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1.
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
2.
The aim of this study was to determine possible associations between bone mineral density (BMD), 25-hydroxyvitamin D (25(OH)D)
and intact parathyroid hormone (PTH). In a retrospective study we examined the case notes of free-living postmenopausal women
living in our city (34° S). We also report a low prevalence of vitamin D deficiency (25(OH)D <25 nmol/l, 5.6%) and of secondary
hyperparathyroidism (intact PTH >65 pg/ml, 7.5%). Age was correlated with BMD at the lumbar spine (r=−0.25, p = 0.00038) and femoral neck (r=−0.252, p = 0.0003). Body mass index (BMI) was correlated with BMD at the femoral neck (r= 0.177, p = 0.021) but not at the lumbar spine. 25(OH)D was positively correlated with BMD at the femoral neck (r = 0.149, p=0.036) but not at the lumbar spine. PTH was positively correlated with age (r= 0.279, p = 0.012) and negatively correlated with 25(OH)D (r=−0.322, p = 0.0036). PTH was also negatively correlated with BMD at the lumbar spine (r=−0.258, p=0.02) and the femoral neck (r=−0.282, p = 0.011). Forward stepwise multiple regression showed that BMI, age and 25(OH)D made significant contributions to BMD at
the femoral neck. PTH also showed a significant contribution to BMD at both sites. In conclusion, weak correlations found
between PTH and 25(OH)D and BMD suggest these biochemical variables, among other factors, contribute to lumbar spine and femoral
neck BMD.
Received: 19 February 2000 / Accepted: 20 June 2000 相似文献
3.
Altered Calcium Homeostasis in Adults with Cystic Fibrosis 总被引:1,自引:0,他引:1
Bone mineral density (BMD) in cystic fibrosis (CF) patients falls progressively below normal with advancing age, in part
due to steroid administration, low levels of sex hormones, chronic inflammatory disease, physical inactivity, and chronic
malabsorption of calcium and/or vitamin D. The purpose of this study was to compare the fractional absorption of 45Ca and urinary excretion of calcium in CF subjects and normal controls following a high-calcium breakfast containing 45Ca. Seven young men and 5 young women with CF with pancreatic insufficiency were studied on two separate occasions, with and
without administration of pancreatic enzymes. Eleven healthy young adults with normal BMD measurements served as controls.
Mean T-scores at the lumbar spine and femur were significantly lower in the CF subjects (p<0.002). Following baseline, fasting collections, timed serum and urine samples were obtained for 5 h after the meal. Fractional
absorption (FA) of 45Ca was estimated by the method of Marshall and Nordin. At baseline, CF subjects had lower mean serum 25-hydroxyvitamin D,
calcium and albumin values (p<0.03 for each), slightly, but not significantly (p= 0.12), lower albumin-corrected calcium values, equivalent serum 1,25-dihydroxyvitamin D values and a trend toward a higher
mean serum parathyroid hormone (PTH) value (p= 0.10). Without pancreatic enzymes, CF subjects showed significantly impaired calcium absorption (5 h FA: 11.8 ± 0.5 for
controls vs 8.9 ± 0.2 for CF subjects, p= 0.02) and excretion (4 h excretion: 0.20 ± 0.08 mg Ca/mg creatinine for controls vs 0.16 ± 0.09 mg Ca/mg for CF subjects,
p= 0.025). Addition of pancreatic enzymes did not fully compensate for this deficiency. In addition, CF patients had higher
serum PTH values after a high-calcium meal (p= 0.03), suggesting mild secondary hyperparathyroidism. Altered calcium homeostasis is likely to be a factor in the development
of bone disease in CF patients.
Received: 9 July 1998 / Accepted: 27 December 1998 相似文献
4.
J.-Y. Reginster R. Deroisy H. Pirenne I. Frederick W. Dewe A. Albert J. Collette S. X. Zheng C. Gosset 《Osteoporosis international》1999,9(2):121-128
The present study was designed to visit elderly women living in nursing homes and to compare their femoral neck bone mineral
density (BMD) and circulating levels of parathyroid hormone (PTH) and 25-OH vitamin D (25-OHD) with those of subjects living
at home, in the immediate vicinity of the nursing homes. Of 1483 women, aged 70 years and older, who were selected, 993 agreed
to participate in this trial. Their femoral neck BMD (n= 993) was measured by dual-energy X-ray absorptiometry, with a specific device installed in a mobile truck. The circulating
levels of 25-OHD and PTH were assessed after an overnight fast (n= 748). After stratification for age, there were no significant differences in mean femoral neck BMD values, prevalence of
femoral neck osteoporosis, mean serum 25-OHD and prevalence of absolute or relative 25-OHD deficiency between the two groups.
Serum levels of PTH were significantly higher in women over 80 years old living in nursing homes, compared with the community-dwelling
women. After adjustment for age, a significant relation was found between femoral neck BMD and PTH levels in the whole population
(p= 0.004) and in community-dwelling subjects (p= 0.039). When stratifying our population by quartiles of serum PTH values, the odds ratios for femoral neck osteoporosis
were significantly increased for the top two quartiles compared with the lowest one both before (p= 0.00146) and after (p= 0.0013) adjustment for age and type of housing. From this study we conclude that femoral osteoporosis is largely underestimated
in European women. Living in a nursing home is not, per se, a risk factor for decreased femoral BMD, and circulating PTH levels
are a key determinant of low femoral bone density and osteoporosis.
Received: 4 March 1998 / Accepted: 20 May 1998 相似文献
5.
To establish the prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient
clinic in Northern Italy, we evaluated 25-hydroxyvitamin D (25(OH)D) levels in 570 postmenopausal women who had been consecutively
referred to our clinic in the 12 months beginning October 1995. Parathyroid hormone (PTH), serum calcium (Ca), creatinine
(Cr) and osteocalcin (OC), urinary calcium (Ca24h) and creatinine (Cr24h), and the bone mineral density of the lumbar spine
(LBMD) and femur (FBMD) were also measured. 1,25-Dihydroxyvitamin D (1,25(OH)2D) concentrations were measured in 23 women. All women had normal electrolyte serum concentrations and kidney function. Mean
± SD 25(OH)D concentration was 18.3 ± 8.3 ng/ml. A significant (p<0.001) seasonal variation was seen for both 25(OH)D and PTH. Women were divided into two groups based on their vitamin D
status: low vitamin D status (25(OH)D <12 ng/ml, n= 161, 28%) and normal vitamin D status (25(OH)D ≥12 ng/ml, n= 409, 72%). Hypovitaminosis D was found in 38.5% of all the women in the time period December–May and in 12.5% in the other
half-year; among women >70 years old 51% had hypovitaminosis D in the time period December–May and 17% in the other half-year.
PTH was significantly (p<0.05) increased, and Ca24h, OC and FBMD significantly (p<0.05) decreased in women with hypovitaminosis D. 1,25(OH)2D positively correlated with 25(OH)D (p<0.0001), but did not correlate with PTH, age or creatinine clearance. In conclusion, hypovitaminosis D is an important, underestimated
problem in Italian free-living postmenopausal women referred to an outpatient osteoporosis clinic.
Received: 9 February 1998 / Accepted: 8 July 1998 相似文献
6.
Sairanen S Kärkkäinen M Tähtelä R Laitinen K Mäkelä P Lamberg-Allardt C Välimäki MJ 《Calcified tissue international》2000,67(2):122-127
To evaluate the long-term effect of calcitriol treatment on bone mineral density (BMD) of the femoral neck and lumbar spine
and the parameters of calcium and bone metabolism in elderly women, 55 healthy, postmenopausal women, all aged 66 years, were
enrolled in the study. Eighteen started a 4-year supplementation with 0.5 μg of calcitriol daily and 37 served as controls.
Calcium intake of all the subjects was adjusted to 800 mg daily. In 4 years femoral neck BMD increased by 3.0% in the calcitriol
group, but decreased by 1.6% in the control group (P= 0.009). The respective changes in lumbar spine BMD were +2.3% and +0.9% (P= 0.067). Two years' treatment with calcitriol increased the intestinal absorption of strontium by 57% (P < 0.001), doubled the urinary excretion of calcium (P < 0.001), and decreased the mean parathyroid hormone (PTH) level by 32% (P < 0.01). In the calcitriol group the marker of bone formation, serum osteocalcin, decreased by 27% (P < 0.01), and the marker of bone resorption, serum C-telopeptide of type I collagen (CTx), by 33% (P= 0.05) after 2 years. In two subjects the calcitriol dose had to be reduced because of hypercalciuria. We conclude that calcitriol
treatment increases bone mass at the femoral neck and lumbar spine, the increases being maintained for up to 4 years. The
gain in bone mass results from reduced bone turnover which is partly a consequence of the enhanced intestinal absorption of
calcium and suppressed serum PTH levels.
Received: 8 January 1999 / Accepted: 29 February 2000 相似文献
7.
P. Aguado M. T. del Campo M. V. Garcés M. L. González-Casaús M. Bernad J. Gijón-Baños E. Martín Mola A. Torrijos M. E. Martínez 《Osteoporosis international》2000,11(9):739-744
To evaluate a possible relationship between vitamin D levels and bone mineral density (BMD) and the prevalence of hypovitaminosis
in a population of postmenopausal women from a rheumatologic outpatient clinic in Madrid, Spain, 171 postmenopausal women
(aged 47–66 years) divided into two groups (osteoporotic and nonosteoporotic, according to WHO criteria) were studied between
November and June. Liver and kidney function were normal in all subjects. Serum parathyroid hormone (PTH) and calcidiol levels
were determined and bone densitometry carried out at the lumbar spine and hip level. PTH and calcidiol serum levels did not
show any correlation. Serum PTH was inversely related to BMD at both hip and lumbar spine in the total group, and at the hip
with calcidiol levels lower than 37 nmol/l. Calcidiol was directly related to hip BMD only when levels were lower than 37
nmol/l. Results of a stepwise multiple regression analysis showed that the single factor which affected BMD at the hip was
calcidiol in the subgroup with serum calcidiol levels below 37 nmol/l, while in the subgroup with serum calcidiol levels above
37 nmol/l, the main factor affecting hip BMD was serum PTH. The prevalence of vitamin D deficiency at a cutoff of 37 nmol/l
was 64%. In summary, calcidiol serum levels below 37 nmol/l seem to affect bone mass, regardless of the effect of PTH. Vitamin
D deficiency is a frequent finding in the postmenopausal women who attend a rheumatology outpatient clinic in Madrid. Vitamin
D supplementation should therefore be considered in this population during the winter season.
Received: 2 July 1999 / Accepted: 3 March 2000 相似文献
8.
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
9.
Bone mineral density (BMD) at the lumbar spine and the neck of femur and serum concentrations of 25-hydroxyvitamin D (25OHD),
intact parathyroid hormone (PTH), alkaline phosphatase, calcium, albumin, creatinine and phosphate were measured in a group
of 166 postmenopausal women (30–79 years) attending a bone clinic for bone density measurements. Four subjects with suspected
primary hyperparathyroidism were excluded from analysis. BMD at the lumbar spine was correlated with body mass index (BMI)
(r=0.278,p=0.0003), age (r=−0.194,p=0.0134) and serum 25OHD (r=0.188,p=0.0167). BMD at the neck of femur correlated with BMI (r=0.391,p<0.0001), age (r=−0.356,p<0.0001), PTH (r=−0.156,p=0.047) and serum 25OHD (r=0.231,p=0.0031). Stepwise multiple regression analysis showed that age, BMI and serum 25OHD contributed to the variation in BMD at
lumbar spine. At the neck of femur, PTH was an additional contributor. We conclude that serum 25OHD makes a contribution to
BMD a lumbar spine and neck of femur. 相似文献
10.
Longitudinal Evaluation of Vitamin D Status in Healthy Subjects from Southern Italy: Seasonal and Gender Differences 总被引:4,自引:0,他引:4
V. Carnevale S. Modoni M. Pileri A. Di Giorgio I. Chiodini S. Minisola R. Vieth A. Scillitani 《Osteoporosis international》2001,12(12):1026-1030
Vitamin D status is currently considered among the relevant determinants of skeletal integrity. Since vitamin D levels present
seasonal variations, we longitudinally studied young healthy men and women in order to investigate the related physiologic
modifications of both calcium homeostasis and bone remodeling. Thirty-two men (mean age 39.4 ± 7.8 years) and 58 premenopausal
women (aged 36.9 ± 6.4 years) from southern Italy were studied. In all subjects the following parameters were measured both
in winter and in summer: serum calcium, phosphorus, creatinine, total alkaline phosphatase activity, 25-hydroxyvitamin D (25OHD),
parathyroid hormone (PTH), osteocalcin (BGP), together with urinary calcium (Ca/Cr), total pyridinoline (Pyr/Cr) and deoxypyridinoline
(d-Pyr/Cr), corrected for creatinine excretion. In both sexes 25OHD levels were significantly higher in summer, while PTH
values were lower, than in winter. The prevalence of hypovitaminosis D, defined by concentrations of 25OHD lower than 30 nmol/l,
was 17.8% in winter and 2.2% in summer in the whole sample, while it was 27.8% and 3.4%, respectively, among female subjects.
Indeed male subjects did not display hypovitaminosis D, having throughout the year significantly higher calcium and 25OHD
levels together with lower PTH values, than the women. Moreover, alkaline phosphatase total activity was more elevated in
men both in winter and in summer. In women, during winter, bone remodeling markers levels were higher while urinary calcium
levels were lower than in summer. In the whole sample serum 25OHD correlated positively with serum calcium and inversely with
PTH. The seasonal percentage variations in PTH were inversely correlated with those of Ca/Cr. Our results show a relatively
high prevalence of subclinical vitamin D deficiency among young healthy women from southern Italy. Significant gender-specific
differences have been demonstrated in both calcium homeostasis and skeletal remodeling indexes; the seasonal fluctuations
in the vitamin D–PTH axis are accompanied by cyclical variations of bone turnover rate, which were more pronounced in women.
Received: 11 January 2001 / Accepted: 6 July 2001 相似文献
11.
Y. Sato M. Kaji F. Higuchi I. Yanagida K. Oishi K. Oizumi 《Osteoporosis international》2001,12(6):445-449
Although hip fracture is one of the most common causes of acute immobilization in elderly patients, little is known about
the influence of immobilization on changes in bone and calcium metabolism following this event. We therefore compared serum
biochemical indices of bone and calcium metabolism in 20 elderly subjects with hip fracture with those measured in 20 healthy
age-matched controls. Rankin scores, a measure of functional dependence with 0 representing independence and 5 representing
total dependence, were assigned. We also examined serial changes in these biochemical indices from shortly following the fracture
to the early recovery period. Ionized calcium, intact parathyroid hormone (PTH), intact bone Gla protein (BGP), pyridinoline
cross-linked carboxyterminal telopeptide of type I collagen (ICTP), 25-hydroxyvitamin D (25-OHD), and 1,25-dihydroxyvitamin
D (1,25-[OH]2D) were measured. One week after the fracture, mean serum concentrations of calcium and ICTP were elevated in correspondence
to degree of immobilization (mean Rankin score; 4.4), while serum concentrations of BGP, PTH, 25-OHD, and 1,25-[OH]2D were depressed. Rankin score (mean: 4.4) correlated positively with ICTP and negatively with BGP at this time. At 2 months,
calcium and ICTP elevation decreased and BGP, PTH and 1,25-[OH]2D were less depressed, coinciding with a decline in Rankin score from 4.2 to 2.2. Indices were further improved at 3 months
(mean Rankin score, 1.3), with calcium and BGP returning to normal. We concluded that increased bone resorption, and decreased
bone formation, and hypercalcemia are present by 1 week following the hip fracture, and some resorption increase persists
for at least 3 months. These changes could explain in part the high risk of another hip fracture.
Received: 3 April 2000 / Accepted: 15 December 2000 相似文献
12.
A. Monegal M. Navasa N. Guañabens P. Peris F. Pons M. J. Martinez de Osaba J. Ordi A. Rimola J. Rodés J. Muñoz-Gómez 《Osteoporosis international》2001,12(6):484-492
After liver transplantation there is a high incidence of fractures, with important rates of bone loss during the first months.
However, the long-term evolution of bone mass and metabolism parameters have been scarcely studied. In order to determine
the incidence and risk factors involved in the development of skeletal fractures and to analyze the long-term evolution of
bone mass, bone turnover and hormonal status after liver transplantation, a 3-year prospective study was performed in 45 patients
following liver transplantation. Serum osteocalcin, parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH D) and testosterone
levels (men), and bone mass at the lumbar spine and femur were measured before and sequentially at different time points during
3 years. Spinal X-rays were obtained during the first year. Histomorphometric analysis of bone biopsies obtained in 24 patients
within the first 12 hours after surgery and 6 months after transplantation was performed. Fifteen patients (33%) developed
fractures after liver transplantation, and pre- transplant risk factors for fractures were age and low bone mass (odd”s ratio
for osteoporosis, 95% confidence interval: 5.69, 1.32–24.53). Serum PTH, osteocalcin, 25-OH D, testosterone and creatinine
levels increased after transplantation. Moreover, PTH correlated with creatinine and osteocalcin values. Bone mass decreased
during the first 6 months and reached baseline values at the lumbar spine the second year, with posterior significant recovery
at the femoral neck. Long term evolution of femoral neck BMD correlated with PTH levels. Six months after transplantation
bone histomorphometric data showed an increase in bone formation parameters. After liver transplantation there is a high incidence
of fractures, specially in elderly patients and those with osteoporosis. Bone mass decreased in the short-term period and
improved, initially at the lumbar spine and later at the femur, according to histomorphometric evidences of an increase in
bone formation. The increase in creatinine values induces a secondary hyperparathyroidism that influences the changes in femoral
bone mass. Treatment of osteoporosis shortly after liver transplantation may be important in the prevention of bone fractures,
particularly in patients with low bone mass.
Received: June 2000 / Accepted: November 2000 相似文献
13.
Biochemical Responses of Bone Metabolism to 1,25-Dihydroxyvitamin D Administration in Black and White Women 总被引:2,自引:0,他引:2
F. Cosman V. Shen D. Morgan S. Gordon M. Parisien J. Nieves R. Lindsay 《Osteoporosis international》2000,11(3):271-277
The basis for the racial difference in bone mass between black and white women is not known. Lower bone turnover, better
renal calcium conservation, and decreased sensitivity to parathyroid hormone (PTH) have been proposed as explanations. A dynamic
comparison of osteoblast function, utilizing stimulation by 1,25-dihydroxyvitamin D [1,25(OH)2D], has not been tested between these two ethnic groups. We compared well-matched black (n= 15) and white (n= 15) premenopausal women, before and during 5 days of 1,25(OH)2D administration (1.0 μg/day) in order to assess dynamic indices of bone metabolism. As expected, at baseline, black women
had lower levels of serum 25-hydroxyvitamin D and biochemical markers of bone turnover with slightly higher levels of PTH.
Black women also had superior renal calcium conservation than white women at baseline. In response to 1,25(OH)2D administration, black women had a slightly greater increase in serum calcium and greater decrement in PTH. Moreover, black
women showed a lesser increment in urinary calcium than white women and a more robust increase in two markers of bone formation
– osteocalcin and carboxyterminal propeptide of type 1 procollagen – than white women. There were no changes in bone resorption
indices in either race upon 1,25(OH)2D administration. These data provide preliminary evidence that black women conserve calcium more efficiently under both static
and dynamic conditions, and also appear to have better osteoblastic functional reserve than white women.
Received: 22 June 1999 / Accepted: 6 September 1999 相似文献
14.
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
15.
We conducted a cross-sectional study of the effects of soybean protein intake on bone mineral density and biochemical markers
in 85 postmenopausal Japanese women. Nutrients in the diet of postmenopausal Japanese women visiting the osteoporosis unit,
including subjects with normal lumbar spine bone mineral density (L2–4 BMD), were investigated by questionnaire, and the calculated
daily energy, protein, soy protein and calcium intake were obtained. L2–4 BMD was measured with dual-energy X-ray absorptiometry,
and assays done of serum alkaline phosphatase (ALP) and serum intact osteocalcin (IOC) as bone formation markers and urinary
pyridinoline (UPYR) and urinary deoxypyridinoline (UDPYR) as bone resorption markers. Soy protein intake was significantly
associated with the Z-score for L2–4 BMD (r= 0.23, p = 0.038) and UDPYR (r =−0.23, p = 0.034). Stepwise multiple regression analyses showed that soy protein intake is significantly associated with the Z-score for L2–4 BMD (β= 0.225, p = 0.04) and UDPYR (β=−0.08, p = 0.03) among four nutritional factors. These results suggest that high soy protein intake is associated with a higher bone
mineral density and a lower level of bone resorption, but further studies are needed to confirm the causal dynamic mechanisms.
Received: 17 September 1999 / Accepted: 29 February 2000 相似文献
16.
Abnormal Bone Turnover in Cystic Fibrosis Adults 总被引:2,自引:0,他引:2
R. M. Aris D. A. Ontjes H. E. Buell A. D. Blackwood R. K. Lark M. Caminiti S. A. Brown J. B. Renner W. Chalermskulrat G. E. Lester 《Osteoporosis international》2002,13(2):151-157
Cystic fibrosis (CF) patients often have low bone mineral density (BMD) and may suffer from fractures and kyphosis. The pathogenesis
of low BMD in CF is multifactorial. To study bone metabolism, we collected fasting serum and urine from 50 clinically stable
CF adults (mean age 28 years) and 53 matched controls to measure markers of bone formation and bone resorption. The CF subjects
had moderate lung disease (FEV1: 46.1 ± 18.6% predicted) and malnutrition (BMI: 20.0 ± 3.3 kg/m2). Only 3 subjects had normal BMD. CF subjects had higher urinary N-telopeptides of type I collagen (81.0 ± 60.0 vs 49.0 ±
24.2 nm BCE/mmol creatinine, p= 0.0006) and free deoxypyridinoline (7.3 ± 5.0 vs 5.3 ± 1.9 nM/mM, p= 0.004) levels than controls. Serum osteocalcin levels were similar in the two groups, a result confirmed by two immunoassays
that recognize different epitopes on osteocalcin. Serum bone-specific alkaline phosphatase levels were elevated in CF patients
(32.0 ± 11.3 vs 21.8 ± 7.0 U/l, p<0.0001), but were much more closely associated with serum total alkaline phosphatase levels (r = 0.51, p = 0.001) than with age or gender. Parathyroid hormone levels were elevated (p= 0.007) and 25-hydroxyvitamin D levels were depressed (p= 0.0002) in the CF patients in comparison with controls. These results indicate that adults with CF have increased bone resorption
with little change in bone formation. Medications that decrease bone resorption or improve calcium homeostasis may be effective
therapies for CF bone disease.
Received: 22 June 2001 / Accepted: 1 August 2001 相似文献
17.
Regular Physical Exercise and Bone Mineral Density: A Four-Year Controlled Randomized Trial in Middle-aged Men. The DNASCO Study 总被引:3,自引:0,他引:3
J. Huuskonen S. B. Väisänen H. Kröger J. S. Jurvelin E. Alhava R. Rauramaa 《Osteoporosis international》2001,12(5):349-355
The aim of the study was to investigate the effects of regular aerobic exercise training on bone mineral density (BMD) in
middle-aged men. A population based sample of 140 men (53–62 years) was randomly assigned into the exercise and reference
groups. BMD and apparent volumetric BMD (BMDvol) of the proximal femur and lumbar spine (dual-energy X-ray absorptiometry, DXA) and anthropomorphic measurements were performed
at the randomization and 2 and up to 4 years later. The participation rate was 97% and 94% at the second and third BMD measurements,
respectively. As another indication of excellent adherence and compliance, the cardiorespiratory fitness (aerobic threshold)
increased by 13% in the exercise group. The 2% decrease in the reference group is regarded as an age-related change in cardiorespiratory
fitness. Regardless of the group, there was no association between the increase in aerobic threshold and change in BMD. In
the entire group, age-related bone loss was seen in the femoral neck BMD and BMDvol (p<0.01). BMD and BMDvol values increased with age in L2–L4 (p<0.004). An increased rate of bone loss at the femoral neck was observed in men with a low energy-adjusted calcium intake
(p = 0.003). Men who increased their alcohol intake during the intervention showed a decrease in the rate of bone loss at the
femoral neck (p = 0.040). A decrease in body height associated with decreased total femoral BMD (r= 0.19, p = 0.04) and the change in body height was a predictor of bone loss in the femoral neck (β= 0.201). Long-term regular aerobic
physical activity in middle-aged men had no effect on the age-related loss of femoral BMD. On the other hand, possible structural
alterations, which are also essential for the mechanical strength of bone, can not be detected by the DXA measurements used
in this study. The increase seen in lumbar BMD reflects age-related changes in the spine, thus making it an unreliable site
for BMD follow-up in men.
Received: August 2000 / Accepted: November 2000 相似文献
18.
M. Blum S. S. Harris A. Must S. M. Phillips W. M. Rand B. Dawson-Hughes 《Osteoporosis international》2002,13(8):663-668
Subjects exposed to environmental tobacco smoke have been found to be at increased risk for several health problems. Whether
exposure to passive tobacco smoke is associated with reduced bone mineral density (BMD) is unknown. In order to examine this,
we measured BMD in 154 healthy premenopausal women (age range 40–45 years). BMD of the total hip, femoral neck, lumbar spine
and total body was measured by dual-energy X-ray absorptiometry (DXA). Data were collected on exposure to household tobacco
smoke from age 10 years to the present as well as on other lifestyle factors related to bone mass. We found that 67.5% of
the subjects had a history of household tobacco smoke exposure. Subjects exposed to household tobacco smoke had a mean adjusted
BMD that was significantly lower at the total hip (p= 0.021) and femoral neck (p= 0.018) compared with subjects who were not exposed. In addition, duration of household tobacco smoke exposure was negatively
associated with BMD at the total hip (p = 0.010), femoral neck (p= 0.004), lumbar spine (p = 0.037) and total body (p = 0.031). Subjects exposed to household tobacco smoke for 15 years or more had mean adjusted BMD that was 4% lower at the
total body, and more than 8% lower at the total hip, femoral neck and lumbar spine, compared with subjects who were not exposed.
In conclusion, household tobacco smoke exposure during adolescence and young adulthood was found to be negatively associated
with BMD at the total hip and femoral neck, and duration of exposure was negatively associated with BMD at the total hip,
femoral neck, lumbar spine and total body in premenopausal women.
Received: 17 December 2001 / Accepted: 16 February 2002 相似文献
19.
The aim of this cross-sectional study was to evaluate the relationships between circulating β2 microglobulin (β2 m) and bone mineral density (BMD), parameters of bone remodeling, vitamin D metabolites, parathyroid hormone (PTH), estradiol
levels, and age in a group of 165 clinically healthy or osteoporotic, but otherwise normal untreated women. In this group
of women, systemic β2 m correlated with BMD (g/cm2) levels for total hip and Ward's triangle (r =−0.298, P < 0.0001; and r =−0.299, P < 0.0001, respectively), but only at the borderline level with BMD at the spine (r =−0.145, P= 0.0604). Serum β2 microglobulin markedly correlated with age (r = 0.512, P= 0.0001). β2 m levels correlated with indices of bone remodeling, as well as with serum creatinine and estradiol levels. However, after
stratification of all analyses by age, body mass index, and serum 25OHD3, 1,25(OH)2D3, PTH, or estradiol levels (using standard multiple regression and stepwise forward regression models), only 25OHD3 was found to be an independent predictor of BMD at the hip, including Ward's triangle, as estradiol of BMD at the spine.
On the other hand, β2 m was not associated with BMD at any of the measured regions. Also, no association was found between serum PTH and BMD values.
Therefore, systemic β2 m seems to be an indicator of bone remodeling in the course of natural skeletal aging rather than a variable independently
predicting bone loss.
Received: 21 July 1998 / Accepted: 10 June 1999 相似文献
20.
S S Sherman J D Tobin B W Hollis C M Gundberg T A Roy C C Plato 《Journal of bone and mineral research》1992,7(10):1123-1130
A causal role in age-related bone loss has been attributed to alterations in vitamin D status, the bone mineral regulating hormones, and/or renal function. We assessed biochemical parameters of bone metabolism and renal function in healthy subsets of young and old men (n = 191) and women (n = 120) and evaluated the relationships between these parameters and bone mineral density (BMD) in the radius, spine, and femur. There were no significant associations between BMD at any site and serum 25-OHD, 1,25-(OH)2D, PTH, or creatinine clearance in either young men or in young or old women, after controlling for age. In old men, however, lower radius BMD was significantly related to higher PTH and higher 1,25-(OH)2D and marginally related to lower 25-OHD values. In young men, there were unexpected but significant associations between lower femoral neck BMD and higher serum osteocalcin and urinary calcium/creatinine excretion after age adjustment. In old women, lower spine and radius BMD was also significantly correlated with higher serum osteocalcin. In this healthy, vitamin D-replete population, there were significant cross-sectional declines in BMD in the femur in young and old men and at all sites in old women. Elevated remodeling may be an important feature that contributes to reduced femoral BMD in young men and reduced spine and radius BMD in old women. However, compromised renal function or levels of 1,25-(OH)2D or elevated PTH appear to be neither necessary nor relevant as determinants of osteopenia in the spine or femur in these normal, healthy men and women. 相似文献