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1.
C. Nagata H. Shimizu R. Takami M. Hayashi N. Takeda K. Yasuda 《Osteoporosis international》2002,13(3):200-204
To evaluate soy intake and serum concentrations of estradiol and isoflavonoids and their relationship to bone mineral density
(BMD) and serum bone-specific alkaline phosphatase (bone ALP) activity, we conducted a cross-sectional study of 87 postmenopausal
Japanese women. Soy product and isoflavone intake from soy products and intake of nutrients were assessed with a semiquantitative
food-frequency questionnaire. BMD (mg/cm2) was measured by single-energy X-ray absorptiometry at the site of the calcaneus. Serum estradiol (E2) and the sex hormone-binding globulin (SHBG) were measured by radioimmunoassay. Serum genistein and daidzein concentrations
were measured by a high-performance liquid chromatography MS/MS method. A statistically significant correlation was observed
between the ratio of E2 to SHBG and BMD (Spearman r = 0.38, p = 0.0003) after controlling for age, body mass index, smoking status, age at menarche, and intake of vegetable fat, vitamin
C and salt. Soy product and isoflavone intake and serum isoflavones were not significantly correlated with BMD after controlling
for the covariates. Serum ALP was not significantly correlated with soy product and isoflavone intake, the E2/SHBG ratio or serum isoflavones. The present study supports the association of BMD with serum estradiol; however, it does
not support the association of BMD with soy or isoflavone intake or serum isoflavone levels.
Received: 13 August 2001 / Accepted: 30 October 2001 相似文献
2.
Determinants of Bone Mineral Density and Spinal Fracture Risk in Postmenopausal Japanese Women 总被引:6,自引:0,他引:6
D. Nakaoka T. Sugimoto H. Kaji M. Kanzawa S. Yano M. Yamauchi T. Sugishita K. Chihara 《Osteoporosis international》2001,12(7):548-554
The present study analyzed the factors that determine bone mineral density (BMD) and predict spinal fracture risk in postmenopausal
Japanese women. Two hundred and five postmenopausal Japanese women aged 48–84 years (mean age 64 years) were enrolled in the
cross-sectional study. BMD of the lumbar spine, femoral neck and total body as well as body composition were measured by dual-energy
X-ray absorptiometry (DXA). Mid-radial BMD was measured by single-photon absorptiometry. We also determined serum levels of
insulin-like growth factor (IGF)-I, IGF binding protein-2, -3 and osteocalcin as well as urinary levels of pyridinoline (Pyr),
deoxy-Pyr (D-Pyr) and growth hormone. Multiple regression analysis revealed that lean body mass (LBM) was positively correlated
with BMD at all sites. In contrast, femoral neck BMD was highly related to fat mass as well as LBM, although fat mass was
not an independent correlate of total body and mid-radial BMD. LBM and urinary D-Pyr were crucial determinants at all sites
except the mid-radius in stepwise regression analysis. Fat mass and serum IGF-I were determinants of femoral neck and mid-radial
BMD, respectively. In terms of reproductive history, parity affected lumbar BMD. Factors affecting BMD differed according
to the site. On the other hand, lumbar BMD as well as serum levels of IGF-I and albumin were selected as predictors of spinal
fracture risk in multiple logistic regression analysis. Lumbar BMD, serum IGF-I and LBM were selected in women with lumbar
BMD above 0.727 g/cm2. In conclusion, the present study indicates that LBM is a more important determinant of BMD than fat mass at any site except
the femoral neck. Age, serum IGF-I and urinary D-Pyr were also determinants of BMD, dependent on the regions measured. Lumbar
BMD and LBM as well as serum levels of IGF-I and albumin were useful markers which predicted the risk of osteoporotic spinal
fractures in postmenopausal Japanese women.
Received: 6 June 2000 / Accepted: 11 January 2001 相似文献
3.
K. Brooke-Wavell P. R. M. Jones A. E. Hardman I. Tsuritani Y. Yamada 《Osteoporosis international》2001,12(7):581-587
Regular walking is associated with reduced risk of fracture and, in our recent randomized trial, reduced calcaneal bone loss
relative to controls. The present follow-up study compared the effects on dual-energy X-ray absorptiometry, ultrasound and
biochemical indices of bone density and metabolism of (i) taking up (ii) continuing with and (iii) ceasing brisk walking for
exercise. Subjects were 68 postmenopausal women aged 60–70 years. Twenty previously sedentary women remained sedentary (Sed/Sed)
whilst 17 took up brisk walking (Sed/Walk). Fifteen women who had been walking regularly for 1 year returned to their former
sedentary lifestyle (Walk/Sed), whilst 16 continued brisk walking over a second year (Walk/Walk). Bone mineral density (BMD),
broadband ultrasonic attenuation (BUA), and biochemical markers of bone formation (serum osteocalcin, C-terminal propeptide
of type I collagen and bone alkaline phosphatase) and resorption (urinary deoxypyridinoline) were assessed at baseline and
12 months. Women in the Sed/Walk and Walk/Walk groups completed a mean (SEM) of 16.9 (0.7) and 20.8 (1.2) min of brisk walking
per day, respectively. Changes in BMD did not differ significantly between groups. Calcaneal BMD decreased significantly in
Walk/Sed women [by 2.7 (1.4)%; p= 0.01] whilst changes in other groups were not significant. Calcaneal BUA increased significantly (p= 0.02) in Sed/Walk women [by 7.4 (3.3)%] relative to other groups. Urinary deoxypyridinoline increased over the year in the
Sed/Sed group but there were no significant changes in biochemical markers in other groups. Women taking up brisk walking
for exercise showed no change in BMD but a significant increase in calcaneal BUA. There was no significant effect on BMD or
BUA of continuing brisk walking but calcaneal BMD declined on ceasing brisk walking. Bone resorption increased in sedentary
women but not exercisers, suggesting the effect on exercise on bone in postmenopausal women could be through amelioration
of this increased turnover.
Received: 12 September 2000 / Accepted: 13 February 2001 相似文献
4.
S. Störk C. Störk P. Angerer W. Kothny P. Schmitt U. Wehr C. von Schacky W. Rambeck 《Osteoporosis international》2000,11(9):790-796
Accelerated bone remodeling after the menopause is associated with increased bone loss that can be abolished using hormone
replacement therapy (HRT). Biochemical markers of bone metabolism are known to correlate closely with changes in bone histomorphometry
and osteodensitometry. Bone sialoprotein (BSP), a major constituent of bone matrix, is almost exclusively found in mineralized
tissues and therefore considered a potential marker of bone metabolism. In 82 postmenopausal women, randomly allocated to
either low-dose sequential HRT or no HRT, serum BSP was measured and compared with established specific biochemical markers
of bone resorption [urinary deoxypyridinoline (DPD), pyridinoline (PYD) and amino-terminal telopeptide (NTx)] and markers
of bone formation [serum osteocalcin (Oc) and bone-specific alkaline phosphatase (bALP)]. Longitudinal analysis showed a marked
response of BSP levels following commencement of HRT, resulting in a 52% reduction after 12 months compared with initial values.
The changes of BSP levels over time were at least as strong as in conventional markers of bone formation and resorption and
paralleled their changes. A moderate to close correlation was found between BSP and both markers of bone resorption (r= 0.57 for NTx; r= 0.38 for DPD) and formation (r= 0.55 for Oc; r= 0.39 for bALP; p<0.0001, respectively). Our data demonstrate a cause and effect relationship between commencement of HRT and a change in serum
BSP. In conclusion, serum BSP circumvents some of the limitations of urinary measurements and appears valuable for the quantitative
monitoring of the skeletal response to HRT in healthy postmenopausal women.
Received: 5 October 1999 / Accepted: 30 March 2000 相似文献
5.
Alendronate significantly increases bone mass and reduces hip and spine fractures in postmenopausal women. To determine whether
forearm densitometry could be used to monitor the efficacy of alendronate, we examined changes in bone mineral density (BMD)
at the forearm (one-third distal, mid-distal, ultradistal radius) versus changes at the hip (femoral neck, total hip) and
spine (posteroanterior and lateral) in a double-masked, randomized, placebo-controlled clinical trial of 120 elderly women
(mean age 70 ± 4 years) treated with alendronate for 2.5 years. We found that among women in the treatment group, BMD increased
by 4.0–12.2% at the hip and spine sites (all p<0.001), whereas BMD increased only nominally at the one-third distal radius (1.3%, p<0.001) and mid-radius (0.8%, p<0.05), and remained stable at the ultradistal radius. At baseline, forearm BMD correlated with that of the hip (r= 0.55–0.64, p<0.001), femoral neck (r= 0.54–0.61, p<0.001) and posteroanterior spine (r= 0.56–0.63, p<0.001). Changes in radial BMD after 1 year of therapy were not correlated with changes in hip and spine BMD after 2.5 years
of therapy. In contrast, short-term changes in total hip and spine BMD were generally positively associated with long-term
changes in total hip, femoral neck and spine BMD (r= 0.30–0.71, p<0.05). Furthermore, long-term BMD changes at the forearm did not correlate with long-term hip and spine BMD changes, in contrast
to the moderate correlations seen between spine and hip BMD at 2.5 years (r= 0.38–0.45, p<0.01). We conclude that neither short- nor long-term changes in forearm BMD predict long-term changes in overall BMD for
elderly women on alendronate therapy, suggesting that measurements of clinically relevant central sites (hip and spine) are
necessary to assess therapeutic efficacy.
Received: 18 February 1999 / Accepted: 20 May 1999 相似文献
6.
Influence of Grip Strength on Metacarpal Bone Mineral Density in Postmenopausal Japanese Women: A Cross-Sectional Study 总被引:5,自引:0,他引:5
Osei-Hyiaman D Ueji M Toyokawa S Takahashi H Kano K 《Calcified tissue international》1999,64(3):263-266
Most published studies on the role of muscle strength in the maintenance of bone mineral density (BMD) focused on the relationship
between specific muscle groups and adjacent bones, mostly in young and premenopausal women. This study examined the influence
of grip strength on BMD of the metacarpal index in postmenopausal Japanese women. Subjects included 1168 postmenopausal women
aged 40–70 years. BMD measurement was done with computed X-ray densitometry (CXD) by analyzing X-ray films of the right second
metacarpal index. Grip strength was measured in both the dominant and nondominant hands using a squeeze dynamometer. Grip
strength (r = 0.2474; P= 0.0001) and age (r =−0.5443; P= 0.0001) significantly correlated positively and negatively, respectively, with BMD. Physical activity (r = 0.1318; P= 0.0001) also correlated positively with BMD. Breastfeeding (r =−0.1658; P= 0.0001), however, correlated negatively with BMD. Subjects with a history of regular physical activity had higher grip strengths
and BMD, than those with no physical activity. Adjustment for age, physical activity, calcium intake, BMI, breastfeeding,
testing site, and menopausal type indicated a significant (P for trend = 0.0013) positive association of grip strength with BMD. Subjects with stronger grip strengths had a decreased
risk for low BMD.
Received: 24 February 1998 / Accepted: 7 August 1998 相似文献
7.
Bone Mineral Density in French Canadian Women 总被引:3,自引:0,他引:3
C. Blanchet S. Dodin M. Dumont Y. Giguère L. Turcot-Lemay J. Beauchamp D. Prud'homme 《Osteoporosis international》1998,8(3):268-273
This cross-sectional study investigated bone mineral density (BMD) at the lumbar spine (L2–4) and femoral neck in French
Canadian women residing in the Quebec city area. Data collection was initiated in 1988 and completed in 1994. A total of 747
French Canadian Caucasian women (16–79 years of age) with no metabolic bone disease were evaluated. BMD measurements were
obtained using dual-photon absorptiometry (DPA) or dual-energy X-ray absorptiometry (DXA). Anthropometric measures such as
weight, height and body mass index (BMI) were recorded. Medical files provided information on demographic characteristics,
hormonal profile and lifestyle habits. Results show a curvilinear trend of BMD with aging. Furthermore, the peak BMD at the
lumbar spine (L2–4) was reached at 29 years followed by a stable phase until 35 years, after which BMD started to decrease.
The pattern of bone evolution at the femoral neck was different, peak BMD being achieved earlier, at 21 years, while after
age 26 years a significant decrease was already observed. Women older than 60 years showed the lowest BMD. Regression analysis
showed that age, weight and height are determinants of BMD at the lumbar spine and explained 33.9% of inter-individual variation.
At the femoral neck, 29.1% of variation was explained by age and height only. In conclusion, our data suggest that French
Canadian women have a different pattern of bone loss at the femoral neck compared with the lumbar spine, according to their
mean BMD values.
Received: 21 July 1997 / Accepted: 15 October 1997 相似文献
8.
Long-Term Effects of Continuous Combined HRT on Bone Turnover and Lipid Metabolism in Postmenopausal Women 总被引:1,自引:0,他引:1
D. M. Hart E. Farish C. D. Fletcher J. F. Barnes H. Hart D. Nolan K. Spowart 《Osteoporosis international》1998,8(4):326-332
This study was undertaken to investigate the effect of 10 years of hormone replacement therapy (HRT) on bone turnover and
lipid metabolism in postmenopausal women. The single-centre trial was initiated as a 1-year, double-masked, randomized, parallel-group
study of continuous combined HRT with 2 mg 17b-estradiol and 1 mg norethisterone acetate administered once daily with or without
1 mg estriol. Following preliminary results which showed no difference between the addition and omission of estriol, patients
continued on an open-label extension phase of continuous combined HRT without estriol for a further 9 years. Of the 52 women
who entered the original double-masked study, 32 entered the open-label extension phase. The 10-year analysis was based on
27 patients. Major increases in bone mineral density (BMD) of the lumbar spine were seen during the first 3 years of treatment,
remaining statistically significant compared with baseline at all visits throughout the 10-year follow-up (p40.025). Statistical modelling confirmed that there were no decreases in BMD after these initial increases. BMD remained 5.5%
higher than baseline values after 10 years of continuous combined HRT. Mean total cholesterol levels were significantly reduced
after 10 years of therapy (p= 0.012), with no significant changes in serum triglyceride and low-density lipoprotein (LDL)-cholesterol levels from baseline
values at this time. High-density lipoprotein (HDL)-cholesterol levels, however, were reduced by 15.4% (p50.001). In conclusion, 10 years of continuous combined HRT resulted in a significant and sustained increase in BMD. This
treatment regimen therefore appears to be well suited for the long-term prevention of osteoporosis in postmenopausal women.
Received: 1 July 1997 / Accepted: 15 December 1997 相似文献
9.
F. Scopacasa M. Horowitz A. G. Need H. A. Morris B. E. C. Nordin 《Osteoporosis international》1999,9(6):494-498
Norethisterone 2.5 mg/day was administered to 26 postmenopausal women (aged 54–79 years) with varying degrees of osteoporosis
and with a forearm bone mineral density value more than 2 SD below the young normal mean. Fasting blood and urine samples
were collected and radiocalcium absorption measured at baseline and after treatment for a median period of 4 months. There
were significant falls in serum calcium and its fractions, phosphate, alkaline phosphatase and cholesterol (HDL and LDL),
and significant rises in serum chloride and parathyroid hormone. In the urine, there were significant falls in calcium, sodium
and hydroxyproline. These changes were in close agreement with our previously reported responses to norethisterone 5 mg/day.
We conclude that norethisterone in a dose of 2.5 mg/day is probably as effective as 5 mg/day in reducing bone resorption in
postmenopausal women with low bone density.
Received: 8 June 1998 / Accepted: 23 September 1998 相似文献
10.
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
11.
S. Vedi D. W. Purdie P. Ballard S. Bord A. C. Cooper J. E. Compston 《Osteoporosis international》1999,10(1):52-58
Conventional hormone replacement therapy preserves bone mass predominantly by reducing bone turnover but does not exert significant
anabolic skeletal effects. In contrast, high doses of estrogen have been shown to increase bone formation in animals and we
have recently reported high bone mineral density values in women treated long-term with estradiol implant therapy. The aim
of this study was to investigate the mechanisms by which high doses of estrogen may increase bone mass in postmenopausal women.
Iliac crest biopsies were obtained from 12 women who had received long-term treatment with estradiol implants (at least 14
years), on demand, following hysterectomy and bilateral salpingo-oophorectomy. Indices of bone turnover, remodeling balance
and cancellous bone structure were assessed by image analysis and compared with those of premenopausal women. Mean wall width
was significantly higher in women treated with estradiol therapy than in premenopausal women (44.8 ± 4.8 vs 38.8 ± 2.8 mm;
mean ± SD; p = 0.001) and eroded cavity area was significantly lower in the implant-treated women (3612 ± 956 vs 5418 ± 1404 mm2; p = 0.001). Bone formation rate at tissue level and activation frequency were lower in the women treated with implants, although
the differences were not statistically significant. Indices of cancellous bone structure were generally similar between the
two groups. These results provide the first direct evidence that high-dose estrogen therapy produces anabolic skeletal effects
in postmenopausal women and indicate that these are achieved by stimulation of osteoblastic activity.
Received: 18 August 1998 / Accepted: 9 December 1998 相似文献
12.
Geographic Differences in Bone Mineral Density of Mexican Women 总被引:11,自引:2,他引:11
M. Delezé F. Cons-Molina A. R. Villa J. Morales-Torres J. G. Gonzalez-Gonzalez J. J. Calva A. Murillo A. Briceño J. Orozco G. Morales-Franco H. Peña-Rios G. Guerrero-Yeo E. Aguirre J. Elizondo 《Osteoporosis international》2000,11(7):562-569
The aim of this study was to generate standard curves for normal spinal and femoral neck bone mineral density (BMD) in Mexican
women using dual-energy X-ray absorptiometry (DXA), to analyze geographic differences and to compare these with “Hispanic”
reference data to determine its applicability. This was a cross-sectional study of 4460 urban, clinically normal, Mexican
women, aged 20–90 years, from 10 different cities in Mexico (5 in the north, 4 in the center and 1 in the southeast) with
densitometry centers. Women with suspected medical conditions or who had used drugs affecting bone metabolism, were excluded.
Lumbar spine BMD was significantly higher (1.089 ± 0.18 g/cm2) in women from the northern part of Mexico, with intermediate values in the center (1.065 ± 0.17 g/cm2) and lower values (1.013 ± 0.19 g/cm2) in the southeast (p<0.0001). Similarly, femoral neck BMD was significantly higher in women from the north (0.895 ± 0.14 g/cm2), intermediate in the center (0.864 ± 0.14 g/cm2) and lower (0.844 ± 0.14 g/cm2) in the southeast part of Mexico (p<0.0001). Northern Mexican women tend to be taller and heavier than women from the center and, even more, than those from
the southeast of Mexico (p<0.0001). However, these differences in BMD remained significant after adjustment for weight (p<0.0001). A significant loss (p<0.0001) in BMD was observed from 40 to 69 years of age at the lumbar spine and up to the eighth decade at the femoral neck.
Higher and lower lumbar spine values, as compared with the “Hispanic” population, were observed in Mexican mestizo women from
the northern and southeastern regions, respectively. In conclusion, there are geographic differences in weight and height
of Mexican women, and in BMD despite adjustment for weight.
Received: 1 September 1999 / Accepted: 20 October 1999 相似文献
13.
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
14.
Performance of COLIA1 Polymorphism and Bone Turnover Markers to Identify Postmenopausal Women with Prevalent Vertebral Fractures 总被引:3,自引:0,他引:3
P. Mezquita-Raya M. Muñoz-Torres J. de Dios Luna F. Lopez-Rodriguez J. M. Quesada F. Luque-Recio F. Escobar-Jiménez 《Osteoporosis international》2002,13(6):506-512
Some studies have suggested that bone turnover markers (BTM) and collagen type I alpha 1 gene (COLIA1) may be useful in the
prediction of rates of future bone loss, and may therefore provide information about fracture risk. Our study aimed to examine
the association of the COLIA1 genotype with the risk of vertebral fracture and to investigate the predictive value of this
genetic factor in comparison with bone mineral density (BMD) and BTM, in ambulatory postmenopausal Spanish women. We determined
the COLIA1 polymorphism by polymerase chain reaction, BMD by dual-energy X-ray absorptiometry and BTM in 43 postmenopausal
women with prevalent vertebral fracture and a control group of 101 postmenopausal women without fracture. There was a significant
overrepresentation of the ‘T’ allele in fractured women (p= 0.029). BTM exhibited no differences between women with or without fractures or COLIA1 genotype groups. After adjusting
for all other variables, the osteoporosis densitometric criteria variable was the most strongly associated with fracture (OR
= 5 [1.8–13.3]) followed by COLIA1 (OR = 2.1 [1–4.3] per copy of the ‘T’ allele). Our study shows that COLIA1 is associated
with prevalent vertebral fracture independently of bone mass, and the performance of this genetic factor to assess prevalent
vertebral fracture is better than bone turnover markers.
Received: 29 June 2001 / Accepted: 11 December 2001 相似文献
15.
Birth Weight as a Predictor of Adult Bone Mass in Postmenopausal Women: The Rancho Bernardo Study 总被引:3,自引:0,他引:3
D. E. Yarbrough Elizabeth Barrett-Connor D. J. Morton 《Osteoporosis international》2000,11(7):626-630
Understanding the determinants of adult bone mass may help to identify women for prevention of osteoporosis. We postulated
that birth weight would predict low adult bone mass in old age. Subjects were 305 postmenopausal Caucasian women (mean age
70 years). Bone mineral content (BMC) and bone mineral density (BMD) were measured at the wrist, forearm, hip and lumbar spine.
Birth weight was assessed by self-report. Birth weight was positively correlated with BMC at the forearm (r= 0.15), hip (r= 0.12) and lumbar spine (r= 0.18), and the age-adjusted mean BMC increased significantly from the lowest to the highest birth weight tertile. Adjusting
for adult weight diminished this association at the forearm and hip, but not at the spine. Adjustment for multiple other covariates,
including height, did not materially change these associations. Adult weight and height were significantly correlated with
birth weight (r= 0.19 and r= 0.24, respectively). Birth weight was not independently correlated with BMD. Birth weight was thus positively correlated
with adult weight and BMC 70 years later. These findings suggest that low birth weight may be a marker for future low bone
mass and that different mechanisms exist for establishing the adult bone envelope (estimated by BMC) versus its density (estimated
by BMD).
Received: 18 August 1999 / Accepted: 21 January 2000 相似文献
16.
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
17.
N. B. Watts D. K. Jenkins J. M. Visor D. C. Casal P. Geusens 《Osteoporosis international》2001,12(4):279-288
Alendronate therapy in osteoporotic women decreases bone turnover and increases bone mineral density (BMD). Optimal patient
management should include verification that each patient is responding to therapy. Markers of bone turnover and BMD have both
been proposed for this purpose. We have investigated changes resulting from alendronate therapy with an enzyme immunoassay
for bone alkaline phosphatase (BAP) and compared it with total alkaline phosphatase (TAP) and BMD of the lumbar spine, hip,
and total body. Subjects were drawn from a multicenter randomized, placebo-controlled trial of alendronate in postmenopausal
women with osteoporosis. BAP and TAP levels were measured at baseline and following 3, 6 and 12 months of therapy with either
placebo (n= 180) or alendronate 10 mg/day (n= 134). All subjects also received 500 mg/day supplemental calcium. BMD was measured at baseline and following 3, 6, 12, 18,
24 and 36 months of therapy. To compare BAP, TAP and BMD at each site for identifying women that experienced a skeletal effect
of alendronate, we calculated least significant change (LSC) values from the long-term intraindividual variability in each
placebo-treated woman. Median levels of BAP decreased by 34%, 44% and 43% at 3, 6 and 12 months, respectively, in alendronate-treated
women (p<0.0001 compared with baseline and with placebo). These changes were significantly greater (p<0.0001) than changes observed for TAP. Following 6 months of alendronate therapy, 90% of the women had experienced a decrease
in BAP exceeding the LSC compared with only 71% for TAP. The greatest number of women similarly identified with BMD at any
site (i.e. a gain in BMD exceeding the LSC) was 81% for spinal BMD at 36 months. All other sites were less than 70% at 36
months. Short-term changes in BAP and TAP were modestly associated with subsequent changes in BMD at all sites (Spearman’s
rho −0.22 to −0.52, p<0.05). Compared with TAP and BMD, BAP testing rapidly and sensitively identified skeletal effects of alendronate thus enabling
appropriate drug monitoring of osteoporotic women. Though BAP and TAP changes were modestly predictive of BMD changes, the
value of the bone marker tests is their ability to detect rapidly a skeletal effect of therapy.
Received: 19 May 2000 / Accepted: 31 October 2000 相似文献
18.
An Assessment Tool for Predicting Fracture Risk in Postmenopausal Women 总被引:21,自引:14,他引:7
D. M. Black M. Steinbuch L. Palermo P. Dargent-Molina R. Lindsay M. S. Hoseyni O. Johnell 《Osteoporosis international》2001,12(7):519-528
Due to the magnitude of the morbidity and mortality associated with untreated osteoporosis, it is essential that high-risk
individuals be identified so that they can receive appropriate evaluation and treatment. The objective of this investigation
was to develop a simple clinical assessment tool based on a small number of risk factors that could be used by women or their
clinicians to assess their risk of fractures. Using data from the Study of Osteoporotic Fractures (SOF), a total of 7782 women
age 65 years and older with bone mineral density (BMD) measurements and baseline risk factors were included in the analysis.
A model with and without BMD T-scores was developed by identifying variables that could be easily assessed in either clinical practice or by self-administration.
The assessment tool, called the FRACTURE Index, is comprised of a set of seven variables that include age, BMD T-score, fracture after age 50 years, maternal hip fracture after age 50, weight less than or equal to 125 pounds (57 kg),
smoking status, and use of arms to stand up from a chair. The FRACTURE Index was shown to be predictive of hip fracture, as
well as vertebral and nonvertebral fractures. In addition, this index was validated using the EPIDOS fracture study. The FRACTURE
Index can be used either with or without BMD testing by older postmenopausal women or their clinicians to assess the 5-year
risk of hip and other osteoporotic fractures, and could be useful in helping to determine the need for further evaluation
and treatment of these women.
Received: 7 November 2000 / Accepted: 23 May 2001 相似文献
19.
Inhibition of Bone Resorption by Divided-Dose Calcium Supplementation in Early Postmenopausal Women 总被引:3,自引:0,他引:3
Scopacasa F Need AG Horowitz M Wishart JM Morris HA Nordin BE 《Calcified tissue international》2000,67(6):440-442
We have previously shown that a calcium (Ca) supplement of 1000 mg given in the evening reduces the overnight and early morning,
but not the daytime, excretion of bone resorption markers in postmenopausal women within five years of the menopause. In the
present study, we have looked at the effect of splitting the Ca into two doses of 500 mg each given in the morning and evening.
We studied 19 healthy women (median age 53 years) who were all within 5 years of the menopause. On the 2 study days, urine
was collected from 9 a.m. to 9 p.m. (day collection), and from 9 p.m. to 9 a.m. (night collection); a further fasting (spot)
urine sample was obtained at 9 a.m. at the end of the night collection. The first day was a control day; on the second day
the subjects ingested 500 mg Ca as the carbonate at 9 a.m. and 9 p.m. We measured pyridinoline cross-links excretion in all
the samples, as well as hydroxyproline in the fasting urine. The Ca supplements lowered urinary excretion of the markers during
the day (P < 0.01), had only a marginal effect during the night, but reduced excretion significantly in the fasting urine (P < 0.001). In the whole 24-hour period, the falls in resorption markers were small but comparable to those seen after the
ingestion of 1 g of Ca in the evening. We conclude that the acute administration of 0.5 g Ca in the morning and evening reduced
the markers of bone resorption in early postmenopausal women during the day but not during the following night, whereas the
single 1 g supplement had the reverse effect. Over the 24-hour period, there was nothing to choose between the two regimes.
Women at this stage in their life cycle probably require a larger Ca supplement if they are not taking estrogen.
Received: 5 April 2000 / Accepted: 27 July 2000 / Online publication: 2 November 2000 相似文献
20.
Randomized Trial of the Effects of Risedronate on Vertebral Fractures in Women with Established Postmenopausal Osteoporosis 总被引:21,自引:0,他引:21
J.-Y. Reginster H. W. Minne O. H. Sorensen M. Hooper C. Roux M. L. Brandi B. Lund D. Ethgen S. Pack I. Roumagnac R. Eastell 《Osteoporosis international》2000,11(1):83-91
The purpose of this randomized, double-masked, placebo-controlled study was to determine the efficacy and safety of risedronate
in the prevention of vertebral fractures in postmenopausal women with established osteoporosis. The study was conducted at
80 study centers in Europe and Australia. Postmenopausal women (n= 1226) with two or more prevalent vertebral fractures received risedronate 2.5 or 5 mg/day or placebo; all subjects also
received elemental calcium 1000 mg/day, and up to 500 IU/day vitamin D if baseline levels were low. The study duration was
3 years; however, the 2.5 mg group was discontinued by protocol amendment after 2 years. Lateral spinal radiographs were taken
annually for assessment of vertebral fractures, and bone mineral density was measured by dual-energy X-ray absorptiometry
at 6-month intervals. Risedronate 5 mg reduced the risk of new vertebral fractures by 49% over 3 years compared with control
(p<0.001). A significant reduction of 61% was seen within the first year (p= 0.001). The fracture reduction with risedronate 2.5 mg was similar to that in the 5 mg group over 2 years. The risk of nonvertebral
fractures was reduced by 33% compared with control over 3 years (p= 0.06). Risedronate significantly increased bone mineral density at the spine and hip within 6 months. The adverse-event
profile of risedronate, including gastrointestinal adverse events, was similar to that of control. Risedronate 5 mg provides
effective and well-tolerated therapy for severe postmenopausal osteoporosis, reducing the incidence of vertebral fractures
and improving bone density in women with established disease.
Received: 29 September 1999 / Accepted: 10 November 1999 相似文献