围绝经期和绝经后女性雌二醇和卵泡刺激素水平与骨密度的关系

目的研究围绝经期女性血清雌二醇(E2)及卵泡刺激素(FSH)变化规律及其与腰椎、髋部、股骨颈骨密度(bone mineral density,BMD)之间的关系。方法采用化学发光法测定402例就诊于北京友谊医院妇产科更年期门诊的40～65岁健康中国汉族女性早卵泡期或绝经后任意时期空腹血清E2和FSH水平,并采用双光能X线DXA测定其腰椎、总髋部、股骨近端BMD,分析血清E2和FSH与BMD的关系。结果低骨量组血清FSH水平显著高于正常组(P<0.05),E2水平显著低于正常组(P<0.05)。E2与BMD变化呈正相关(r=0.017～0.42,P<0.05);FSH与BMD变化呈负相关(r=-0.012～-0.94,P<0.05)。绝经后低骨量组FSH高于正常组,而E2无明显变化。结论血清E2和FSH水平与绝经前后妇女的BMD有关,绝经后FSH与BMD进一步丢失有关,而低水平雌激素可能不再是继续影响骨量的主要因素。     

Tibolone and osteoporosis

Background We conducted a 5-year prospective, observational, controlled study to assess the effects of tibolone 1.25 mg/day on bone mineral density (BMD) in postmenopausal women with osteopenia or osteoporosis. Methods The subjects were 420 women, an average of 66.4 years old, who had been postmenopausal between 8 and 19 years when enrolled in the study. Of the 420 women enrolled, 346 agreed to take tibolone for 5 years. The 74 who refused tibolone took only calcium/vitamin D supplements and served as the control group. BMD was measured in the lumbar spine and total hip region at baseline and annually by dual-energy X-ray absorptiometry (DXA). Results At the first two follow-up visits, women taking tibolone had a significant increase in BMD at the spine (P < 0.001) and at the hip (P < 0.001) when compared to baseline values and when compared to BMD values for the control group, which decreased from baseline. In the final 3 years of the study, BMD values (spine and hip) continued to decrease in the control group and also tended to decrease in the tibolone group, but at the end of the fifth year, mean BMD in the tibolone group was still higher than BMD before the start of tibolone treatment (P < 0.05). Calculations showed that if women taking tibolone continued to lose BMD at the same rate as during the final 3 years of the study, after 11 years of tibolone treatment the average patient would have the same BMD as she had when treatment started. Conclusion This 5-year observational study provides evidence that tibolone is effective in increasing BMD in postmenopausal women with osteopenia and osteoporosis during the first 2 years of treatment, but because BMD starts to decline in the third year, it is vital that postmenopausal women start treatment with tibolone as early as possible, so that bone mineral density levels are kept high as long as possible.     

Comparison of the effects of raloxifene and low-dose hormone replacement therapy on bone mineral density and bone turnover in the treatment of postmenopausal osteoporosis

Objective. The aim of the present study was to compare the effects of raloxifene and low-dose hormone replacement therapy (HRT) on bone mineral density (BMD) and bone turnover markers in the treatment of postmenopausal osteoporosis.

Methods. Forty-two postmenopausal osteoporotic women, who were randomized to receive raloxifene 60 mg or estradiol 1 mg/norethisterone acetate 0.5 mg daily for 1 year, were studied. All women received calcium 600 mg/day and vitamin D 400 IU/day. BMD and markers of bone turnover were measured at baseline and at 12 months.

Results. After 12 months of treatment, there were statistically significant increases in BMD in both groups at all sites (all p < 0.05). For the lumbar spine, the increase in BMD was 2.3% for raloxifene compared with 5.8% for low-dose HRT and corresponding values for total body BMD were 2.9% for raloxifene and 4.6% for low-dose HRT; the increases being significantly greater in the low-dose HRT group (p < 0.001 and p = 0.02, respectively). Although the increase in BMD at the hip was significant for both raloxifene (2.1%) and low-dose HRT (3.2%) compared with baseline, the difference between the two regimens did not reach statistical significance. The decrease in serum C-terminal telopeptide fragment of type I collagen and serum osteocalcin levels for the low-dose HRT group (?53% and ?47%, respectively) was significantly greater than for the raloxifene group (?23% and ?27%, respectively; both p < 0.01).

Conclusions. In postmenopausal women with osteoporosis, low-dose HRT produced significantly greater increases in BMD of the lumbar spine and total body and greater decreases in bone turnover than raloxifene at 12 months.     

Low bone mass in urban Indian women above 40 years of age: prevalence and risk factors

Objective.?To assess the prevalence and the relative importance of risk factors for low bone mass in Indian pre- and post-menopausal women.

Methods.?Data were collected on anthropometry and lifestyle factors in apparently healthy 80 pre- and 92 post-menopausal (40–75 years) women. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. Fasting blood samples were analysed for Parathyroid hormone, vitamin D, calcium and zinc.

Results.?BMD at all three sites was significantly lower in post-menopausal than the pre-menopausal women (p?<?0.001). Prevalence of osteoporosis was highest at the lumbar spine (25.8%) in post-menopausal women, while prevalence of osteopenia was high in pre-menopausal women (44.3%). Vitamin D deficiency was seen in 54.5% pre and 41.8% post-menopausal women and significant correlation of serum 25(OH)D levels (r?=?0.16) was obtained only for total hip Z-score (p?<?0.05). Correlation between sun index and lumbar spine BMD was marginally significant (r?=?0.14, p?=?0.07). Generalised linear models revealed that after adjusting for age, weight and height, percent decrease of 2.1–4.5% in BMD may be attributed to menopause.

Conclusion.?Age, weight, height, menopause, low intakes of calcium and low 25(OH)D along with poor sunlight exposure are the major factors contributing to bone loss in Indian women above 40 years of age.     

Effect of specific exercise training on bone mineral density in women with postmenopausal osteopenia or osteoporosis

Aim.?To analyse the effect of a specific program of weight training exercise with closed kinetic chain in bone mineral density in postmenopausal women with osteopenia or osteoporosis.

Methods.?A total of 59 postmenopausal women with osteoporosis or osteopenia were included in this prospective study. Subjects were divided into two groups: the study group (SG, n = 30; 57.5 ± 5.1 years) and the control group (CG, n = 29; 56.6 ± 4.6 years). In the study group was applied a weight exercise protocol (longitudinal forces in closed kinetic chain) during 12 months, whereas in the control group no weight exercise protocol was applied. Bone mineral density at the lumbar spine and hip was assessed at baseline and at the end of follow-up by dual energy X-ray absorptiometry.

Results.?Although no significant intragroup differences were found, patients in SG showed a 1.17% increase in the lumbar spine whereas in CG a 2.26% decrease in bone density was detected.

Conclusion.?This protocol of weight training exercise did not significantly improve bone mineral density in postmenopausal women with osteopenia or osteoporosis, but in comparison to the control group, the results showed the importance of practising the specific exercise program for maintenance of bone health in postmenopausal women.     

Comparison of the effects of raloxifene and low-dose hormone replacement therapy on bone mineral density and bone turnover in the treatment of postmenopausal osteoporosis.

OBJECTIVE: The aim of the present study was to compare the effects of raloxifene and low-dose hormone replacement therapy (HRT) on bone mineral density (BMD) and bone turnover markers in the treatment of postmenopausal osteoporosis. METHODS: Forty-two postmenopausal osteoporotic women, who were randomized to receive raloxifene 60 mg or estradiol 1 mg/norethisterone acetate 0.5 mg daily for 1 year, were studied. All women received calcium 600 mg/day and vitamin D 400 IU/day. BMD and markers of bone turnover were measured at baseline and at 12 months. RESULTS: After 12 months of treatment, there were statistically significant increases in BMD in both groups at all sites (all p < 0.05). For the lumbar spine, the increase in BMD was 2.3% for raloxifene compared with 5.8% for low-dose HRT and corresponding values for total body BMD were 2.9% for raloxifene and 4.6% for low-dose HRT; the increases being significantly greater in the low-dose HRT group (p < 0.001 and p = 0.02, respectively). Although the increase in BMD at the hip was significant for both raloxifene (2.1%) and low-dose HRT (3.2%) compared with baseline, the difference between the two regimens did not reach statistical significance. The decrease in serum C-terminal telopeptide fragment of type I collagen and serum osteocalcin levels for the low-dose HRT group (-53% and -47%, respectively) was significantly greater than for the raloxifene group (-23% and -27%, respectively; both p < 0.01). CONCLUSIONS: In postmenopausal women with osteoporosis, low-dose HRT produced significantly greater increases in BMD of the lumbar spine and total body and greater decreases in bone turnover than raloxifene at 12 months.     

Association between ghrelin levels and BMD: a cross sectional trial

Objective: Our aim was to determine whether the level of plasma total ghrelin varies with the menopause stage (pre-, peri-, and postmenopause). Participants and interventions: women were divided in three groups: premenopausal, perimenopausal and postmenopausal. All participants had bone mineral densitometry and blood assay of plasma ghrelin, estradiol E₂. Correlation between plasma ghrelin levels, their reproductive status and BMD was done. Results: The mean plasma level of ghrelin was significantly decreased in the perimenopausal and postmenopausal groups in comparison to the premenopausal group. A significant positive correlation was found between ghrelin and each of E₂ and BMD (at one or more of the three sites assessed) in all subjects, as well as, in peri- and postmenopausal women, whereas a significant negative correlation was found between ghrelin and FSH. Conclusion: It may be assumed that ghrelin can affect BMD. Whether ghrelin and estrogen work independent or through convergent mechanisms needs further studies.     

Related factors in bone mineral density of lumbal and femur in natural postmenopausal women

Objective: To assess possible factors affecting the bone mineral density (BMD) in postmenopausal women. Methods: A retrospective analysis of 267 cases with spontaneous menopause within 3 years of period was performed. None of the enrolled cases were taken any hormone replacement therapy and/or treatment for osteoporosis. BMD measurements were done in lumbal vertebral (L1–L4) and left femur (neck, intertrochanteric and ward triangle) via dual energy X-ray absorbtiometry (DEXA) method, yielding corresponding T-scores of above-mentioned areas. In addition, age at menarche, parity, menopausal age, duration of postmenopausal state, lactation, physical activity, cigarette smoking, dietary calcium intake, oral contraceptive use and body mass index (BMI) were determined. Results: There were no relationships between BMD and age at menarche, parity, menopausal age, lactation, physical activity, smoking, dietary calcium intake and oral contraceptive use. Two associated factors with BMD were BMI and time since menopause. BMI was found to be positively and time since menopause was negatively correlated with BMD of both lumbal region and femur. Conclusions: BMD changes and its related factors should be kept in mind during postmenopausal years. Therefore, adequate peak bone mass and related life style measures should be achieved to confront osteoporosis-related symptoms and its consequences.     

Statins have additive effects to vertebral bone mineral density in combination with risedronate in hypercholesterolemic postmenopausal women

BACKGROUND: Recent data suggest that statins used in the treatment of hypercholesterolaemia decrease fracture risk. In this study, we aimed to investigate prospectively whether statins have an additive effect to bisphosphonates (risedronate) according to the primary hypothesis that the addition of atorvastatin to risedronate would produce an increase, from baseline, in lumbar vertebrae and total hip BMD that was greater than that observed with risedronate alone. METHODS: A total of 120 hypercholesterolaemic postmenopausal women with osteoporosis or osteopenia were randomized to receive risedronate (5 mg/day) or risedronate (5 mg/day) plus atorvastatin (20 mg/day). Changes in bone mineral density in the lumbar spine and hip, and serum lipid and glucose metabolism changes were assessed. RESULTS: Compared with risedronate alone, at 6 months, risedronate plus atorvastatin produced significantly greater increases in the bone mineral density of the lumbar spine (1.58% versus 0.75%, p < 0.05). We found no difference after therapy in BMD of the total hip (1.2% versus 1.1%). Risedronate plus atorvastatin therapy had favorable effects on the serum lipid profile: LDL and total cholesterol. Serum fasting glucose and HbA1c levels were not affected during the treatments. CONCLUSION: Statins have modest additive effects to bisphosphonates in improving lumbar spine bone mineral density in hypercholesterolaemic postmenopausal women with established osteoporosis-osteopenia. A long-term study with adequate sample size is necessary to assess the effects of statins -- in combination or alone -- on the bones and prevention of fractures.     

Comparison of bone mineral density and its variables between premenopausal and postmenopausal women

Objectives

To compare the bone mineral density (BMD) and its variables in premenopausal and postmenopausal women.

Methods

In this cross sectional study, 62 premenopausal and 62 postmenopausal apparently healthy women were evaluated by a questionnaire. The dietary intake of calcium was evaluated by 24 hours recall method and using table for proximate principle of common Indian food by Indian Council of Medical Research (ICMR). BMD at lumbar spine, femoral neck and Ward’s triangle were measured by dual energy X-ray absorptiometry (DXA). A correlation between BMD and various variables were calculated for each of the two groups.

Results

The mean age of premenopausal and postmenopausal women was 32.46±7.8 and 51.74±7.1 years respectively. The body mass index (BMI), height and weight were comparable in both the groups. The daily intake of calcium was significantly higher in premenopausal women (p<0.01). Approximately, 17% of the postmenopausal women and 9.6% of the premenopausal women were having osteoporosis; 28.56% of the postmenopausal women and 43.54% of the premenopausal women were having osteopenia at the lumbar spine. The BMD at lumber spine was found to be statistically significantly higher in premenopausal women than that in postmenopausal women (p=0.03). BMD at lumbar spine, femoral neck and Ward’s triangle were positively correlated with height, weight, BMI in premenopausal as well in postmenopausal women.

Conclusion

A significant number of women had osteopenia during premenopausal period and osteoporosis in postmenopausal phase. By increasing awareness towards bone health in second and third decade, morbidity of osteoporosis can be reduced.     

初潮及绝经年龄等因素与绝经后骨质疏松症发病的关系

目的探讨初潮年龄和绝经年龄、生育次数及哺乳时间与绝经后骨质疏松症发病的关系。方法1999年5月至2003年4月,对已绝经的1472例妇女进行骨密度测定,并对不同月经初潮年龄、绝经年龄、生育次数及哺乳时间妇女的骨质疏松症发生率及骨密度进行分析比较。骨质疏松症的诊断标准为骨密度值低于或等于正常年轻妇女平均骨密度峰值减去2.5个标准差。结果1472例中,共发生骨质疏松症861例,发生率为58.5%。其中绝经年限为1~10年、初潮年龄≥17岁者336例,发生骨质疏松症119例(35.4%);初潮年龄≤13岁者276例,发生骨质疏松症75例(27.2%)。1472例妇女中,初潮年龄11~13岁者,腰椎骨密度为(0.83±0.16)g/cm2;14~16岁者为(0.82±0.16)g/cm2;17~19岁者为(0.80±0.14)g/cm2;初潮年龄11~13岁者与17~19岁者比较,差异有统计学意义(P<0.05)。1472例妇女中,年龄为55~65岁、绝经年龄≤48岁者156例,发生骨质疏松症98例(62.8%);绝经年龄≥54岁者80例,发生骨质疏松症33例(41.3%),两者比较,差异有统计学意义(P<0.01)。1472例妇女中,生育次数≥4次者225例,腰椎、大转子及W ard三角区骨密度分别为(0.76±0.16)、(0.49±0.10)及(0.38±0.19)g/cm2;生育次数≤1次者475例,分别为(0.85±0.15)、(0.57±0.10)及(0.52±0.11)g/cm2,两者各部位骨密度比较,差异均有统计学意义(P<0.05)。1472例妇女中,哺乳时间≥36个月者249例,腰椎、W ard三角区骨密度分别为(0.76±0.16)及(0.40±0.10)g/m2;哺乳时间≤6个月者418例分别为(0.83±0.17)及(0.48±0.12)g/m2,两者各部位骨密度比较,差异均有统计学意义(P<0.05)。结论月经初潮时间晚及绝经时间早的妇女,骨质疏松症的发生率高;生育次数多,哺乳时间长的妇女的骨密度低于生育次数少、哺乳时间短的妇女。     

Low levels of endogenous estradiol protect bone mineral density in young postmenopausal women.

OBJECTIVE: Low levels of endogenous estrogens may play a role in the protection of bone mineral density (BMD) in healthy postmenopausal women. The aim of this study was to evaluate the effect of endogenous estradiol and testosterone on bone mass in young and older healthy postmenopausal women. METHODS: The study involved 99 postmenopausal women aged 55-75 years. The BMDs of the lumbar spine, proximal femur and total skeleton were determined. Measurements were taken of serum calcium, bone alkaline phosphatase, Crosslaps, estradiol, estrone, sex hormone binding globulin, testosterone, bioavailable testosterone and urine calcium. Estradiol was measured using a sensitive assay with a lower detection limit at 5 pg/ml. RESULTS: A multivariate analysis showed that the BMD of the lumbar spine was significantly predicted by estradiol (p < 0.05), and testosterone (p < 0.0001). Likewise, testosterone was found to be an independent predictor of the BMD of the total femur (p < 0.001) and the total skeleton (p < 0.001). The population was divided into two groups: < or = 65 (Group 1) and > 65 years (Group 2) of age and also stratified according to estradiol levels: > 10 and < or = 10 pg/ml. Significant differences in BMD were found in women in Group 1 in whom estradiol levels higher than 10 pg/ml were associated with a higher BMD of the lumbar spine (+ 14%, p < 0.01), proximal femur (+ 6%, p < 0.05) and total skeleton (+ 7%, p < 0.05) compared with women with estradiol levels below 10 pg/ml. Bone alkaline phosphatase levels (p < 0.05) and serum Crosslaps (not significant) were lower in women in Group 1 with a level of estradiol more than 10 pg/ ml. CONCLUSION: Endogenous estradiol levels higher than 10 pg/ml and testosterone protected bone mass in healthy postmenopausal women under 65 years of age. These results were not observed in the group of older women.     

Postmenopausal women with osteoporosis may be associated with high endothelin-1

Aim. We aimed to find out if there was any difference of the endothelin-1 (ET-1) and asymmetric dimethylarginine (ADMA) levels between osteoporotic and non-osteoporotic healthy postmenopausal women and whether there were any associations between ET-1 and ADMA levels and bone mineral density (BMD).

Methods. A total of 75 healthy postmenopausal women were enrolled in the study. BMD was measured at lumbar spine (LS) and femur neck (FN). Serum ET-1 and ADMA levels were measured by ELISA. In this population, 41 (54%) women had BMD t-scores ≥ 2.5 at the LS and/or FN defined as osteoporosis and 34 (46%) of them had normal BMDs (non-osteoporotic group).

Results. The mean value of ET-1 serum level in patients was 0.42 ± 0.30, 0.28 ± 0.12 fmol/ml in osteoporotic and non-osteoporotic groups, respectively (p = 0.018). In non-osteoporotic group, there was an only significant positive correlation was found between BMD (g/cm²) and total t-scores at the lumbar region and ET-1 level. In osteoporotic group, no correlation was found between BMD and total t-scores and ET-1 levels. Serum ADMA level was not significantly different between osteoporotic and non-osteoporotic postmenopausal women (p > 0.05).

Conclusions. ET-1 may be a physiologic regulator in non-osteoporotic healthy postmenopausal women. Osteoporotic postmenopausal women had higher ET-1 levels than non-osteoporotic postmenopausal women. ADMA seems not to have effect on bone in postmenopausal women.     

绝经后女性同型半胱氨酸、脂质水平、CRP、NLR与骨质减少的关系

目的：探究绝经后女性同型半胱氨酸（HCY）、C反应蛋白（CRP）、中性粒细胞/淋巴细胞比值（NLR）、脂质水平与骨质减少的关系。方法：收集2013年1月—2014年12月于南京医科大学附属杭州医院妇科门诊就诊的绝经后女性患者269例,年龄45～60岁,均未应用绝经期激素治疗。骨密度采用双能X线吸收测定法（DXA）测量,根据测定结果将受试者分为骨质正常组（n=128）和骨质减少组（n=141）。HCY采用酶联免疫吸附法测定,CRP、脂质指标采用化学发光免疫分析法测定。结果：骨质减少组绝经时间及血清低密度脂蛋白（LDL）、CRP、HCY、NLR水平高于骨质正常组,绝经年龄低于骨质正常组,差异有统计学意义（均P＜0.05）。绝经年龄晚是骨质减少的保护因素,绝经时间长及血清LDL、CRP、HCY、NLR水平升高是骨质减少的危险因素,OR（95%CI）分别为0.755（0.623～0.914）,1.408（1.043~1.901）,1.038（1.018~1.058）,1.398（1.115~1.753）,3.534（2.355~5.303）和3.959（2.148~7.299）,差异有统计学意义（均P＜0.05）。结论：绝经年龄、绝经时间及血清LDL、CRP、HCY、NLR水平可作为绝经后女性骨质丢失的评价指标。     

Correlations of serum prolidase activity between bone turnover markers and mineral density in postmenopausal osteoporosis

Prolidase is a specific imidodipeptidase involved in collagen degradation. The increase in the enzyme activity is believed to be correlated with the increased intensity of collagen degradation. The aim of this study was to evaluate the serum prolidase activity and its relationship between bone turnover markers and bone mineral density (BMD) in postmenopausal osteoporosis. The study included 45 postmenopausal osteoporotic, 55 postmenopausal nonosteoporotic and 38 premenopausal healthy women. BMD was measured at the femoral neck and lumbar spine with DEXA. T score was more than 2.5 SD below the normal at the lumbar spine or femoral neck in postmenopausal osteoporotic patients. Serum levels of prolidase, C-terminal telopeptide of type I collagen (C-telopeptide), total alkaline phosphatase (ALP), osteocalcin (OC), urinary deoxypyridinoline (Dpd) and urinary creatinine were also assayed. C-telopeptide, total ALP, OC, urinary Dpd levels were significantly higher in postmenopausal osteoporotic group compared with premenopausal women. However, there was no statistical difference in serum prolidase activity between the three groups. There were also no significant correlations between serum prolidase and any biomarkers of bone turnover as well as BMD. To conclude, in postmenopausal osteoporotic women with increased bone turnover, serum prolidase concentration was not correlated with the biomarkers of bone formation or bone resorption and with BMD.     

Higher level of circulating estradiol is associated with lower frequency of cognitive impairment in Southeast China

Background: Estrogen has been proved to have positive effects on the brain cognitive function. However, many clinical studies investigating the associations between cognitive functions and circulating estrogen levels in perimenopausal and postmenopausal women demonstrated controversial results.

Method: Circulating estradiol and follicle stimulating hormone (FSH) levels were obtained from 199 perimenopausal and postmenopausal women (mean age: 49.61?years). The cognitive function has been assessed using the Beijing version of the Montreal Cognitive Assessment.

Results: Results revealed that higher estradiol levels were associated with better cognitive function (p?Conclusions: In perimenopausal and postmenopausal women, higher levels of circulating estradiol are associated with lower risk of cognitive impairment.     

Postmenopausal vaginal atrophy correlates with decreased estradiol and body mass index and does not depend on the time since menopause

Objective. To evaluate the relationship between morphologic cell characteristics in Papanicolaou (Pap) smears and serum estradiol, body mass index (BMI) and the time elapsed since menopause.

Study design. In 92 women Pap smears were grouped into atrophic and mature cell patterns and compared with estradiol, BMI and the time since menopause.

Results. Forty-one patients with mature cell pattern were on average 7.1 years from menopause and 51 patients with atrophic pattern 8.2 years, but this difference was not significant. Estradiol in patients with mature cell pattern was significantly higher (52.1 ± 48.5 pmol/l) than in patients with atrophic pattern (25.6 ± 40.0 pmol/l). Similarly, BMI was significantly higher (27.9 ± 4.2 kg/m²) in patients with mature cell pattern than in patients with atrophic pattern (25.7 ± 3.8 kg/m²). There was no significant correlation between the time since menopause and estradiol among patients with mature and atrophic cell pattern. The same was true for the correlation between the time from menopause and BMI in patients with mature and atrophic pattern.

Conclusions. Estradiol and BMI are associated with vaginal cell maturation and atrophy in postmenopausal women. Vaginal cell atrophy does not depend on the time since menopause.     

An evaluation of homocysteine,C-reactive protein,lipid levels,neutrophils to lymphocyte ratio in postmenopausal osteopenic women

Objective: In the present study, the risk coefficients of serum homocysteine (hcy), lipid levels, C-reactive protein (CRP), neutrophils to lymphocyte ratio (NLR) in postmenopausal osteopenic women were determined.

Methods: We enrolled 269 patients with postmenopausal women from Hangzhou No.1 Hospital gynecological clinic, who aged 45 to 60 years old and never received menopause hormone therapy. According to the bone mineral density determination results, subjects were divided into normal group (n = 128), osteopenia group (n = 141). Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA). Serum hcy, CRP and lipid indexes were determined by enzyme chemiluminescence immunoassay.

Results: The odds ratios (OR) and 95% confidence intervals (CI) of those variables (menopausal age, duration of menopause, LDL, CRP, hcy and NLR) were found significant (p < 0.05). Menopausal age, duration of menopause, LDL, CRP, hcy and NLR variables were found statistically significant in the analysis of receiver operating characteristic (ROCs).

Conclusion: The present study shows that menopause age, duration of menopause, serum LDL, CRP, hcy and NLR levels are risk factors for postmenopausal osteopenic women, which may be used as the indicators of bone loss in postmenopausal women.     

Effect of vitamin K2 treatment on carboxylation of osteocalcin in early postmenopausal women.

OBJECTIVE: We examined the serum level of undercarboxylated osteocalcin (uc OC), which is a sensitive marker of vitamin K status, and levels of bone turnover markers in early postmenopausal women receiving vitamin K2 treatment with or without vitamin D3. METHODS: Thirty-four postmenopausal women with a mean age of 53 years whose bone mineral density (BMD) was less than 0.809 g/cm2 (osteopenia and osteoporosis) were treated with vitamin K2 or with a combination of vitamin K2 and vitamin D3. Seventeen women received daily oral administration of 45 mg vitamin K2 and 17 women received daily oral administration of 45 mg vitamin K2 plus 0.75 microg 1alpha-hydroxyvitamin D3. Serum levels of uc OC, intact osteocalcin (OC) and bone alkaline phosphatase (BAP), urinary deoxypyridinoline (DPD) levels and BMD at the lumbar spine were measured before and at 1 and 2 years after the start of treatment. RESULTS: Serum uc OC levels in women treated with vitamin K2 alone and with both vitamin K2 and vitamin D3 decreased significantly (p < 0.05). Serum levels of intact OC and BAP in women treated with vitamin K2 did not show significant changes, while those in women who received the combined treatment decreased significantly (p < 0.05). On the other hand, urinary DPD level in women treated with vitamin K2 did not change, while that in women who received the combined treatment tended to decrease (p < 0.1). CONCLUSION: Serum uc OC levels in early postmenopausal women who received vitamin K2 decreased due to carboxylation of uc OC. Combined treatment with vitamin K2 and vitamin D3 may be effective for sustaining BMD in early postmenopausal women whose bone turnovers are highly activated.     

Genetic polymorphism of the calcitonin receptor gene and bone mineral density in Polish population of postmenopausal women

INTRODUCTION: In recent years the influence of genetic factors in the pathogenesis of osteopenia and osteoporosis was indicated. The investigations focused on the gene coding for calcitonin receptor. The goal of our analysis was to determine the genotype frequencies of AluI polymorphism of the calcitonin receptor gene (CTR) in the group of Polish postmenopausal women and its possible contribution to osteoporosis development. MATERIAL AND METHODS: 139 postmenopausal women with osteopenia (t-score value from -1.0 to -2.5) (mean age 58.5 +/- 5.9 years, mean age of menopause 49.8 +/- 3.9 years) have been investigated. AluI polymorphism of the CTR gene was determined using PCR/RFLP assay. We have analysed 3 subgroups: CC, CT, and TT. In each subgroup mean weight, height, body mass index (BMI), mean age of menopause and years since menopause (YSM) and parameters of bone turnover: bone mineral density (BMD), t-score, index: young adults (YA) and--age matched (AM) have been analysed. Additionally the group of 138 selected women (mean age 26.5 +/- 4.3 years) as general population has been analysed. RESULTS: In investigated group the frequency of all 3 genotypes was determined as follows: CC: CT : TT = 8.6 : 45.3 : 46.1. Analysing BMD in particular subgroups the higher value for the CT genotype (0.967 +/- 0.161 g/cm2) was found. Similarly t-score (-1.94), YA (80.6%) and AM (90.8%) index were higher in CT genotype carriers. CONCLUSION: Our results suggest possible connection of the AluI polymorphism of the CTR gene with osteopenia and osteoporosis development. To confirm this tendency further investigations in the large number population are necessary.