肌注醋酸甲羟孕酮避孕对25～40岁妇女骨矿物质密度的影响

目的:探讨肌肉注射避孕药醋酸甲羟孕酮(DMPA)对骨矿物质密度的影响。方法:随机选择68例应用DMPA避孕的25～40岁女性,每3个月肌注DMPA1次,用药24个月;同时选择59例25～40岁从未应用激素避孕药的女性做为对照,应用双能X光线吸收法测量腰椎和股骨颈骨矿物质密度(BMD)。结果:用药组用药2年后腰椎和股骨颈平均BMD从基础值1.106±0.110g/cm2和0.913±0.100g/cm2下降到1.045±0.103g/cm2和0.855±0.100g/cm2,分别下降了5.5%和5.9%,与对照组相比明显降低(P<0.01)。结论:25～40岁女性肌注醋酸甲羟孕酮避孕导致骨矿物质密度降低。     

肌注醋酸甲羟孕酮对25～40岁妇女骨矿物质密度的影响及停药后的恢复

目的:观察应用醋酸甲羟基孕酮(DMPA)避孕对BMD的影响,分析停药后的恢复情况。方法:随机选择68例应用DMPA避孕的25～40岁女性,每3个月肌注DMPA 1次,用药24个月;同时选择59例25～40岁未应用激素避孕药的女性作为对照,其中用药组61例,对照组52例完成2年的停药观察。对两组患者用药及随访期间应用双能X光线吸收法测量腰椎和股骨颈BMD。结果:用药组用药2年后腰椎和股骨颈平均BMD从基础值(1.11±0.11)g/cm2和(0.91±0.10)g/cm2下降到(1.05±0.10)g/cm2和(0.86±0.10)g/cm2,分别下降了5.52%和6.35%;与对照组相比骨矿物质密度明显降低(P<0.001)。停药2年后,应用DMPA组平均BMD明显增高,虽然DMPA组腰椎和股骨颈BMD仍然低于其用药前基础水平的1.08%和2.30%,但与对照组相比,无统计学差异(P>0.05)。结论:年龄25～40岁女性应用DMPA导致骨矿物质密度降低,停止注射DMPA后,因使用DMPA所致BMD降低得以恢复。     

青春期女性应用孕激素避孕药对骨健康的影响

单纯孕激素避孕药醋酸甲羟基孕酮因高效、长效而被广泛应用,这种避孕方法 明显降低了青春期女性的妊娠率.但是,醋酸甲羟基孕酮也有许多副作用,尤其是对骨矿物质密度的影响,因此人们担心青春期女性应用醋酸甲羟基孕酮对骨健康产生不利影响.该文就近年来有关青春期女性应用醋酸甲羟基孕酮对骨矿物质密度影响的研究进行综述.     

复方口服避孕药对青春期女性骨矿物质密度的影响

目的:观察16～18岁女性应用妈富隆和炔雌醇醋酸环丙孕酮对骨矿物质密度(BMD)的影响。方法:选择376例16～18岁青春期女性,其中127例女性应用妈富隆,134例应用炔雌醇醋酸环丙孕酮,115例应用非激素避孕(对照组),应用双能X线吸收法测量腰椎和股骨颈BMD,比较口服复方避孕药者与对照组女性BMD的改变。结果:用药24个月,应用妈富隆的女性腰椎、股骨颈BMD与基础值相比轻度降低,但差异无统计学意义(P>0.05);而应用炔雌醇醋酸环丙孕酮的女性腰椎和股骨颈BMD与基础值相比轻度增高,差异无统计学意义(P>0.05);与对照组相比,腰椎和股骨颈BMD增加幅度减小。应用妈富隆和炔雌醇醋酸环丙孕酮者与对照组女性相比,腰椎和股骨颈BMD没有明显差异(P>0.05)。结论:16～18岁青春期女性应用妈富隆或炔雌醇醋酸环丙孕酮2年对BMD没有不利影响,但是继续应用是否影响BMD峰值的获得有待进一步研究。     

育龄妇女应用炔雌醇环丙孕酮对骨矿物质密度的影响

目的:观察复方口服避孕药(COCs)炔雌醇环丙孕酮片对骨矿物质密度(BMD)的影响。方法:对55例年龄25～40岁,口服炔雌醇环丙孕酮片避孕24个月的妇女(观察组)应用双能X光线吸收测量腰椎和股骨颈BMD,并以53例年龄25～40岁从未应用激素避孕药妇女(对照组)做对照。结果:观察组腰椎和股骨颈BMD与基础值和对照组相比差异无统计学意义(P>0.05)。结论:年龄25～40岁妇女应用炔雌醇环丙孕酮避孕药避孕与非激素避孕者相比,BMD没有改变。     

左炔诺孕酮皮下埋植避孕对育龄妇女骨矿物质密度的影响

目的:探讨应用左炔诺孕酮皮下埋植剂避孕和非激素宫内节育器(IUD)避孕对育龄妇女骨矿物质密度(BMD)的影响。方法:对比观察126例应用左炔诺孕酮皮下埋植剂的妇女和93例采用非激素IUD避孕妇女腰椎和股骨颈BMD。结果:一般检测特征在两组间类似,左炔诺孕酮皮下埋植剂平均使用期为35.2±6.7个月,与对照组相比,两组BMD差异无统计学意义。结论:左炔诺孕酮皮下埋植避孕对育龄妇女骨矿物质密度无不利影响。     

育龄妇女应用妈富隆对骨矿物质密度的影响

目的 观察复方口服避孕药妈富隆(Marvelon)对骨矿物质密度的影响.方法 随机选择46例年龄为25～40岁女性应用妈富隆药物24个月;随机选择53例年龄为25～40岁从未应用激素避孕药女性做对照;应用双能X线吸收法测量腰椎和股骨颈骨矿物质密度.结果 用药组用药2年后腰椎和股骨颈平均骨矿物质密度从基础值1.110(0.114g/cm2),0.917(0.088g/cm2)下降到1.106(0.109g/cm2)和0.902(0.091g/cm)2,分别下降了0.36%和1.64%;与对照组相比骨矿物质密度无显著性差异(腰椎t=0.097,股骨颈t=0.516,均P>0.05).结论 年龄为25～40岁女性应用妈富隆避孕药与非激素避孕者相比,其骨矿物质密度无明显差异.     

醋酸甲羟孕酮对妇女外周血淋巴细胞姊妹染色单体交换率影响的研究

<正> 醋酸甲羟孕酮(狄波—普维拉150)作为一种新型长效避孕针剂,具有高效,安全、简便、不影响乳汁分泌,对哺乳期妇女安全可靠,副作用小等优点,但用药后对妇女是否有诱变作用及遗传学效应尚未见报道。为此,我们对30例应用狄波—普维拉150避孕妇女进行了用药前后外周血淋巴细胞姊妹染色单体交换(SCE)的自身对照观察,现将结果报告如下。 材料和方法     

口服复方避孕药对青春期女性骨密度的影响

目的:观察复方口服避孕药(COCs)妈富隆(去氧孕烯/炔雌醇)对青春期女性骨矿物质密度(BMD)的影响。方法:接纳150例年龄16～18岁女性应用COCs避孕为观察组,用药24个月;接纳150例年龄16～18岁从未应用激素避孕药女性做对照组;应用双能X-线吸收法测量腰椎和股骨颈BMD。结果:观察组用药2年后腰椎和股骨颈BMD从基础值1.010±0.107g/cm3和0.818±0.089g/cm3降低到1.007±0.108g/cm3和0.813±0.090g/cm3,分别降低了0.29%和0.61%;而对照组则从基础值1.008±0.109g/cm3和0.816±0.087g/cm3增高至1.027±0.106g/cm3和0.824±0.089g/cm3,分别增高了1.88%和0.98%;用药2年后,观察组与对照组相比BMD无明显差异(P>0.05)。结论:青春期女性应用COCs避孕2年对BMD无明显影响。     

体育锻炼对女性儿童少年骨矿物质及骨密度的影响

目的 ]研究体育锻炼对儿童少年骨骼发育的影响。 [方法 ]对蚌埠市凤阳路第二小学 60名 8～ 10岁小学女生进行为期 4个月的中等强度 ( 110～ 14 0次 /min心率 )的体育锻炼 ,并在锻炼前及锻炼后测定其骨矿物质(BMC)及骨密度 (BMD)。 [结果 ]实验组桡骨及股骨颈BMC和BMD均值高于对照组 ,差异分别有高度显著性 (P<0 0 1)和显著性 (P <0 0 5 )。 [结论 ]体育锻炼对儿童少年各部位骨骼发育有良好的影响。     

膳食因素对骨密度的影响

骨质疏松作为一种常见的老年病 ,近年来受到人们越来越多的关注。而膳食营养素摄入对骨密度的影响也是值得重视的一个方面 ,我们对 1 86名健康志愿者及 57例骨质疏松病人进行了膳食调查及骨密度测定 ,以了解膳食因素对骨密度的影响。1　对　象　与　方　法1 .1　观察对象及分组　　健康正常人 1 86名 ,其中男性 81名 ,年龄 2 4～82岁 ,平均年龄 (48.7± 1 7)岁 ,分为 2 4～ 55岁和 56～ 82岁两个亚组 ,分别为 50和 31名。女性 1 0 5名 ,年龄 2 4～ 82岁 ,平均年龄 (47.2± 1 4)岁 ,分为与男性年龄相同的两个亚组 ,分别为 74和 31名。均无内…     

Exercise Effects on Bone Mineral Density in Men

In contrast to postmenopausal women, evidence for a favorable effect of exercise on Bone Mineral Density (BMD) is still limited for men. This might be due to the paucity of studies, but also to the great variety of participants and study characteristics that may dilute study results. The aim of the present systematic review and meta-analysis was to evaluate the effect of exercise on BMD changes with rational eligibility criteria. A comprehensive search of six electronic databases up to 15 March 2021 was conducted. Briefly, controlled trials ≥6 months that determined changes in areal BMD in men >18 years old, with no apparent diseases or pharmacological therapy that relevantly affect bone metabolism, were included. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) and femoral neck (FN) were considered as outcomes. Twelve studies with 16 exercise and 12 control groups were identified. The pooled estimate of random-effect analysis was SMD = 0.38, 95%-CI: 0.14–0.61 and SMD = 0.25, 95%-CI: 0.00–0.49, for LS and FN, respectively. Heterogeneity between the trials was low–moderate. Funnel plots and rank and regression correlation tests indicate evidence for small study publication bias for LS but not FN-BMD. Subgroup analyses that focus on study length, type of exercise and methodologic quality revealed no significant difference between each of the three categories. In summary, we provided further evidence for a low but significant effect of exercise on BMD in men. However, we are currently unable to give even rough exercise recommendations for male cohorts.     

Physical Activity in Adolescence Has a Positive Effect on Bone Mineral Density in Young Men

Objectives

Little is yet known about the determinants of bone mineral density (BMD) in young adults. Thus, in this study, we aimed to determine the factors that have an impact on BMD in young men.

Methods

Questionnaires were sent out to 111 male medical students. Information on age, socio-economic status, medical history, lifestyle, physical activity during adolescence, school club participation, current physical activity, and dietary intake were collected by the survey. Height, weight, percent body fat and muscle mass were estimated by bioelectrical impedance, and BMD was obtained using calcaneal quantitative ultrasound. Using the Poisson regression model, prevalence ratios (PRs) were used to estimate the degree of association between risk factors and osteopenia.

Results

The height and current physical activity showed a correlation to the Osteoporosis Index. Among the categorized variables, past physical activity during adolescence (p=0.002) showed a positive effect on the bone mineral content. In the multivariate model, past physical activity (≥1 time/wk) had a protective effect on osteopenia (PR, 0.37; 95% confidence interval [CI], 0.18 to 0.75) and present physical activity (1000 metabolic equivalent of task-min/wk) decreased the risk of osteopenia (PR, 0.64; 95% CI, 0.44 to 0.91).

Conclusions

Past physical activity during adolescence is as important as physical activity in the present for BMD in young men.     

不同运动方式对中老年人骨密度的影响

目的探讨不同运动方式对中老年人骨密度的影响,以指导中老年人保健。方法使用单能X线骨密度仪对温州市121名体检的50岁以上中老年人进行跟骨骨密度测定,按标准分为运动组和不运动组,比较两组骨密度,分析不同运动方式,包括运动项目、运动频次、运动时间、运动年限对运动组骨密度的影响。结果运动组与不运动组年龄、性别、体重指数比较差异无统计学意义(P0.05)。运动组骨密度高于不运动组,差异有统计学意义(t=3.568,P=0.001)。年龄、性别、运动项目、运动频次、运动年限是中老年人骨密度的影响因素(F=20.601,P0.01)。结论运动可以改善中老年人的骨密度,不同的运动方式对中老年人骨密度影响有区别。中老年人要想通过运动获得骨量的增长,要在临界强度负荷下选用适宜自己个体的对骨骼冲击力大的运动,并提高运动频次,延长运动年限。     

糖皮质激素治疗对肾小球疾病患者骨密度的影响

目的　探讨长期用糖皮质激素 (glucorticoid ,GC)治疗对肾小球疾病患者骨密度 (bonemineraldensity ,BMD)的影响。方法　前瞻性对 41例肾小球疾病患者 ,应用常规剂量GC治疗 ,于治疗前及治疗后每隔 3～ 6个月 ,用双能X线吸收仪测量腰椎 (L2 -4)和股骨BMD ;PCR -RFLP法检测维生素D受体 (VDR)基因多态性。结果　用药 15个月后各部位BMD均减少 ( 2 9 9～ 83 8)mg/cm2 ,以L2 -4和股骨粗隆更明显 (P =0 0 1,P <0 0 5 ) ,两部位BMD减少与GC累计剂量 (P均 <0 0 5 )及用药时间负相关 (P <0 0 0 1和0 0 1) ;各部位BMD减少与病程负相关 (P <0 0 5 )。用药前BMD减低组 4/14例用药 15个月后发展为骨质疏松、BMD正常组中 6/2 7例发生BMD减少。用药 15个月、GC累计剂量 10克以上时 ,BMD减少和 (或 )骨质疏松的患者从用药前 1/3增至 1/2。VDR基因型 :AA、aa型以L2 -4BMD下降明显 ( P 均 <0 0 5 ) ,而Aa型以股骨颈部下降明显 ;三组用药前BMD或治疗后骨丢失率间的差别无统计学意义。结论　GC治疗后各部位BMD均减少 ,以L2 -4最突出 ,骨丢失与病程、GC累计剂量及用药时间负相关与VDR基因多态性无相关。治疗前骨密度是GC治疗后是否发生骨密度减少和 /或骨质疏松的决定性因素     

民航飞行人员骨密度和骨代谢指标的测定

目的探讨高空环境对飞行人员骨密度和骨代谢指标的影响,分析飞行人员骨密度和骨代谢水平与飞行时间的关系。方法某航空公司健康男性飞行员139名（20～60岁）和健康地面男性对照人员37名（20～60岁）,按照年龄分成4组：20～年龄组,30～年龄组,40～年龄组,50～印年龄组,分别采用单光子超远端两维骨密度测量法测量骨密度,放射免疫分析法测定血清骨钙素（BGP）水平,采用酶联免疫分析法测定血清骨特异性碱性磷酸酶（BALP）,其结果用组间t检验进行比较,各变量与飞行时间之间进行相关分析。结果飞行员各年龄段骨密度均值水平均低于正常值,P〈0．05;50～60岁年龄组尺骨BMD明显低于正常组,P〈0．05。尺骨的BMD受飞行年限的影响较桡骨敏感。飞行人员BGP水平和BALP水平均低于对照组,飞行人员BGP水平和BALP水平与对照组比较,在20～年龄组和30～年龄组均显著降低（P〈0．01）,40～年龄组之间差异无显著性（P〉0．05）,与累积飞行时间呈显著性负相关（P〈0．01）。结论高空环境能降低飞行员的骨密度,尺骨受高空环境的影响较桡骨敏感。并影响飞行人员的骨代谢水平,且与飞行时间相关。     

维持性血液透析患者骨密度改变

为观察慢性肾衰维持性血透患者骨密度改变,要用ＤＥＸＡ方法测定１９５例维持性血透患者桡骨远端１／３点骨密度（ＢＭＤ）,同时检测其血清中段甲状旁腺素（Ｍ－ＰＴＨ）,碱性磷酸酶（ＡＬＰ）。结果显示血透患者骨密度低于相应年龄性别对照组,并随透析期间延长而更显突出。血透患者骨密度与ＰＴＨ,ＡＬＰ呈逆向改变关系。说明慢性肾衰血透患者存在骨量丢失,血透治疗似未能有效阻止其过程。骨密度测定对肾性骨病防治具有临床应     

Soy Isoflavones: No Effects on Bone Mineral Content and Bone Mineral Density in Healthy,Menstruating Young Adult Women after One Year

Background: The effects of isoflavone-enriched soy protein on human bone mineral content (mass) and density in healthy, menstruating young adult females have not been examined in a comparative prospective investigation. Peri- and post-menopausal women have been reported to show beneficial effects of isoflavones on bone measurements. Therefore, young women may also be able to improve their accrual of peak bone mineral content (BMC) and bone mineral density (BMD) during the early adult years of bone consolidation with an isoflavone-enriched diet.

Objectives: In this controlled, double-blind intervention, we tested the hypothesis that an isoflavone-rich soy protein diet increases BMC and BMD in young adult females over a period of one year in comparison to a control group receiving soy protein that has isoflavones removed.

Design: Young healthy women of any ethnic background, 21 to 25 years of age, were divided into two groups, placebo (n = 13) and supplement (n = 15). The soy protein supplement was enriched with isoflavones (～90 mg of total isoflavones/day), whereas the control protein diet was isoflavone-deficient, even though it contained the same amount of soy protein and other ingredients as the isoflavone-rich diet. Dual-energy x-ray absorptiometric (DXA) measurements of BMC and BMD were made at baseline and at 6 and 12 months. DXA estimates of body composition, including fat mass and lean body mass, were generated from whole-body BMC measurements. BMI was calculated as weight (kg) over height (m) squared. Physical activity was assessed, and three-day dietary records were taken at entry (baseline) and at 6 and 12 months.

Results: No changes in BMD after 12 months were found in either the isoflavone-treated (treatment) group or the isoflavone-deficient (control) group. Other variables also remained essentially constant over the 12-month period, including normal menstrual patterns in both the treatment and control groups.

Conclusions: The isoflavone-rich soy preparation had no effects on BMC and BMD over a 12-month period in young healthy adult females with normal menses. An isoflavone-rich supplement appears to have little or no effect on bone in young adult women with normal ovarian function, at least over this 12-month study period.     

The Combined Effects of Milk Intake and Physical Activity on Bone Mineral Density in Korean Adolescents

The purpose of this study was to examine the combined effects of milk intake and physical activity on bone mineral density in adolescents. This study was conducted using data from the 2009–2011 Korea National Health and Nutrition Examination Survey (KNHANES), which provided measurements of bone mineral density (BMD) in addition to basic health-related data. This study included 1061 adolescents aged 13 to 18 years (557 males and 504 females) whose data on milk intake and participation time in moderate to vigorous physical activity were available. BMD was measured by dual-energy X-ray absorptiometry (DXA). Milk intake was assessed using the 24-h recall method, and the levels of physical activity were examined using a questionnaire. The physical activity questions of 2009–2011 KNHANES were based on the Korean version of the International Physical Activity Questionnaire (IPAQ) short form. The subjects were classified into four groups according to milk intake and physical activity level: no milk intake + low-level physical activity group (M_noP_low), no milk intake + high-level physical activity group (M_noP_high), milk intake + low-level physical activity group (M_yesP_low), and milk intake + high-level physical activity group (M_yesP_high). The results of partial correlation controlling for age, body mass index (BMI), and energy intake showed that the BMD variables were associated significantly with physical activity in both males and females. Among males, the M_noP_low group had the lowest BMD in all BMD variables, showing a significant difference from the high-level physical activity groups (M_noP_high, M_yesP_high) by multiple logistic regression analysis. Among females, the M_yesP_high group showed a significantly higher lumbar BMD value than the other groups. The M_noP_low group had approximately 0.3 to 0.5 times lower odds ratio for median or higher BMD values, compared to M_yesP_high group. These results show that milk intake and physical activity have a combined effect on BMD, and suggest that to achieve healthy bone growth, it is important to encourage both moderate to vigorous physical activity and milk intake during adolescence.