利塞膦酸钠对绝经后骨质疏松症妇女血清BALP和尿HOP的影响

目的 用利塞膦酸钠治疗绝经后骨质疏松妇女6个月，观察其对骨密度（BMD）、血清骨特并性碱性磷酸酶、尿羟脯氨酸的影响。方法 将46例绝经后骨质疏松妇女每日早饭前半小时服用5mg利塞膦酸钠和凯思力D1片，疗程6个月；另选25名健康的绝经女性作为对照组。治疗前后分别用美国DPX双能X线骨密度仪测骨密度，免疫渗滤和全血干化学技术测定骨特异性碱性磷酸酶，化学比色法测尿羟脯氨酸；同时观察骨痛、骨折及胃肠道等副反应情况。结果 利塞膦酸钠治疗后腰椎2～4、股骨颈BMD值显著升高，Wards三角区BMD呈增加趋势；血清骨特异性碱性磷酸酶及尿羟脯氨酸明显下降；与治疗前相比，利塞膦酸钠治疗后还可缓解骨质疏松引起的腰背痛等症状，增加关节活动度。结论 利塞膦酸钠可提高预绝经后骨质疏松妇女骨密度，降低血清骨特异性碱性磷酸酶及尿羟脯氨酸。     

绝经前后妇女骨代谢状况的改变

本文通过对168名妇女的空腹尿钙/肌酐、尿羟脯氨酸/肌酐及141名妇女的血碱性磷酸酶测定结果的分析,评价了绝经前后妇女骨代谢变化的状况。结果表明:妇女绝经后较绝经前、50岁后较50岁前其骨吸收和骨形成都显著增快;骨吸收速度上升后无下降趋势,骨形成速度的上升持续约20年后略有下降;骨吸收和骨形成速度的增快呈相关性。     

老年人尿钙氟锰镁和羟脯氨酸与骨密度的关系

目的　探讨影响老年人骨密度的因素及防治老年骨质疏松的措施。方法　采用整群抽样方法对两所高等院校 2 86例 5 0岁以上老人进行骨密度及尿钙、氟、锰、镁 ,羟脯氨酸调查研究。结果　本研究表明女性骨矿物质含量和骨矿物质密度显著低于男性 (P <0 .0 1) ,女性尿钙含量明显高于男性 (P <0 .0 5 ) ,女性尿羟脯氨酸含量明显低于男性 (P <0 .0 1) ,而尿氟含量差别不明显。尿钙、锰、羟脯氨酸与骨矿物含量和骨密度呈现显著性负相关 ,尿氟与尺骨骨矿物含量和骨密度呈现显著性正相关 (P <0 .0 5或P <0 .0 1)。结论　提示尿钙、氟、锰、羟脯氨酸均可影响骨代谢。     

维甲酸对大白鼠骨代谢影响的实验研究

目的 :探讨用维甲酸建立骨质疏松模型时 ,维甲酸影响骨代谢的作用机理。方法 :大剂量维甲酸灌胃两周后 ,造成大白鼠骨质疏松症模型 ,检测分析多个相关指标。观察大鼠体重 ,骨骼湿重、比重、去脂干重、灰重、抗弯载荷以及子宫、胸腺、脾脏重量的变化 ;测定骨钙、骨磷、尿钙、尿羟脯氨酸及血中钙、磷、碱性磷酸酶、雌二醇含量 ;镜下观察骨骼形态结构改变。结果 :维甲酸能降低骨钙、磷及骨矿含量 ;破坏松质骨结构 ,影响骨骼负重功能 ,降低骨骼抗折能力 ,增加骨折危险度 ;使骨生成减少 ,骨吸收增加 ;影响免疫功能等。结论 :维甲酸能影响骨代谢 ,进而导致骨质疏松症。     

强骨宝2号激素性骨质疏松大鼠血和尿生化指标影响的实验研究

为探索强骨宝2号对激素性骨质疏松大鼠骨代谢相关血尿生化指标指标的影响。将42只3月龄雄性SD大鼠进行分组及醋酸泼尼松造模，于第8周和第13周取大鼠血尿标本，测定血清钙、磷、碱性磷酸酶和尿钙，磷及羟脯氨酸。结果显示在实验第8周第13周，模型组的尿钙、磷及羟脯氨酸显著高于空白组，而预防组的各项指标与空白无明显差异。结果说明强骨宝2号有预防糖皮质激素致骨代谢紊乱的作用。     

尿脱氧吡啶酚是新的骨吸收生化指标

<正>1 前言 骨在整个生命过程中都具有新陈代谢的活性。骨形成、骨吸收和静止三个阶段构成骨再建的全过程。随着对骨转换的深入理解,人们对骨代谢生化指标的灵敏度和特异性提出了更高的要求。与骨形成有关的标志物主要有血清碱性磷酸酶、骨碱性磷酸酶、骨钙素和Ⅰ型前胶原羧基端展开肽。与骨吸收有关的标志物主要有血清或血浆抗酒石酸盐酸性磷酸酶、Ⅰ型胶原交联羧基末端肽、尿羟赖氨酸糖甙、羟脯氨酸肽、Ⅰ型胶原交联氨基末端肽、胶原吡啶交联和钙等。以往常用尿钙和尿羟脯氨酸评价骨吸收水平,因为它们特异性和敏感性低,不能反映绝经前后出现的骨吸收增加现象,应用受到限制。     

绝经妇女骨质丧失与雌激素水平的关系

对76例绝境前后妇女进行了血清性激素水平、血清碱性磷酸酶(ALP)、空腹尿钙/肌酐(Ca/Cr)、羟脯氨酸/肌酐(Hyp/ Cr)比值及桡骨骨矿含量(BMC)测定.结果 绝经妇女血清ALP、空腹Ca/Cr比值显著高于为绝经妇女,及绝经后骨质生成及吸收增强,其中以骨吸收为主.从绝经妇女中随机选出14例,给予口服觉雌醇每日5ug,观察1个月,血清ALP、空腹尿/Ca/Cr及Hyp/Cr比值显著降低,其中以骨吸收抑制为主.     

补肾方药骨疏康防治原发性骨质疏松机理研究

目的：研究补肾方药骨疏康冲剂防治原发性骨质疏松的机制。方法：用维甲酸致Wistar大鼠骨质疏松模型,分别给与骨疏康、钙（Ca）、骨疏康＋Ca治疗,保留一组模型不给药为对照;同时取相同数量正常大鼠为正常组。检测各组骨矿物质密度（BMD）骨生物力学性能、骨生化代谢指标。临床观察绝经后骨质疏松病人30例,服骨疏康并用钙剂6个月为观察组,单用钙剂组30例为对照组,检测骨代谢相关生化指标。结果：骨疏康＋Ca组大鼠BMD增加;生物力学最大载荷、刚性系数、极限强度、弹性模量等指标达到正常水平,优于单钙组。单用骨疏康组大鼠骨吸收指标尿钙／肌酐（Ca/Cr）、尿羟脯氨酸／肌酐（Hop/Cr）、血抗酒石酸盐酸性磷酸酶（TRAP）下降;骨形成指标血碱性磷酸酶（ALP）、骨钙素（BGP）上升。绝经后骨质疏松病人服用骨疏康和钙剂血TRAP下降;血中雌激素（E2）、睾酮（T）上升。结论：骨疏康通过增加血中E2、T水平,降低骨吸水,增加骨形成;与钙剂合用促进BMD增加并能加强骨生物力学性能。     

Ⅱ型糖尿病血清骨钙素水平及其相关因素分析

目的 :分析血清骨钙素 (BGP)水平在Ⅱ型糖尿病中的变化规律及其与相关因素的关系 ,探讨Ⅱ型糖尿病骨代谢异常的特点及其机制。方法 :测定 6 7例Ⅱ型糖尿病患者的血清骨钙素 (BGP)、血钙 (Ca)、血磷 (P)、血碱性磷酸酶 (AKP)、血糖 (Glu)、血胰岛素 (Ins)、尿羟脯氨酸 (HOP/Cr)以及尿钙 (Ca/Cr)的浓度 ,并与正常对照组进行比较。结果 :Ⅱ型糖尿病的血清骨钙素水平显著低于正常对照组 (P <0 .0 5 ) ;并与血胰岛素呈明显正相关 (r=0 .4 4 6 ) ,与血糖、尿羟脯氨酸呈明显负相关 (r=- 0 .35 6、r=- 0 .2 76 ) ,与已知病程、年龄等无明显相关性。尿羟脯氨酸浓度显著高于正常对照组 (P <0 .0 1) ,并与尿钙呈明显正相关 (r =0 .5 0 6 )。结论 :骨形成减少、骨吸收增加可能是Ⅱ型糖尿病骨代谢异常的特点之一 ,其发生可能与胰岛素分泌绝对或相对不足有关 ;血清骨钙素、尿羟脯氨酸可作为检测糖尿病性骨代谢异常的敏感指标。     

糖尿病增加老年患者骨质疏松的发生分析

目的：探讨老年糖尿病患者骨质疏松的发生率。方法：应用超声成像骨密度测量仪对133例糖尿病踝中部骨密度(BMD)及155例正常对照组进行检测，并同时检测空腹血糖(FBG)、血钙(CA)、血磷(P)、骨钙素(BGP)、碱性磷酸酶(AKP)、24h尿钙(U-CA)，尿磷(U-P)。结果：糖尿病组骨质疏松发生率高于正常组，两组空腹血糖、尿钙、尿磷有显著差异，血钙、磷、碱性磷酸酶则无显著差异。结论：糖尿病可加快骨质疏松症的进程。     

成都市340名绝经后妇女骨质疏松发病情况调查及影响因素探讨

In this cross-sectional study, the radius bone mineral content (BMC) of 340 postmenopausal women (mean age: 53; mean years since menopause: 5.56) were assessed by single photon absorptiometry (SPA) for determining prevalence rate of postmenopausal osteoporosis in Chengdu, and some factors relative to BMC were investigated. Eighty-five of 340 postmenopausal women were diagnosed osteoporosis by SPA. The prevalence rate, which increases with year since menopause and age, is 25%. There is significant increase in prevalence after the age of 60 years or 5 years since menopause. Sixteen factors were analysed by STEPWISE REGRESSION. The variables selected were serum calcium(SCa), serum alkaline phosphatase (SAkP), urine calcium (UCa), urine hydroxypoline (UH), age, and Para. Fisher DISCRIMINANT ANALYSIS was used for diagnosis with these variables, the accuracy of diagnosis being 75.2%. Our study showed that postmenopausal osteoporosis is a common disease in Chengdu. High SCa, UH, age and low SAkP level may be risk factors of osteoporosis.     

Accuracy study on "Osteorisk": a new osteoporosis screening clinical tool for women over 50 years old.

CONTEXT AND OBJECTIVE: Osteoporosis is the greatest cause of quality-of-life reductions, morbidity and mortality among postmenopausal women, with growing incidence as populations age. Clinical tools like Osteorisk provide an easy-access and low-cost alternative method that helps physicians to reduce the need for dual-energy X-ray absorptiometry (DXA), the expensive gold standard examination for diagnosing osteoporosis. The aim here was to study the accuracy of Osteorisk using heel ultrasonography for bone mineral density (BMD). DESIGN AND SETTING: Cross-sectional study, at Faculdade de Medicina do ABC. METHODS: A structured questionnaire was applied to 615 postmenopausal women, with anthropometric measurements, Osteorisk calculations and quantitative ultrasound on the heel using Sonost 2000 equipment. RESULTS: 461 women were included, with mean age 60 +/- 9 years, weight 67.6 +/- 12.9 kg and body mass index (BMI) 28.8 +/- 5.0 kg/m(2). Their Osteorisk classifications were: 61.0% low-risk, 28.4% medium-risk and 10.6% high-risk. Quantitative ultrasound showed 81.3% low-risk, 10.0% medium-risk and 8.7% high-risk regarding osteoporosis. Statistically significant results were observed (p < 0.001) when Osteorisk was correlated with age, years since menopause and BMI. Correlating these same variables with quantitative ultrasound, statistically significant results were observed for age (p < 0.001), years since menopause (p < 0.001) and BMI (p < 0.006). The sensitivity, specificity, negative predictive value and positive predictive value for Osteorisk were 64%, 6.7%, 89% and 30.6%, respectively. CONCLUSION: Osteorisk is a valid tool for screening for women at low risk of osteoporosis, making it possible for these women not to have to undergo densitometry.     

Cardiac performance in relation to age of onset of menopause

It is well known that post menopausal women are more prone to cardiovascular diseases, osteoporosis and cancer. This study was done to detect the effect of early onset of menopause on the cardiac performance in postmenopausal women. The cardiac functions were evaluated by the noninvasive technique of measuring systolic time intervals (STI) in the form of total electromechanical systolic time (OS2), left ventricular ejection time (LVET), pre-ejection period (PEP) and PEP/LVET ratio. The study included 50 postmenopausal women with age at the onset of menopause ranging from 29 years to 55 years, divided into three groups I, II and III with mean age at onset of menopause being 36.80 +/- 2.97, 43.97 +/- 2.97 and 52.05 +/- 1.61 years, respectively. In group I, there was a highly significant increase in QS2, PEP and PEP/LVET ratio and in group II, there is a significant decrease in LVET with a highly significant increase in PEP and PEP/LVET ratio. This signifies asymptomatic and subclinical cardiac systolic dysfunction in groups I and II as compared to group III. Early onset of menopause could thus be considered as a risk factor for increased cardiovascular morbidity; hence efforts should be made to timely detect and prevent these diseases in the postmenopausal stage.     

绝经前后妇女骨密度测定

目的研究妇女绝经后骨质疏松与雌激素的关系。方法收集了２５５例年龄在３２～７３岁之间的绝经前后的妇女。分成４组：月经正常、月经紊乱、自然绝经和人工绝经（双侧卵巢切除术）。用双能Ｘ线骨密度测定仪进行测量。结果妇女月经紊乱后,骨密度就明显下降,而绝经后的５年内显著下降。手术切除卵巢后,５年内骨密度也显著下降。结论绝经前切除卵巢或过早的闭经易导致骨质疏松,即妇女绝经后骨质疏松与雌激素下降有显著关系（Ｐ＜０．００１）。     

绝经后妇女绝经年限、绝经及初潮年龄与骨密度关系的研究

目的探讨安徽合肥地区绝经后妇女绝经年限、绝经及初潮年龄与骨密度关系。方法调查240例合肥市健康妇女的年龄、绝经年限、绝经年龄和初潮年龄、测量身高、体重、体重指数（BMI）,及正位腰椎（L2～L4）、股骨各部位（Neck,ward,GT）的骨密度（BMD）,并进行相关分析。结果绝经年限与各部位骨密度呈负相关（P〈0．01）,初潮年龄与L2、L3、L4、大转子的骨密度呈负相关（P〈0．01）,绝经年龄与L2、L3、L4的骨密度呈正相关（P〈0．01）。结论随着绝经年限增加,初潮年龄越大,绝经年龄越早,骨密度呈下降趋势。     

绝经后女性腰椎骨密度影响因素的研究

目的分析绝经后女性腰椎骨密度的相关影响因素,提高对绝经后女性骨质疏松症的预防,减少骨质疏松症的发生。方法随机抽取2012年1¹2月在武汉大学人民医院进行骨密度测量(采用美国生产的DEXA双能X线骨密度测量仪)的绝经后女性251例。测量记录251例自然绝经女性的年龄、绝经年龄、身高、体质量、第112月在武汉大学人民医院进行骨密度测量(采用美国生产的DEXA双能X线骨密度测量仪)的绝经后女性251例。测量记录251例自然绝经女性的年龄、绝经年龄、身高、体质量、第1⁴腰椎骨密度T值平均值,分析绝经后女性腰椎骨密度的相关影响因素。结果多元逐步回归分析结果显示:体质量和绝经年限为影响绝经后女性腰椎骨密度的主要因素(P<0.05)。绝经后14腰椎骨密度T值平均值,分析绝经后女性腰椎骨密度的相关影响因素。结果多元逐步回归分析结果显示:体质量和绝经年限为影响绝经后女性腰椎骨密度的主要因素(P<0.05)。绝经后1¹0年与绝经后10年以上腰椎骨密度T值比较差异均有统计学意义,绝经10年以后腰椎骨密度明显下降(P<0.05)。不同体质量组腰椎骨密度T值比较差异均有统计学意义(P<0.05),其中低体质量组最低,超体质量组最高,正常体质量组居中。结论女性绝经越早,绝经时间越长,体质量越低,绝经后的腰椎骨密度越低。体质量是腰椎骨密度的保护因素,绝经后女性保持适当的体质量有助于减少骨质疏松症的发生。     

绝经后妇女腰椎骨密度测量及其临床意义

目的 探讨绝经后妇女腰椎骨量的变化规律,找寻低骨量的危险因素。方法 记录２０９例绝经后妇女的年龄、绝经年龄、绝经年限,测量体重和身高,采用Ｈｏｌｏｇｉｃ双能Ｘ线骨密度测量仪检测腰椎正侧位的骨密度。结果 绝经后妇女年龄越大、绝经越早、绝经年限越长、体重指数越小,骨密度越低。结论 绝经和低体重是绝经后骨质疏松症的危险因素,应加强对绝经后妇女尤其是早绝经和低体重的中老年妇女进行骨密度的监测。     

绝经后骨质疏松与血清OPG及RANKL关系的研究

目的研究血清护骨素（OPG）和核因子-κβ受体活化子配体（RANKL）与绝经后骨质疏松及其引起的骨折、相关骨代谢指标（BTMs）,包括OC,NTX及IGF-1）的关系。方法应用双能X线骨密度仪测量82例绝经后妇女腰椎骨密度（BMD）,按WHO标准,分为无骨质疏松组（NOP）、骨质疏松组（0P1）、骨质疏松伴骨折组（OP2）。测定血清OPG,RANKL及其他骨代谢指标。结果OP1组及OP2组血清OPG水平均低于NOP组（P〈0．05）,OP2组血清RANKL水平低于NOP组（P〈0．01）。校正年龄、绝经年限、体质指数及雌二醇后,血清OPG与BMD呈正相关（P〈0．05）。血清OPG与IGF-1呈正相关（P〈0．001）。Logstic回归分析表明校正年龄、骨转换指标、雌二醇和BMD后,血清OPG及RANKL对骨折有显著影响。结论血清OPG增高可能是对抗绝经后骨吸收加快的一个代偿反应。低水平的血清RANKL可能不利于骨重塑,从而增加了骨折的危险。血清OPG与RANKL是对骨折有显著影响的独立因素,提示它们可望作为更加准确的单独预测骨质疏松骨折的骨代谢标志物。     

广西地区绝经后妇女骨密度影响因素分析

目的 探讨广西地区门诊就诊或住院的绝经后妇女年龄、绝经年龄及绝经年限对女性骨密度的影响,为骨质疏松症的预防提供科学依据.方法 对门诊就诊或住院、以腰背痛和关节痛为主诉的633例中老年妇女,采用美国GE公司生产Lunar Prodigy型骨密度检测仪,测量腰椎及双侧股骨颈骨密度,根据不同的民族、不同年龄、绝经年龄、绝经年限进行分组,并进行统计学分析.结果 汉族妇女骨质疏松患病率为35.3％,壮族妇女骨质疏松患病率为32.5％,两组差异无统计学意义（P＞0.05）;腰椎及股骨颈骨密度降低随年龄、绝经年限的增加逐渐降低,各组间差异均有统计学意义（P＜0.05）;腰椎骨密度随绝经年龄的增加逐渐降低,除46岁以下组与46～50岁组之间差异无显著性（P＞0.05）外,46岁以下组与50岁以上组、46～50岁组与50岁以上组之间差异均有统计学意义（均P＜0.05）.结论 绝经年龄早更容易引起骨密度降低,年龄越大、绝经年限越长,骨密度降低越明显,就更容易出现骨质疏松.     

Calcaneal ultrasound parameters in men and women from central Croatia.

BACKGROUND: The aim of this study was to compare quantitative ultrasound parameters between women and men of various ages in a population from central Croatia and also to estimate the prevalence of osteoporosis in women. MATERIAL/METHODS: A total of 1006 participants were recruited for this study (550 men, 456 women), aged 20 to 89 years. Calcaneal quantitative ultrasound measurements were performed using a Sahara device (Hologic). Data were analyzed using the t-test and analysis of variance (ANOVA) with Tukey's post hoc test. RESULTS: Comparison of the ultrasound measures of the men exhibited significant differences across the age groups with the exception of broadband ultrasound attenuation (BUA). In the women, significant differences were found for BUA, speed of sound (SOS), and the quantitative ultrasound index (QUI). Gender comparison revealed significant differences between ultrasound parameters in the last three decade groups. Using a T-score threshold of -1.8, the prevalence of osteoporosis in women aged over 50 was 30.7% based on the quantitative ultrasound index. CONCLUSIONS: This study is the first report of quantitative ultrasound parameters in Croatian women. The results revealed lower QUI, BUA, and SOS in postmenopausal women than in men of the same age. The prevalence of osteoporosis in women over 50 years of age based on the quantitative ultrasound index was considerably higher than the previously reported prevalence of osteoporosis in men.