-term androgen-receptor blockade with flutamide (500 mg daily in two divided
doses for 12 months) on BMD was assessed too. BMD was measured at lumbar spine (L2–L4) by a dual energy X-ray densitometer.
Before flutamide treatment, patient BMD (1.14 ± 0.07 g/cm2) was not significantly different from that of the control group (1.16 ± 0.12 g/cm2, n= 22), and was normal for age and sex (BMD 0.14 ± 0.69 SDS, P= NS vs. 0). After 12 months of treatment, absolute BMD in patients increased (1.18 ± 0.08 g/cm2, P < 0.002), but SDS BMD did not change (0.21 ± 0.72, P= NS vs. baseline). Flutamide treatment determined a clinical, marked improvement of androgen hypersensitivity (Ferriman–Gallwey
score: before 22.0 ± 6.2; 6 months: 13.2 ± 6.4, P < 0.003; 12 months; 7.6 ± 4.1, P < 0.001; acne score: before 3.8 ± 0.8; 3 months 0.8 ± 0.5, P < 0.001; later disappeared). The serum levels of 3α-androstenediol-glucoronide decreased (before: 8.6 ± 1.1 μg/liter; 12
months: 7.2 ± 1.0 μg/liter, P < 0.02), whereas the other endocrinological parameters did not change. No relationship was found between BMD and clinical
or biochemical parameters of hyperandrogenism. We concluded that in adolescent women, peripheral hyperandrogenism is not associated
with abnormal BMD; long-term treatment with flutamide, which blocks the androgen receptor, does not alter their BMD.
Received: 19 February 96 / Accepted: 31 December 96 相似文献
5.
L. Carbone F. A. Tylavsky A. J. Bush W. Koo E. Orwoll S. Cheng 《Osteoporosis international》2000,11(5):388-392
Ehlers-Danlos Syndrome (EDS) is the most common inherited disorder of connective tissue recognized. The objectives of the
present study were to determine bone mineral density (BMD) and biochemical markers of bone metabolism in EDS. Twenty-three
subjects with Type III EDS and 23 matched controls underwent BMD measurement by dual-Energy X-ray absorptiometry (DXA) of
the lumbar spine and femoral neck. Health history questionnaires and biochemical markers of bone and connective tissue metabolism
were also assessed. No significant differences in BMD at the lumbar spine or differences in biochemical markers of bone and
connective tissue metabolism were found between EDS subjects and controls. EDS subjects had a significantly decreased BMD
at the femoral neck compared with controls, but this difference disappeared after adjustment for body height, weight and physical
activity levels.
Received: 3 March 1999 / Accepted: 6 August 1999 相似文献
6.
We performed a prospective study to evaluate the normal changes in bone mineral density (BMD) in the forearm, hip, spine
and total body, and to study the agreement between changes in BMD estimated from cross-sectional data and the actual longitudinal
changes. Six hundred and twenty subjects (398 women, 222 men; age 20–89 years) without diseases or medication known to affect
bone metabolism undertook baseline evaluations, and 525 (336 women, 189 men) completed the study. BMD was measured twice 2
years apart by dual-energy X-ray absorptiometry. From cross-sectional evaluations the only premenopausal bone loss (<0.003
g/cm2/year) was found in the hip. In women after menopause and in men an age-related bone loss (0.002–0.006 g/cm2/year) was found at all sites. The data from the longitudinal evaluation showed a small bone loss in women before menopause
at the hip and lumbar spine (<0.4%/year (<0.004 g/cm2/year)); this bone loss nearly tripled in the early postmenopausal years (<10 years since menopause), and thereafter decreased
to the premenopausal rate for the hip, and to zero for the lumbar spine. The most pronounced bone loss after menopause occurred
in the forearm (1.2 %/year (0.006 g/cm2/year)), and it remained constant throughout life. In men there was a small longitudinal bone loss in the hip throughout life,
and a small bone loss in the distal forearm after the age of 50 years. In all groups, except for the early postmenopausal
women, we found a small increase in total body BMD with age. When comparing the changes in BMD estimated from cross-sectional
data with the longitudinal changes, only the hip and forearm generally displayed agreement, whereas the changes in the total
body and spine generally were incongruous. In conclusion, the hip and forearm appear to be the sites with the best agreement
between the cross-sectional estimated and the longitudinal age-related changes in BMD.
Received: 22 August 2000 / Accepted: 22 June 2001 相似文献
7.
N. E. Lane S. Sanchez H. K. Genant D. K. Jenkins C. D. Arnaud 《Osteoporosis international》2000,11(5):434-442
The purpose of this study was to test the ability of early changes in markers of bone turnover to predict subsequent changes
in bone mineral density (BMD) induced by parathyroid hormone fragment, PTH (1–34), in postmenopausal osteoporotic women treated
with estrogen and glucocorticoids. Forty-nine postmenopausal women with chronic, inflammatory diseases and BMD T-scores ≤–2.5 at the lumbar spine or femoral neck who were concurrently treated with estrogen ≥ 1 year and prednisone 5–20
mg/day for ≥ 1 year participated. Subjects were randomized to treatment with human PTH (1–34) 400 IU/day or to a control group
for 1 year and followed for an additional year. Serum and urine were collected at baseline and 1, 3, 6, 9, 12, 18 and 24 months
for measurement of bone alkaline phosphatase (BAP), osteocalcin (OC) and deoxypyridinoline (DPD). We constructed an Uncoupling
Index (UI) from all three markers (UI = [Z
BAP+Z
OC]/2 –Z
DPD, where the Z-score for each marker in each subject was calculated from the mean and standard deviation of the study population at baseline).
BMD of the lumbar spine and hip was measured at baseline and every 6 months thereafter by dual-energy X-ray absorptiometry
(DXA) and annually by quantitative computed tomography (QCT; spine only). BMD of the spine, but not hip (total, femoral neck
or trochanter), and levels of all three markers increased significantly as a result of PTH treatment (p<0.01 compared with controls). The resorption response lagged behind that of formation as evidenced by a significant increase
(p<0.05) in the UI for the first 9 months of treatment. The UI values and changes from baseline to 1, 3 and 6 months in BAP,
OC and DPD were correlated with the 12- and 24-month changes in spine BMD measured both with QCT and with DXA (Spearman’s
rank coefficients ≤0.76; p<0.05). Most PTH-treated subjects could be identified as biochemical responders by least significant change analysis. Following
1 month of therapy, BAP and OC identified 65% and 81% as responders, respectively. The responder rates were 79%, 79% and 75%
for BAP, OC and DPD, respectively by 6 months. Responders exhibited a high level of diagnostic accuracy for predicting a gain
in BMD (areas under the receiver operating characteristic curves exceeding 0.79 for QCT and 0.70 for DXA), but not the magnitude
of the gain. These data suggest that serial bone marker measurements may be useful in identifying skeletal responders to an
anabolic therapy, such as PTH, in estrogen-replete postmenopausal women with glucocorticoid-induced osteoporosis.
Received: 27 July 1999 / Accepted: 2 November 1999 相似文献
8.
Serum albumin has been found to be positively correlated with bone mass in small studies of ambulatory men or women with
diagnosed osteoporosis. In this study the relation between serum albumin and bone mineral density (BMD) was examined in 1593
white, community-dwelling men and women aged 50–95 years. BMD was determined using single-photon absorptiometry (SPA) at the
ultradistal radius and the midshaft radius, and using dual-energy X-ray absorptiometry (DXA) at the hip and spine. Albumin
was measured from a fasting blood sample using the Technicon SMA 12 autoanalyzer. Mean albumin levels in both men and women
decreased significantly with increasing age. All but four values were within the normal range (3.5–5.0 g/dl). BMD decreased
with increasing age at all sites. In both sexes there was weak positive correlation between serum albumin and BMD in the unadjusted
model (Pearson's rvalues <0.3, p values <0.005). After age adjustment, however, the relationship was no longer significant (Pearson's r values <0.05, p values >0.18). Men and women were divided into three sex-specific categories – osteoporotic, osteopenic and normal – based
on World Health Organization criteria in relation to young adult means (normal, BMD > –1 SD; osteopenia, BMD between –1 SD
and –2.5 SD; osteoporosis, BMD <–2.5 SD). Mean albumin values did not differ significantly across the three BMD categories
in men or women. BMD levels stratified for albumin levels and calcium supplement status (a marker for osteoporosis awareness)
also did not differ. Albumin levels were also not associated with a history of low-trauma fractures. In summary, there was
no age-independent association between serum albumin within the normal range and low BMD or fractures in community-dwelling
healthy older adults. We conclude that previously reported associations most likely reflect inadequate adjustment for the
age-related decrease in albumin levels and the selection of very frail osteoporotic subjects.
Received: 7 October 1997 / Revised: 21 January 1998 相似文献
9.
The Association between Parathyroid Hormone, Vitamin D and Bone Mineral Density in 70-Year-Old Icelandic Women 总被引:4,自引:0,他引:4
G. Sigurdsson L. Franzson L. Steingrimsdottir H. Sigvaldason 《Osteoporosis international》2000,11(12):1031-1035
Parathyroid hormone (PTH) may be an important determinant of cortical bone remodeling in the elderly. Vitamin D status is
one of the determining factors in this relationship. The aim of this study was to quantify the relationship between serum
PTH, vitamin D and bone mineral density (BMD) in elderly women in Reykjavik (64° N), where daily intake of cod liver oil is
common and mean calcium intake is high. ln PTH correlated inversely with 25(OH)D (r=−0.26, p<0.01). In multivariate analysis PTH correlated inversely with whole body BMD (mostly cortical bone) (R
2= 2.2%, p = 0.04) but not with the lumbar spine BMD, reflecting more cancellous bone. No association was found between 25(OH)D levels
and BMD at any site in univariate or multivariate analysis. Osteocalcin, a measure of bone turnover, was negatively associated
with BMD and this association remained significant when corrected for PTH levels. In summary, in this fairly vitamin D replete
population with high calcium intake, PTH was negatively associated with total body BMD. We infer that suppression of PTH may
reduce cortical bone loss, but other factors are likely to contribute to age-related bone remodeling and osteoporosis.
Received: 3 January 2000 / Accepted: 10 April 2000 相似文献
10.
Bone Mineral Density of 704 Amateur Sportsmen Involved in Different Physical Activities 总被引:12,自引:0,他引:12
The aim of the study was to analyze the relation between sports and bone mass. Seven hundred and four men with no history
of chronic disease were questioned on their adolescent and adult sporting activities. Their total body (TB) and regional (head,
spine, arms and legs) bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry. BMD measurements and ratios
of regional BMD to TB BMD were compared using a multiple regression analysis. Probands (mean age 30 years) were engaged in
14 sports activities: rugby, soccer, other team sports, endurance running, fighting sports, bodybuilding, multiple weightbearing
activities, swimming, swimming with flippers, biking, rowing, climbing, triathlon and multiple mixed activities. They stated
that they were practising a physical activity at the amateur level: 7.1 h/week between the ages of 11 and 18 years and 9 h/week
between age 18 years and the day of the interview (no significant difference between physical activities). Rowers and swimmers
had low TB BMD (1.22 and 1.17 g/cm2) and low leg BMD (1.37 and 1.31 g/cm2). Participants in rugby, soccer, other team sports and fighting sports had a high TB BMD (1.27–1.35 g/cm2) and high leg BMD (1.41–1.5 g/cm2). For head BMD, there was no stastistical difference among the different groups. Constructed ratios pointed out the site-specific
adaptation of the skeleton: soccer player and runners had a higher leg ratio; bodybuilders, fighters, climbers and swimmers
had a higher arm ratio; rugby players had a higher spine ratio. Head ratio was higher in non-weightbearing sports (rowing,
swimming) than in weightbearing sports (rugby, team sports, soccer, fighting sports and bodybuilding). Thus the BMD and ratio
differences among the 14 disciplines seem to be site-specific and related to the supposedly high and unusual strains created
at certain sites during sport training by muscle stress and gravitational forces. Head ratio is closely related to the type
of practice; its value could predict whether sport participants have developed the maximal peak bone mass they could achieve.
Received: November 1999 / Accepted: 12 September 2000 相似文献
11.
Although osteoporosis in men is increasingly recognized as an important health issue and bone mass appears to be a major
determinant of fracture, there remain few data concerning the determinants of bone mass in men. To determine the correlates
of bone density in men, we studied a large group of older subjects recruited from three rural communities in the northwestern
United States. Three hundred and fifty-five men over the age of 60 years (mean 71.5 ± 7.4 years) without known disorders of
mineral metabolism were recruited by community advertising. Bone mineral density was measured at the lumbar spine, proximal
femur and radius by dual-energy X-ray absorptiometry, and factors potentially related to skeletal status were assessed by
direct measurements or questionnaire. In univariate analyses weight (positively) and age (negatively) were associated with
bone density. After adjustment for these two factors, alcohol intake, osteoarthritis and thiazide use were associated with
higher bone density, while previous fractures, gastrectomy, peptic ulcer disease, rheumatoid arthritis, glucocorticoid use,
hypertension, previous hyperthyroidism, height loss since age 20 years, chronic lung disease and smoking were related to lower
density. In multivariate models, only weight and a history of cancer were related to higher bone mass, and age, previous fracture,
rheumatoid arthritis, gastrectomy and hypertension were associated with lower density. These data contribute to the emerging
field of osteoporosis in men, and may help in the clinical identification of men at higher risk of osteopenia.
Received: 27 September 1999 / Accepted: 20 March 2000 相似文献
12.
R. Patel D. Collins S. Bullock R. Swaminathan G. M. Blake I. Fogelman 《Osteoporosis international》2001,12(4):319-325
Vitamin D status is known to be an important determinant of bone mineral density (BMD). There is a significant seasonal variation
in serum vitamin D, and some studies have reported an associated seasonal variation in BMD. The present study was devised
to investigate whether a seasonal variation in BMD could be detected in healthy normal subjects, along with associated variations
in serum parathyroid hormone (PTH), intestinal calcium absorption and biochemical markers of bone turnover. A second aim was
to investigate whether, if such variations were identified, they could be suppressed by vitamin D supplementation. The subjects
were 70 healthy female volunteers (mean age 47.2 years, range 24–70 years) recruited into a double-masked crossover study
and followed over 2 years. During the first year 35 subjects received a daily oral supplement containing 800 IU (20 mg) cholecalciferol
(group 1) and 35 subjects received a placebo preparation (group 2). During the second year the treatment each group received
was reversed. Lumbar spine (L1–L4), left proximal femur and total body BMD were measured by DXA at 3-month intervals. Serum
25-hydroxyvitamin D (25-OHD), serum PTH, bone markers (bone-specific ALP (BSAP) and urinary crosslinks (DYPD/creatinine))
and calcium absorption were also measured at each visit. Cholecalciferol treatment increased serum 25-OHD by 25.4 nmol/l (p <0.001), while a reciprocal decrease in serum PTH of 6.6 ng/l (p = 0.011) was seen in subjects in the lowest quartile of baseline serum 25-OHD. The treatment had no significant effect on
spine, femur or total body BMD, calcium absorption or bone markers. When Fourier analysis was used to analyze the data for
seasonal effect (defined as twice the amplitude of the 1-year period variation) a highly significant effect for 25-OHD of
18 nmol/l (p <0.001) was found. However, no effect was found for BMD, PTH, calcium absorption or bone markers. The analysis set a 95%
confidence limit to the seasonal effect of less than 0.6% for spine, total hip and total body BMD. It was concluded that in
the population of healthy women studied there was no evidence of seasonal variation in spine, femur or total body BMD, serum
PTH, calcium absorption or bone markers. Vitamin D supplementation was found to have no effect on BMD.
Received: 7 July 2000 / Accepted: 14 November 2000 相似文献
13.
Calcaneus Bone Mineral Density is Lower Among Men and Women with Lower Physical Performance 总被引:5,自引:0,他引:5
Aoyagi K Ross PD Hayashi T Okano K Moji K Sasayama H Yahata Y Takemoto T 《Calcified tissue international》2000,67(2):106-110
Fracture risk is influenced by both bone strength and by falls. Measures of physical function and performance are predictors
of falls. However, the interrelationships among bone mineral density (BMD), regular physical activity, and measures of physical
performance are not well known. We studied 447 community-dwelling Japanese people aged 40 years and over (96 men and 351 women)
to examine the association of calcaneus BMD with measures of physical performance (grip strength, walking speed, chair stand,
and functional reach) and regular physical activity. Calcaneus BMD decreased with age by approximately 25% in men and 42%
in women. Measures of physical performance decreased with age by approximately 30% in both genders, however, performance on
the chair stand test declined by approximately 60%. There were only minimal differences in performance measures and calcaneus
BMD between people with and those without regular physical activity in both genders, and most differences were not significant.
However, there were significant BMD increases of 3–6% per standard deviation (SD) increase in all performance measures for
women and a 7% increase in BMD per SD increase in grip strength for men, after adjusting for age. These associations remained
after additional adjustment for body mass index and regular physical activity. These findings suggest that bone density and
physical function decline markedly in both men and women with age, and that low BMD and poor function tend to occur together,
which would increase fracture risk more than either risk factor alone.
Received: 9 August 1999 / Accepted: 4 February 2000 相似文献
14.
Association Study of Parathyroid Hormone Gene Polymorphism and Bone Mineral Density in Japanese Postmenopausal Women 总被引:15,自引:1,他引:15
Hosoi T Miyao M Inoue S Hoshino S Shiraki M Orimo H Ouchi Y 《Calcified tissue international》1999,64(3):205-208
Association of BST B1 restriction fragment length polymorphism (RFLP) of the parathyroid hormone (PTH) gene with bone mineral density (BMD)
was examined in 383 healthy postmenopausal women in Japan who were unrelated. The RFLP was represented as B or b, the capital
letter signifying the presence of and the small letter the absence of restriction site for BST B1. The frequency of each genotype—BB, Bb, and bb—was 82.5%, 16.7%, and 0.8%, respectively. When we statistically compared
age, years after menopause, body height, and body weight between the BB genotype and the Bb genotype groups, there was no
significant difference between the groups. However, the lumbar BMD and the score of BMD adjusted for age and body weight (Z
score) were significantly lower in the group of genotype Bb than in the BB: 0.859 ± 0.019 g/cm2 versus 0.925 ± 0.011 (mean ± SE, P= 0.01) and −0.412 ± 0.138 versus 0.067 ± 0.082 (mean ± SE, P= 0.01). In addition, the Z score of total body BMD in the Bb genotype group was lower than that in the BB group. Comparison
of serum and urinary biochemical bone metabolic markers suggested that the subjects with Bb genotype might be in a relatively
higher state of bone turnover than those with BB genotype. These results suggest that the polymorphism in the PTH gene would
be a useful genetic marker for lower BMD and the susceptibility for osteoporosis.
Received: 19 March 1998 / Accepted: 24 June 1998 相似文献
15.
C. A. C. Coupland M. J. Grainge S. J. Cliffe D. J. Hosking C. E. D. Chilvers 《Osteoporosis international》2000,11(4):310-315
Few studies have assessed the relationship between occupational activity and bone mineral density (BMD), although two case–control
studies have reported a protective effect of occupational activity on hip fracture. In the present study 580 postmenopausal
women aged 45–61 years completed a risk factor questionnaire including a detailed occupational history. For each job, hours
spent sitting, standing, walking, lifting and carrying were recorded; these measures, evaluated at ages 20, 30, 40 years,
in the current job and over the working lifetime, were used in the analysis. BMD was measured with dual-energy X-ray absorptiometry,
and measurements at five sites were used in a multiple regression analysis adjusting for potential confounding variables.
There was a significant negative association between sitting at age 20 years and BMD at the radius (p= 0.037), with negative relationships of borderline significance at the anteroposterior spine (p = 0.091) and whole body (p= 0.078). There were significant positive associations between standing at age 30 years and BMD at all five sites (p<0.05), but no significant linear associations for standing at ages 20 and 40 years. No significant associations were found
for lifetime or current occupational measures of sitting, standing, walking and lifting or carrying. The lack of consistency
of these significant findings suggests that they may have occurred by chance, and that occupational activity has little if
any effect on BMD in postmenopausal women.
Received: 12 March 1999 / Accepted: 17 September 1999 相似文献
16.
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
17.
Ethnic and Gender Differences in Bone Mineral Density and Bone Turnover in Young Adults: Effect of Bone Size 总被引:3,自引:3,他引:3
Generally, the incidence of osteoporotic fracture is lower in black populations and in men. These effects of ethnicity and
gender may result from differences in peak bone mineral density (PBMD) and bone turnover (BT), which in turn are affected
by bone size. Therefore, the aims of this study were to examine the effects of ethnicity and gender on bone mineral density
(BMD) and BT in young African-Caribbean and Caucasian adults, and to adjust for the effect of bone size on BMD and BT. BMD
was measured at the lumbar spine, L2–L4 (LS), total body (TB) and femoral neck (FN) by dual-energy X-ray absorptiometry in
44 blacks (16 men, 28 women) and 59 whites (28 men, 31 women) ages 20–37 years. We measured serum bone-specific alkaline phosphatase
(BAP) and serum osteocalcin (OC) as markers of bone formation and urinary immunoreactive free deoxypyridinoline (ifDpd) and
crosslinked N-telopeptide of type I collagen (NTx) as markers of bone resorption. To adjust the data for any differences in
bone size, we calculated: (a) bone mineral apparent density (BMAD), an estimated volumetric bone density which attempts to
normalize BMD measurements for bone size; and (b) bone resorption markers as a ratio to total body bone mineral content (TB
BMC). Two-way analysis of variance was used to compare the effects of race and gender, and to test for any interaction between
these two factors. Blacks had higher BMD compared with whites at the TB (p<0.001), LS (p= 0.0001) and FN (p= 0.0005). This increase remained significant at the LS only after calculating BMAD. Men had higher BMD at all sites (except
at the LS). This increase was no longer significant at the FN after calculating BMAD, and LS BMAD was actually greater in
women (p<0.0001). Blacks and whites had similar concentrations of turnover markers, but men had higher bone turnover markers than
women (BAP, p<0.0001; OC, p= 0.002; ifDpd, p= 0.03; NTx, p<0.0001). This increase in bone resorption markers was no longer significant after adjusting for TB BMC (except for NTx in
whites). We conclude that the skeletal advantage in blacks during young adulthood is not explained by bone size. However,
it seems probable that bone size effects partially explain gender differences in BMD and bone turnover.
Received: 2 February 1999 / Accepted: 2 December 1999 相似文献
18.
Z. Efstathiadou V. Kranas J. P. A. Ioannidis I. Georgiou A. Tsatsoulis 《Osteoporosis international》2001,12(4):326-331
Several genetic polymorphisms are implicated as determinants of bone mineral density (BMD) in postmenopausal women. These
include the Sp1 polymorphism of the collagen type Iα 1 (COLIA1) gene, the FokI and BsmI polymorphisms of the vitamin D receptor (VDR) gene, and the PvuII and XbaI polymorphisms of the estrogen receptor (ER) gene. The relative importance and the independence of these genetic effects
have not been studied simultaneously in the same population. We evaluated the effects of these polymorphisms on lumbar spine
BMD among 154 postmenopausal Greek women. BMD tended to differ across Sp1 genotypes (mean 0.842 g/cm2 in SS, 0.851 g/cm2 in Ss, 0.763 in ss, age-adjusted p = 0.056), mostly because ss homozygotes had lower BMD (p = 0.018 compared with SS and Ss). No other polymorphisms were associated with BMD in this population (p= 0.53 for FokI, p= 0.94 for BsmI, p = 0.80 for PvuII, p = 0.91 for XbaI). In multivariate modeling, the effect of ss homozygosity was clinically and statistically significant (–0.105 g/cm2, p= 0.013) after adjusting for age, weight, height, hormone replacement use, and the other four polymorphisms. None of the other
four polymorphisms was retained as an independent predictor of BMD in a backward elimination model and no significant synergistic
effects were observed when gene interactions were tested. When all five polymorphisms are considered simultaneously, the Sp1
COLIA1 polymorphism seems to have the most unequivocal effect on BMD, at least in postmenopausal women.
Received: 3 July 2000 / Accepted: 14 November 2000 相似文献
19.
R. G. Crilly R. J. Sebaldt A. B. Hodsman J. D. Adachi J. P. Brown C. H. Goldsmith D. A. Hanley W. O. Olszynski L.-G. Ste-Marie G. F. Stephenson 《Osteoporosis international》2000,11(7):607-614
We investigated whether an increase in lumbar spine bone mineral density (LS BMD) at 6 months or at 12 months could predict
the response to intermittent cyclical therapy (ICT) with etidronate, defined in one of two ways: (i) an increase in LS BMD
at 24 months (improvement) or (ii) an increase in LS BMD ≥0.028 g/cm2 (significant improvement). The latter is a precision term calculated from test–retest values for LS BMD in osteoporotic patients.
Two hundred and forty-seven patients (32 men; 5 premenopausal and 210 postmenopausal women) were followed for 24 months by
dual-energy X-ray absorptiometry (DXA) and were not taking estrogen, calcitonin or fluoride during treatment with ICT-etidronate.
One hundred and fifty patients had a LS BMD measurement after 6 months of treatment with ICT-etidronate and 205 patients had
one at 12 months. Baseline characteristics (mean;SD) were as follows: age, 66;11 years; years since menopause, 21;10; number
of vertebral fractures at baseline, 0.87;1.26; LS BMD T-score, −2.8;1.2. After 24 months of treatment with ICT-etidronate, 81% of the patients had an improvement, and 55% had a
significant improvement at the LS. Only 6% significantly lost bone (loss of 0.028 g/cm2 or more). The mean percent change from baseline in LS BMD was 5.1% (95% confidence interval 4.2% to 6.0%). The results for
men and postmenopausal women were similar to those for the entire group. Accuracy and sensitivity were marginally, but not
significantly, higher when response was predicted using 12 month versus 6 month LS BMD measurements. The positive predictive
values of improvement at 6 or 12 months were 89% and 90% respectively for improvement at 24 months, and 66% and 68% for significant
improvement at 24 months. Identification of nonresponders was less successful and similar at 6 months and 12 months. Forty
percent and 39% of the patients, who had no improvement at 6 or 12 months respectively, also had no improvement at 24 months,
i.e., were true negatives, while 77% and 71% had no significant improvement at 24 months. The results may reflect slow response
in a small subgroup of patients rather than nonresponse; however, no response at 1 year might identify patients whose rate
of response is sufficiently slow that alternative therapy is justified. These data demonstrate a good response rate to ICT-etidronate
and may help reduce the need for follow-up BMD measurements in those who show an early improvement.
Received: 12 November 1999 / Accepted: 3 January 2000 相似文献
20.
The Vitamin D Receptor Start Codon Polymorphism (Fok1) and Bone Mineral Density in Premenopausal Women in Taiwan 总被引:1,自引:0,他引:1
The vitamin D receptor gene (VDRG) polymorphism as a factor of bone turnover rate or bone mineral density (BMD) is a controversial
issue, especially in different ethnic populations. In addition to intron 8 (Bsm1, Taq1) and exon 9 (Apa1), VDRG polymorphism is present at its translation initiation site on exon 2. The VDRG has two translation initiation sites.
The first shows a thymine/cytosine polymorphism and can be detected by restriction fragment length polymorphism (RFLP) using
the endonuclease Fok1. This start codon polymorphism (SCP) of the VDRG was detected by polymerase chain reaction and then by RFLP with Fok1. While the f allele was assigned for the presence of the restriction site, the F allele was assigned for the absence of
the restriction site, and the encoded vitamin D receptor is shorter by three amino acids. We examined the association between
this SCP of the VDRG and bone turnover as well as BMD in 101 premenopausal Taiwanese women aged 40–53 years. Total body bone
mineral content and BMD of proximal femur and lumbar spine were measured by dual-energy X-ray absorptiometry. We found a prevalence
of 39.6% for the f allele of the VDRG. The frequencies of FF, Ff and ff genotypes were 35.6%, 49.5% and 14.9%, respectively.
There was no statistically significant difference in BMD at any site or bone turnover markers among the three Fok1 genotypes (FF, Ff and ff). The SCP is independent of Bsm1, Apa1 or Taq1 polymorphisms of the VDRG at intron 8 and exon 9. In conclusion, the SCP polymorphism detected by endonuclease Fok1 does not significantly influence BMD or bone turnover in premenopausal women in Taiwan.
Received: 7 July 1998 / Accepted: 10 November 1998 相似文献