Bone mineral content in Polynesian and white New Zealand women

The forearm bone mineral content of Polynesian and European women in New Zealand was measured to assess whether the inter-racial differences found in other populations also occurred in these two groups. The bone mineral content of the nondominant distal radius and ulna was measured by single photon absorptiometry in 123 European and 80 Polynesian women. The mean values were about 20% higher in Polynesians than in Europeans. The reason for this difference in bone mineral content is unknown but the findings do show that high bone density is not confined to African races and that inter-racial differences in bone mineral content may be more common than has been thought hitherto.     

围绝经期妇女胸腰椎骨折患者骨密度分析

目的探讨由轻创伤引起的围绝经期妇女胸腰椎骨折与骨密度的关系，以期为由骨质疏松引起的胸腰椎骨折提供预防和治疗依据。方法对144例40-58岁由轻创伤引起的胸腰椎骨折女性患者和146例同年龄无骨折史来我院健康检查的女性，用双能X线吸收仪测量左股骨近端骨密度，对数据进行统计分析。结果骨折组骨密度（BMD）明显低于对照组，围绝经期妇女骨质疏松检出率胸腰椎骨折组为34．03％，对照组为12．32％，差异有统计学意义（P〈0．05）。结论围绝经期妇女由轻创伤引起的胸腰椎骨折与BMD有密切关系。围绝经期妇女应重视BMD变化，预防椎体骨折的发生。     

Bone mineral density levels of college-aged women in northwest Arkansas

Osteoporosis has affected more than 20 million American, women, completely altering their way of life. Osteoporosis is highly preventable if steps are taken to build healthy bone; however, many college students do not have lifestyle habits that have a positive effect on their bones. For this study, a questionnaire was used to investigate childhood dairy consumption, high school sport participation, dieting behaviors, eating behaviors and bone mineral density levels of college women at the University of Arkansas in Fayetteville. Eighty percent of the participants were Caucasian or of Asian descent, while 20% were of other races; 34% of the participants consumed three or more servings of milk a day as children, while current calcium consumption was at an average of 16 servings a week. Many of the participants were active in high school, as 67% participated in high school sports. Fifty-two percent of the college women in the sample had dieted in the past year, and 44% perceived they were not at a desirable weight. Forty-five percent skip more than three meals a week. Of the participants, two had osteoporosis and 23 had osteopenia. Clearly, development of osteoporosis is not limited to older adults, and college women are in need of education related to bone health.     

Bone mineral density in premenopausal women receiving long-term physiological doses of levothyroxine

Total body and regional bone mineral density (BMD) levels were determined in 26 premenopausal women with Hashimoto's thyroiditis receiving long-term physiological doses of levothyroxine sodium replacement therapy. The BMD levels of each patient were compared with the mean of the BMD levels of age-matched normal controls. The mean levothyroxine sodium dose was 111 +/- 6 micrograms/d, and the mean duration of treatment was 7.5 +/- 5.3 years (range, 1 to 24 years). Dietary calcium intake was similar in both groups, as were serum thyroxine, triiodothyronine, free thyroxine index, and thyrotropin levels. Women receiving the levothyroxine treatment had normal total body BMD levels but had significantly lower BMD levels at the femoral neck (-5.7%), femoral trochanter (-7.0%), Ward's triangle (-10.6%), both arms (right, -7.8%; left, -8.9%), and pelvis (-4.9%). In contrast, lumbar spine BMD levels were similar in the two groups. There was no correlation between the total body or different regional BMD levels and the duration or dosage of levothyroxine treatment or thyroid function test results. However, the z score of the femoral neck of these patients showed a significant negative correlation with their serum free thyroxine index levels. We conclude that patients receiving physiological doses of levothyroxine may have decreased bone density. Thyroid functions in patients receiving long-term levothyroxine treatment should be closely monitored and bone densitometry should be performed in patients at risk for osteoporosis.     

The relation of forearm mineral density to peripheral fractures in postmenopausal women

Forearm bone mineral density was measured in 557 postmenopausal women from whom a history of fractures was also obtained. Known cases of osteoporosis were excluded. The mean age of the subjects was 59 years. Ninety-eight of the subjects had sustained a fracture since the menopause and 37 had done so before the menopause. There had been 188 fractures in all. The mean bone density was significantly lower in the subjects who had experienced a fracture than in those who had not experienced a fracture; this was also true of subjects who had suffered a fracture before the menopause. The lowest bone densities were observed in subjects who had suffered forearm fractures, followed by those who had suffered fractures of the rib, ankle and foot. The mean bone density in subjects with more than one fracture was significantly lower than in those with only one fracture. The difference in bone density between subjects with and without a history of fractures was most significant in the younger subjects and became progressively less significant with age. The estimated relative fracture risk was 3.1 in the group with the lowest bone densities and zero in the group with the highest bone densities.     

Long-term risk of incident vertebral fractures

Jane A. Cauley, DrPH; Marc C. Hochberg, MD, MPH; Li-Yung Lui, MA, MS; Lisa Palermo, MS; Kristine E. Ensrud, MD, MPH; Teresa A. Hillier, MD, MS; Michael C. Nevitt, PhD, MPH; Steven R. Cummings, MD

JAMA. 2007;298(23):2761-2767.

Context  Vertebral fractures are the most common osteoporotic fracture. Women with low bone mineral density (BMD) and prevalent vertebral fractures have a greater risk of incident vertebral fractures over the short-term, but their absolute risk of vertebral fracture over the long-term is uncertain.

Objective  To examine the absolute risk of incident vertebral fracture by BMD and prevalent vertebral fracture status over 15 years.

Design, Setting, and Participants  A total of 9704 white women were recruited at 4 US clinical centers and enrolled in the Study of Osteoporotic Fractures, a longitudinal cohort study. Of these, 2680 attended a clinic visit an average of 14.9 years after baseline; mean age of 68.8 years at entry and 83.8 years at follow-up.

Mean Outcome Measure  Incident vertebral fractures identified from lateral spinal radiographs defined as a decrease of at least 20% and 4 mm at any vertebral level. Prevalent vertebral fractures were identified on the baseline radiographs using vertebral morphometry. Bone mineral density was measured at the total hip and lumbar spine using dual-energy x-ray absorptiometry.

Results  Of the 2680 women, 487 (18.2%) had an incident vertebral fracture including 163 of the 394 (41.4%) with a prevalent vertebral fracture at baseline and 324 of the 2286 (14.2%) without a prevalent vertebral fracture at baseline (odds ratio, 4.21; 95% confidence interval, 3.33-5.34). Low BMD was associated with an increased risk of incident vertebral fracture (odds ratio per 1 SD decrease in total hip BMD, 1.78 [95% confidence interval, 1.58-2.00]). The absolute risk of vertebral fracture ranged from 56% among women with total hip BMD T score of –2.5 or less and a prevalent vertebral fracture to 9% in women with normal BMD and no prevalent vertebral fracture.

Conclusions  Low BMD and prevalent vertebral fractures are independently related to new vertebral fractures over 15 years of follow-up. Women with a prevalent vertebral fracture have a substantially increased absolute risk of an incident fracture, especially if they have osteoporosis diagnosed by BMD.

     

门诊下腰痛患者骨密度评价

目的：分析门诊未有明确诊断的顽固性下腰痛患骨密度（bone mineral demsity,BMD)及骨质疏松（osteopro-sis,OP)患病率变化规律,为骨质疏松预防提供科学依据,方法：分别对患有能明确诊断的顽固性下腰痛的体力劳动与非体力劳动进行整群随机抽样,抽取样本共429人,准确记灵性别和年龄,采用DEXA（双能X－线骨密度仪）测受试L2－4BMD,进行比较和统计分析,结果：随增龄下腰痛患骨密度逐渐下降,同龄男性BMD大于女性BMD,非体力劳动大于体力劳动,骨质疏松患病率随增龄而上升,体力劳动病率大于非体力劳动,尤其是50岁时变化最明显,结论：50岁以后女性下腰痛患,特别是体力劳动,OP的发生率较高。     

中国女性股骨颈和Ward’s三角区骨密度特点研究

对 1 4 88名 1 5～ 95岁的中国湖南长沙地区健康女性采用双能X线骨密度仪测股骨BMD并与Hologic提供的白人女性BMD参考值进行比较。结果表明 ,所有年龄段和测量部位的BMD均略低于白人女性参考值曲线 (P <0 .0 5) ;中国女性股骨颈和Ward’s三角区BMD较对照组晚 5～ 1 0年达到峰值 ;在其后的大约 35年中 ,BMD下降较慢     

Low bone mineral density and risk of fracture in white female nursing home residents

CONTEXT: Low bone mineral density (BMD) is a strong risk factor for fracture in community-dwelling white women, but the relationship in white female nursing home residents, for whom fracture rates are highest, is less clear. OBJECTIVE: To assess the relative contribution of low BMD to fracture risk in nursing home residents. DESIGN: Prospective cohort study with baseline data collected April 1995 to June 1997, with 18 months of follow-up. SETTING: Forty-seven randomly selected nursing homes in Maryland. PATIENTS: A total of 1427 white female nursing home residents aged 65 years or older. MAIN OUTCOME MEASURE: Documented osteoporotic fracture occurring during follow-up as a function of baseline BMD measurements higher vs lower than the median, and after controlling for demographic, functional, cognitive, psychosocial, and medical factors. RESULTS: A total of 223 osteoporotic fractures occurred among 180 women. Low BMD and transfer independence were significant independent risk factors for fracture in this nursing home sample (P<.001) and the 2 factors acted synergistically (P =.06) to further increase fracture risk. Compared with women whose BMD was higher than the median (0. 296 g/cm(2)), those whose BMD was lower than the median had an unadjusted hazard ratio for risk of fracture of 2.1 (95% confidence interval [CI], 1.5-2.8); women who were independent in transfer had a hazard ratio of 1.6 (95% CI, 1.2-2.2) compared with women dependent in transfer. Among residents independent in transfer, those with BMD below the median had a more than 3-fold increase in fracture risk compared with those with higher BMD (unadjusted hazard ratio, 3.1; 95% CI, 2.2-4.4). Among residents dependent in transfer, those with BMD below the median had a 60% increase in fracture risk (unadjusted hazard ratio, 1.6; 95% CI, 1.1-2.3). Adjustment for covariates did not alter the BMD-fracture relationship. CONCLUSIONS: Our data indicate that low BMD and independence in transfer are significant predictors of osteoporotic fracture in white female nursing home residents. JAMA. 2000;284:972-977     

中国女性股骨颈和Ward‘s三角区骨密度特点研究

对１４８８名１５～９５岁的中国湖南长沙地区健康女性采用双能Ｘ线骨密度仪测股骨ＢＭＤ并与Ｈｏｇｏｇｉｃ提供的白人女性ＢＭＤ参考值进行比较。结果表明,氖 年龄段和测量部位的ＢＭＤ均略低于白人女性参考值曲线（Ｐ〈０．０５）,中国女性股骨颈和Ｗａｒｄ‘ｓ三角区ＢＭＤ较对照组５～１０年达到峰值,在其后的大约３５年中,ＢＭＤ下降较慢。     

肥胖青年骨密度状况分析

目的分析肥胖青年骨密度(bone mineral density,BMD)的变化。方法 60例诊断为单纯性肥胖的患者,其中男性26例,女性34例。对照组青年与肥胖青年年龄相仿(出生日期相差<6个月)。所有入选对象均排除继发性肥胖与骨代谢性疾病患者。全身诸骨扇束扫描行全身及上肢、肋骨,胸椎、腰椎、骨盆、下肢和头部7个部位骨量、骨密度测定。结果肥胖组全身的骨量、骨密度均高于志愿者组(P<0.05)。肋骨、胸椎及头部这些非承重骨肥胖组的BMC要高于志愿者组,而BMD在两组之间差异没有统计学意义;上下肢、腰椎、骨盆这些承重骨的骨量及骨密度肥胖组均明显高于志愿者组(P<0.05)。结论肥胖青年承重骨骨量及骨密度与其体质量相关,在平衡体脂因素后肥胖者与对照组骨密度无显著差别。提示肥胖患者在进行体重控制的同时应加强运动来减少体质量减轻所造成的骨量流失。     

藏族2型糖尿病患者骨密度与相关危险因素分析

目的：了解藏族2型糖尿病患者骨密度情况及其相关危险因素的关系,为今后西藏地区藏族人群临床预防和治疗2型糖尿病合并骨质疏松症患者提供一定的理论依据。方法：收集2016年1月至2018年3月于西藏自治区人民医院内分泌科住院的2型糖尿病患者的一般资料及生化指标;按照患者双能X线骨密度测量结果（DXA）的T值,将患者分为正常组（T≥-1.0）、骨量低下组（T=-1.0～-2.5）、骨质疏松组（T≤-2.5）,比较3组一般资料及生化指标有无统计学差异,对有统计学差异的资料及指标再进行多重线性回归分析其危险因素。结果：本研究共纳入受试者456例（男286例,女170例）,平均年龄（55.7±11.3）岁。①3组间（骨量正常组177例、骨量低下组202例及骨质疏松组77例）比较显示,年龄、病程、体质量指数、尿酸、高密度脂蛋白胆固醇水平差异有统计学意义（均P＜0.05）;3组空腹血糖、糖化血红蛋白、血钙、血镁、血磷、甘油三酯、胆固醇、低密度脂蛋白胆固醇、碱性磷酸酶、25羟基维生素D、甲状旁腺激素水平比较未见统计学差异（均P＞0.05）。②尿酸是腰椎骨量减低的危险因素（β=0.215,P＜0.05）,年龄、体质量指数、尿酸是股骨颈骨量减低的危险因素（β分别为-0.329、0.177、0.173,均P＜0.05）。结论：高龄、低体质量指数、低尿酸是藏族2型糖尿病患者骨量减低的危险因素,在针对藏族2型糖尿病患者的临床工作中需加以重视。     

罗格列酮对2型糖尿病绝经后女性患者骨密度和骨转化指标的影响

目的评价罗格列酮对绝经后女性2型糖尿病患者骨密度和骨代谢标志物的影响。方法选取109例绝经后女性2型糖尿病患者,根据用药情况分为2组,分别为口服罗格列酮4mg／d的罗格列酮组,以及不服用罗格列酮的对照组,分析入组患者用药前和用药1年后的骨密度值及骨代谢指标变化,前后两次结果对照并分别进行统计分析。结果罗格列酮组以及对照组用药后骨密度值均下降,其中,股骨颈骨密度下降值罗格列酮组明显大于对照组（P〈0．05）,其余部位骨密度下降值罗格列酮组与对照组相比无显著性差异（P〉0．05）。罗格列酮治疗组I型胶原表现明显的下降趋势,而骨钙素和PTH在TZDs治疗组与对照组比较无明显变化。所有入组病例在本研究观察病程中均无骨折事件报告。结论罗格列酮可能有潜在的致绝经后女性2型糖尿病患者骨质疏松性骨折的风险。