围绝经期女性血清雌二醇及卵泡刺激素变化规律及其与腰椎、髋部和股骨颈骨密度的关系

目的探索围绝经期女性血清雌二醇(E2)、卵泡刺激素(FSH)变化规律与其腰椎、髋部、股骨颈骨密度(BMD)的关系。方法选取2014年1月-2015年1月在该院进行体检的围绝经期妇女440例为研究对象,分为绝经前组(220例)和绝经后组(220例)。测定两组血清E2、FSH水平及其腰椎、髋部、股骨颈BMD值,并进行组间比较。结果绝经后组妇女血清E2与绝经前组比较明显减少,而血清FSH与绝经前组比较明显增加,差异均有统计学意义(P0.05)。绝经后组妇女腰椎、髋部、股骨颈BMD值与绝经前组比较均有明显减少,组间差异均有统计学意义(P0.05)。绝经前低骨量组和绝经后低骨量组血清E2水平均较正常骨量组明显减少,而血清FSH水平均较正常骨量组明显增加,差异均有统计学意义(P0.05)。血清E2水平与腰椎BMD、髋部BMD、股骨颈BMD均呈正相关关系(P0.05);血清FSH水平与腰椎BMD、髋部BMD、股骨颈BMD均呈负相关关系(P0.05)。结论绝经后女性BMD明显减少,雌激素水平变化可能影响骨代谢,应引起临床的高度关注。     

绝经后妇女骨密度与年龄、体质量关系的分析

目的探讨绝经后妇女骨密度(BMD)与年龄、体质量的关系.方法调查142例健康的绝经后妇女的年龄、绝经年龄、绝经年限,测量身高、体质量、腰椎和股骨的骨密度,并进行统计分析.结果随着年龄的增长,腰椎及股骨的BMD值逐渐下降,骨量减少及骨质疏松的发生率呈明显上升趋势;低体质量组的BMD显著的低于正常体质量组;高风险组的年龄远大于中、低风险组;高、中风险组与低风险组比,体质量轻、腰椎及股骨的BMD小.结论年龄、体质量与骨密度有关.对绝经后女性,尤其是年龄大、绝经时间长、低体质量瘦小体型绝经后妇女,应及时监测骨密度,采取适当措施防治骨质疏松,以免发生骨折.     

绝经后骨质疏松妇女血清瘦素与骨密度及骨转换生化指标的关系

为了解瘦素与绝经后骨质疏松妇女BMD与骨转换生化指标之间的关系,选取30例绝经前健康妇女(40.5±0.49岁)为对照组,健康妇女有规则月经,双能X线吸收仪(DEXA)测定腰椎BMD(LS-BMD)正常,BMI正常(20～50)。90例绝经后骨质疏松妇女(58.8±0.51岁)为病例组,DEXA测定LS-BMD     

运动对去卵巢大鼠骨矿含量和骨密度的影响

目的观察运动对去卵巢大鼠骨矿含量(bone mineral contant,简称BMC)和骨密度(bonemineral density,简称BMD)的影响。方法雌性(sprague daivley,简称SD)大鼠随机分为正常对照组(SHAM)、去卵巢手术对照组(OVX)、雌激素治疗组(OVX+ES)、运动组(OVX+ET)。SHAM组行假手术,其余各组行双侧卵巢切除术,术后75天开始为期3个月的治疗。OVX+ES组用尼尔雌醇治疗,OVX+ET组按要求进行运动。治疗结束后检测股骨和胫骨的BMC和BMD。结果股骨BMD比较,SHAM组(0.206±0.009)高于OVX组(0.196±0.012),差异有统计学意义(P<0.05);胫骨BMC比较,OVX+ET组(0.298±0.033)高于OVX组(0.260±0.033),差异有统计学意义(P<0.05);胫骨BMD比较,OVX组比其它3组均低,差异有统计学意义(P<0.05或P<0.01);运动明显提高去卵巢大鼠胫骨的BMC和BMD,运动在提高胫骨BMD方面的功效优于激素疗法。结论运动对绝经后骨质疏松症的形成有一定干预作用。     

绝经后妇女股骨颈骨折与膳食蛋白质摄入量关系的研究

[目的]探讨绝经后妇女发生股骨颈骨折与膳食蛋白质摄入量的关系,以便采取相应的防治措施.[方法]采用12配比的病例对照研究方法,于1998年9月至1999年9月在天津医院骨科病房选取初发的股骨颈骨折的绝经后妇女30名,平均年龄为66.0岁,同时按12配比原则,从老年妇女健康体检中选取60名没有骨折的绝经后妇女作为对照组,平均年龄65.6岁,配比条件是年龄、民族、绝经年限和居住地.调查并比较两组近1年内膳食中蛋白质、热能与钙的摄入量.[结果]骨折组蛋白质的摄入量明显高于对照组,钙的摄入量则低于对照组(P＜0.05),并且两组的骨密度(BMD)、体质指数(BMI)的差异也有统计学意义(P＜0.05),骨折组均低于对照组.[结论]绝经后妇女发生股骨颈骨折与膳食蛋白质的摄入量有关,提示应适量摄取蛋白质,当蛋白质摄入增加时,须适量提高钙的摄入量.     

膳食钙、磷以及奶制品对绝经后妇女骨密度的影响

目的探讨膳食中钙、磷以及奶制品的摄入量对骨密度及骨盐含量的影响,为研究骨质疏松的预防提供相关线索和依据。方法在广州市越秀区农林街社区发放传单招募调查对象,并采用自编的结构化标准问卷,对320名广州绝经后妇女的膳食习惯进行调查,并测量其全身、股骨全身、股骨颈、股骨干、大粗隆、Ward’s三角以及腰锥1～4的骨密度和骨量,采用多因素逐步回归分析探讨膳食钙、磷及奶制品对骨盐含量及骨密度的影响。结果 320名调查对象平均57.1岁,平均绝经年限7.3年,平均每天摄入钙、磷及奶制品分别为822 mg、949 mg和126 g,平均全身骨密度为1.054 g/cm2,磷与7个部位的骨密度及骨盐含量呈正相关关系（P〈0.05）。随着磷摄入量增加,全身及腰锥1～4骨密度增加,偏回归系数值分别为0.121和0.184 g.（cm2）-1.g-1.d-1。随着奶制品摄入量增加,股骨全身、股骨干骨密度也相应增加,骨密度偏回归系数值分别为0.686、0.841mg.（cm2）-1.g-1.d-1。钙与全身、股骨全身、股骨颈、大粗隆、股骨干和Ward’s三角的BMC具有正相关性,而在钙与BMD关系中,钙只与股骨全身、大粗隆和股骨干呈正相关性,且每日膳食中每增加100 g钙的摄入量,则股骨全身、大粗隆、股骨干的骨密度相应增加5.3、4.8和7.6 g/cm2。结论增加膳食中钙、磷以及奶制品的摄入量有利于绝经后妇女的骨盐含量及骨密度的提高。     

北京城区老年绝经妇女维生素D与骨矿密度的关系

目的 分析北京城区老年绝经妇女维生素D水平与其身体各部位骨密度(BMD)的关系.方法 在2008年5月至7月,采用整群随机抽样方法 抽取北京3个城区所辖17个礼区的60岁以上老年绝经妇女400名(年龄的中位数为67.8岁),采用美国DioSorin放射免疫试剂盒测定血清25-羟基维生素D[25(OH)D]浓度,根据血清25(OH)D浓度将对象分为维生素D缺乏组[A组,25(OH)D≤25 nmol/L]、不足组[B组,25 nmol/L<25(OH)D≤50 nmol/L]、适宜组[C组,50 nmol/L<25(OH)D≤75 nmol/L]和维生素D充足组[D组,25(OH)D>75 nmol/L].采用双能X线吸收法(DEXA)测定全身、腰椎(L_(2～4))和股骨近端的BMD.结果 血清25(OH)D浓度为(36.0±14.6)nmol/L,全身和股骨颈BMD分别为(0.829±0.090)、(0.679±0.106)g/cm~2.A、B、C+D组全身BMD分别为(0.811±0.077)、(0.825±0.088)、(0.864±0.112)g/cm~2(F=16.93,P<0.01),股骨颈BMD分别为(0.666±0.107)、(0.673±0.099)、(0.725±0.117)g/cm~2(F=18.36,P<0.01),血清25(OH)D浓度与全身、股骨颈BMD呈正相关(r值分别为0.17、0.18,P值均<0.05).结论我国老年妇女维生素D营养状况与腰椎、股骨近端、髋部以及四肢BMD密切相关.     

长期饮用学生奶与儿童骨密度的关系

目的了解长期饮用学生奶对儿童骨密度的影响。方法于2009年7月份,在湖南省长沙市整群抽取435名10～12岁学生(其中男生188名,女生247名),调查学生奶饮用情况,根据学生饮奶频率和连续饮奶的时间,将被调查的学生分为长期饮奶组(连续1年以上和坚持每周饮奶4次以上或连续3年以上每周饮奶1～3次者为长期饮奶组,220人)和较少饮奶组,测定其右前臂长度、桡尺骨远端1/3处骨宽度(BW)、骨矿物质含量(BMC)和骨密度(BMD)、血磷和钙含量。结果长期饮奶组男孩右前臂长(22.53cm±1.63cm vs.21.95cm±1.75cm,P<0.05)、桡骨BW(1.370cm±0.237cm vs.1.300cm±0.176cm,P<0.05)、桡骨BMC(0.690±0.270 vs.0.599±0.090,P<0.01)、桡骨BMD(0.498±0.135 vs.0.462±0.055,P<0.05);女孩桡骨BMD(0.489±0.076 vs.0.469±0.081,P<0.05)、尺骨BMC(0.564±0.176 vs.0.512±0.100,P<0.01、尺骨BMD(0.470±0.129 vs.0.439±0.059,P<0.05均明显高于较少饮奶组。儿童饮用学生奶与奶制品的种类和性状密切相关。结论长期饮用学生奶可增加儿童骨密度,奶制品的种类及性状影响学生奶计划的实施与推广。     

大豆异黄酮和补充钙对去卵巢大鼠骨密度及肝IGF-1mRNA表达的影响

目的 利用卵巢切除大鼠模型,研究大豆异黄酮和钙对卵巢切除大鼠骨密度及肝脏IGF-1基因表达的影响.方法 将6月龄雌性SD大鼠,按体重随机分成5组假手术组(Sham)、卵巢切除阴性对照组(OVX)、单纯大豆异黄酮组(SI)、单纯碳酸钙组(Ca)、大豆异黄酮加碳酸钙组(SI+Ca).所有大鼠饲以钙含量为3.732g/kg的低钙饮食喂养12周.实验结束时,利用双能X线骨密度扫描仪测量右侧股骨骨密度(BMD),采用逆转录-聚合酶链反应(RT-PCR)方法测定肝脏胰岛素样生长因子-1(IGF-1)基因表达水平.结果 SI+Ca组股骨远心端BMD为(0.263±0.007)g/cm2,Sham组为(0.267±0.008)g/cm2,两组间差异无统计学意义,但这两组BMD均显著性高于OVX(0.245±0.005)g/cm2、SI(0.258±0.011)g/cm2和Ca(0.255±0.004)g/cm2组(P＜0.05).肝脏IGF-1mRNA表达水平在Sham(0.200±0.023)g/cm2、SI(0.278±0.019)g/cm2、Ca(0.302±0.026)g/cm2及SI+Ca(0.231±0.025)g/cm2组中均显著性低于OVX(0.362±0.031)g/cm2,P＜0.05,SI+Ca组IGF-1mRNA表达水平(0.231±0.025)g/cm2低于SI(0.278±0.019)g/cm2和Ca(0.302±0.026)g/cm2两组,并差异有统计学意义.结论 SI+Ca能比单纯喂饲SI或Ca更好地防止卵巢切除大鼠股骨BMD的减小.37.95 mg/kg剂量的SI能够显著抑制由于卵巢切除引起的肝脏IGF-1 mRNA表达水平的上升.     

绝经激素治疗对不同绝经年龄和绝经方式女性骨密度的影响

目的 探讨绝经激素治疗(MHT)对不同绝经年龄和绝经方式女性骨密度(BMD)的影响。方法 选择2012年1月至2021年12月就诊于西安交通大学第一附属医院的绝经后女性869人为研究对象,按照绝经年龄将其分为40～44岁组(n=127)、45～49岁组(n=348)、50～54岁组(n=305)、55～59岁组(n=89);按照治疗方式将其分为MHT组(n=521)与非MHT组(n=348),再根据治疗时间分为<1年组(n=94)、1～<3年组(n=258)、3～<5年组(n=110)、≥5年组(n=59)。观察研究对象的腰椎(L1～L4)BMD、股骨BMD、T值,分析MHT对不同绝经年龄、绝经方式、治疗时间女性BMD的影响。结果 不同绝经年龄组的腰椎(L1～L4)BMD、股骨BMD、T值比较差异均有统计学意义(F值分别为3.205、3.807、4.558,P<0.05),绝经年龄越早BMD越低。40～44岁组、45～49岁组手术绝经者的腰椎(L1～L4)BMD、股骨BMD、T值均明显低于自然绝经者,经比较差异均有统计学意义(t值分别为2.490、2.550、2...     

Dietary iron positively influences bone mineral density in postmenopausal women on hormone replacement therapy

The associations of dietary intakes of iron and calcium on change in bone mineral density (BMD) were examined over 1 y in healthy nonsmoking postmenopausal women (mean age 55.6 +/- 4.6 y) stratified by hormone replacement therapy (HRT) use (HRT, n = 116; no HRT, n = 112). BMD was measured at lumbar spine L(2)-L(4), trochanter, femur neck, Ward's triangle, and total body using dual-energy X-ray absorptiometry at baseline and 1 y. Mean nutrient intakes were assessed using 8-d diet records. All women received 800 mg/d of supplemental elemental calcium. Regression analyses examined the effects of iron and calcium intakes on BMD change adjusting for years past menopause, baseline BMD, weight change, exercise, and energy intake. The interaction of iron with calcium on BMD change was assessed using tertiles of iron and calcium intake and estimated marginal mean change in BMD. Iron was associated (P < or = 0.05) with greater positive BMD change at the trochanter and Ward's triangle in women using HRT. Calcium was associated (P < or = 0.05) with BMD change at the trochanter and femur neck for women not using HRT. In women using HRT in the lowest tertile of calcium intake, change in femur neck BMD increased linearly as iron intake increased. In women not using HRT, BMD increased in the women in the highest tertile of calcium intake. We conclude that HRT use appears to influence the associations of iron and calcium on change in BMD.     

运动对去卵巢大鼠骨矿含量和骨密度的影响

目的观察运动对去卵巢大鼠骨矿含量（bone mineral contant,简称BMC）和骨密度（bone mineral den-sity,简称BMD）的影响。方法雌性（sprague daivley,简称SD）大鼠随机分为正常对照组（SHAM）、去卵巢手术对照组（OVX）、雌激素治疗组（OVX＋ES）、运动组（OVX＋ET）。SHAM组行假手术,其余各组行双侧卵巢切除术,术后75天开始为期3个月的治疗。OVX＋ES组用尼尔雌醇治疗,OVX＋ET组按要求进行运动。治疗结束后检测股骨和胫骨的BMC和BMD。结果股骨BMD比较,SHAM组（0．206±0．009）高于OVX组（0．196±0．012）,差异有统计学意义（P〈0．05）;胫骨BMC比较,OVX＋ET组（0．298士0．033）高于OVX组（0．260±0．033）,差异有统计学意义（P〈0．05）;胫骨BMD比较,0VX组比其它3组均低,差异有统计学意义（P〈0．05或P〈0．01）;运动明显提高去卵巢大鼠胫骨的BMC和BMD,运动在提高胫骨BMD方面的功效优干激素疗法．结诊运动对绝经后骨盾疏凇症的形成有一定干预作用。     

大鼠骨矿物质含量与组织中钙水平的相关性研究

用ＳＤ１０００型单光子骨矿物测定仪研究了９８只１５周龄Ｗｉｓｔａｒ大鼠的股骨矿物质含量（ＢＭＣ）和骨密度（ＢＭＤ，ＢＭＣ／ＢＷ）与组织和血中钙含量的相关性。结果显示：雌、雄动物的身长、体重、骨宽度（ＢＷ）、ＢＭＣ、ＢＭＣ／体重、ＢＭＤ／体重及ＢＭＤ／身长均有显著性差异，活体ＢＭＤ与动物的钙总摄入量、身长、体重、及钙存留率显著相关（Ｐ＜０．０５）；ＢＭＣ与钙总摄入量、身长、体重、性别和肝脏钙含量显著相关（Ｐ＜０．０５）。多元回归分析表明：动物身长、体重、钙总摄入量和心脏钙含量与活体ＢＭＤ呈线性关系，动物身长和血浆钙含量与离体ＢＭＤ呈线性关系。活体测量结果ＢＭＣ、ＢＭＤ由于其与动物的生长发育、钙存留率及肌肉和血浆钙含量具有相关和直线关系，且简便易行、不需要处死动物，因而认为可以反映动物体内钙营养状况和骨质积累情况。     

Association of Dietary Total Antioxidant Capacity with Bone Mass and Osteoporosis Risk in Korean Women: Analysis of the Korea National Health and Nutrition Examination Survey 2008–2011

Antioxidant intake has been suggested to be associated with a reduced osteoporosis risk, but the effect of dietary total antioxidant capacity (TAC) on bone health and the risk of osteoporosis remains unclear. We aimed to assess the hypothesis that dietary TAC is positively associated with bone mass and negatively related to the risk of osteoporosis in Korean women. This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Dietary TAC was estimated using task automation and an algorithm with 24-h recall data. In total, 8230 pre- and postmenopausal women were divided into four groups according to quartiles of dietary TAC. Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio, 0.73; 95% confidence interval, 0.54–0.99; p-value = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women and BMC of the total femur and lumbar spine in premenopausal women. Our study suggests that dietary TAC is inversely associated with the risk of osteoporosis in postmenopausal women and positively associated with bone mass in both pre- and postmenopausal women.     

Changes in Bone Mineral Density and Serum Lipids across the First Postpartum Year: Effect of Aerobic Fitness and Physical Activity

This study evaluated the changes in bone mineral density (BMD) and serum lipids across the first postpartum year in lactating women compared to never-pregnant controls, and the influence of physical activity (PA). The study also explored whether N-telopeptides, pyridinoline, and deoxypyridinoline in urine serve as biomarkers of bone resorption. A cohort of 18 initially lactating postpartum women and 16 never pregnant controls were studied. BMD (dual energy X-ray absorptiometry), serum lipid profiles, and PA (Baecke PA Questionnaire) were assessed at baseline (4–6 weeks postpartum), 6 months, and 12 months. Postpartum women lost 5.2 ± 1.4 kg body weight and BMD decreased by 1.4% and 3.1% in the total body and dual-femur, respectively. Furthermore, BMDdid not show signs of rebound. Lipid profiles improved, with increases in high-density lipoprotein-cholesterol (HDL-C) and decreases in low-density lipoprotein cholesterol (LDL-C) and the cholesterol/HDL-C ratio at 12 months (vs. baseline). These changes were not influenced by lactation, but the fall the Cholesterol/HDL-C ratio was influenced by leisure-time (p = 0.051, time X group) and sport (p = 0.028, time effect) PA. The decrease in BMD from baseline to 12 months in total body and dual femur, however, was greater in those who continued to breastfeed for a full year compared to those who stopped at close to 6 months. Urinary markers of bone resorption, measured in a subset of participants, reflect BMD loss, particularly in the dual-femur, and may reflect changes bone resorption before observed changes in BMD. Results provide support that habitual postpartum PA may favorably influence changes in serum lipids but not necessarily BMD. The benefit of exercise and use of urinary biomarkers of bone deserves further exploration.     

Bone Health in Immigrant Hispanic Women Living in Texas

Osteoporosis is a serious national public health problem, and is expected to increase significantly over the next few decades, especially in women. A limitation of bone health research exists since few studies have involved Hispanic women, and even fewer, Hispanic immigrant women. For this study we examined the effects of anthropometric, behavioral, and health history variables on bone mineral density (BMD) in 84 immigrant Hispanic women, age 40 and above. BMD was assessed at the spine, femur, and forearm using dual energy x-ray absorptiometry (DXA). Demographic information, health histories, and behavioral risk factors were obtained from a questionnaire. In the younger group (mean age = 44.1 years) 61% had spinal osteopenia, and in the postmenopausal group (mean age = 53.0 years) 59% had osteopenia and 13% had osteoporosis. Femur sites were free of osteoporosis. Mean body mass index (BMI) was 31.8 ± 6.1 and mean waist girth was 95.6 ± 12.5 cm, indicating overall and abdominal obesity. Partial correlations indicated a significant positive relationship between body fat variables and total femur BMD values. ANOVAs revealed no differences in BMD values at any bone site across tertile levels for calcium intake or for physical activity. However, supplemental and dietary calcium intakes were very low and few participants engaged in regular physical activity outside of work and activities of daily living (ADL). In light of the expected increase in osteoporosis in this population and the prevalence of spinal osteopenia in the younger participants, education about the health risks of osteoporosis should be made available to this group.     

钙摄入量对青春前期女童骨量增长的影响—两年随机干预实验

目的研究不同钙摄入量对于青春前期女童骨量增长的影响,为该人群钙适宜摄入量的修订提供科学依据。方法以年龄10.0±0.7岁的241名青春前期健康女童为对象,设计普通膳食组、牛奶补充组和钙剂补充组三组,总钙摄入量分别为600、900和1200mg/d,进行2年干预,采用多次称量及3d膳食询问法获得2年间日均膳食钙摄入量,使用双能X线骨密度仪测量干预前后全身、腰椎及近端股骨骨矿物密度和骨矿物含量。结果2年间三组的平均钙摄入量分别为552±61、864±139和1166±207mg/d;日均钙摄入量与全身、多位点骨矿物含量和骨矿物密度显著正相关;当日均钙摄入量达到864mg/d时,全身骨矿物含量增加值显著高于钙摄入量为552mg/d膳食组;当日均钙摄入量达到1166mg/d时,股骨颈骨矿物含量及骨矿物密度和腰椎骨矿物密度的增加值显著高于未达到1166mg/d的干预组。结论9～11.5岁的青春前期女童钙摄入量达到1166mg/d,全身特别是负重部位能获得较高骨矿物含量和骨矿物密度增长,提示青春前期钙适宜摄入量可能为1200mg/d。     

阿法骨化醇对绝经后妇女骨密度及骨转换标志物的影响

目的探讨阿法骨化醇对绝经后妇女骨密度及骨转换标志物的影响。方法选择2009年9月至2011年12月在本院更年期门诊经骨密度（BDM）测量诊断为骨量减少或骨质疏松症,年龄在55～75岁之间的67例绝经后女性为观察对象,随机分为试验组36例,对照组31例。试验组口服氨基酸螯合钙1 000mg/d,阿法骨化醇0.25μg/次,一天两次;对照组口服氨基酸螯合钙1 000mg/d。两组均连续服药48周。两组治疗前、后采用双能X线吸收法测定股骨颈、大粗隆、Ward三角区及腰椎L2-4骨密度;同时采用酶联免疫法检测血清骨碱性磷酸酶（BALP）、抗酒石酸酸性磷酸酶（TRACP）、25羟维生素D3[25-（OH）D3]结果治疗前试验组与对照组间股骨颈、大粗隆、Ward三角区及L2-4骨密度差异均无统计学意义（P〉0.05）。试验组各部位BMD治疗后均有显著增加（P〈0.05）,而对照组治疗前后仅L2-4有显著增加（P〈0.05）。治疗后试验组与对照组各部位BMD差异均有统计学意义（P〈0.05）。血清BALP、TRACP及25-（OH）D3水平治疗前试验组与对照组间比较,差异均无统计学意义（P〉0.05）,治疗后组间比较差异均有统计学意义（P〈0.05）。试验组治疗前血清BALP、TRACP及25-（OH）D3水平分别为（26.52±6.07）μg/L、（2.84±0.97）U/L、（53.91±19.04）nmol/L,治疗后分别为（21.85±5.96）μg/L、（2.37±0.88）U/L、（57.87±19.24）nmol/L,BALP、TRACP均呈显著降低,25-（OH）D3有显著升高（P〈0.05）;对照组治疗前后各骨代谢指标改变差异无统计学意义（P〉0.05）。结论阿法骨化醇可用于绝经后骨质疏松症的治疗,可增加骨密度、降低骨转换,对治疗骨质疏松症有理论依据和临床意义。