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1.
The aim of this study was to determine possible associations between bone mineral density (BMD), 25-hydroxyvitamin D (25(OH)D)
and intact parathyroid hormone (PTH). In a retrospective study we examined the case notes of free-living postmenopausal women
living in our city (34° S). We also report a low prevalence of vitamin D deficiency (25(OH)D <25 nmol/l, 5.6%) and of secondary
hyperparathyroidism (intact PTH >65 pg/ml, 7.5%). Age was correlated with BMD at the lumbar spine (r=−0.25, p = 0.00038) and femoral neck (r=−0.252, p = 0.0003). Body mass index (BMI) was correlated with BMD at the femoral neck (r= 0.177, p = 0.021) but not at the lumbar spine. 25(OH)D was positively correlated with BMD at the femoral neck (r = 0.149, p=0.036) but not at the lumbar spine. PTH was positively correlated with age (r= 0.279, p = 0.012) and negatively correlated with 25(OH)D (r=−0.322, p = 0.0036). PTH was also negatively correlated with BMD at the lumbar spine (r=−0.258, p=0.02) and the femoral neck (r=−0.282, p = 0.011). Forward stepwise multiple regression showed that BMI, age and 25(OH)D made significant contributions to BMD at
the femoral neck. PTH also showed a significant contribution to BMD at both sites. In conclusion, weak correlations found
between PTH and 25(OH)D and BMD suggest these biochemical variables, among other factors, contribute to lumbar spine and femoral
neck BMD.
Received: 19 February 2000 / Accepted: 20 June 2000 相似文献
2.
To establish the prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient
clinic in Northern Italy, we evaluated 25-hydroxyvitamin D (25(OH)D) levels in 570 postmenopausal women who had been consecutively
referred to our clinic in the 12 months beginning October 1995. Parathyroid hormone (PTH), serum calcium (Ca), creatinine
(Cr) and osteocalcin (OC), urinary calcium (Ca24h) and creatinine (Cr24h), and the bone mineral density of the lumbar spine
(LBMD) and femur (FBMD) were also measured. 1,25-Dihydroxyvitamin D (1,25(OH)2D) concentrations were measured in 23 women. All women had normal electrolyte serum concentrations and kidney function. Mean
± SD 25(OH)D concentration was 18.3 ± 8.3 ng/ml. A significant (p<0.001) seasonal variation was seen for both 25(OH)D and PTH. Women were divided into two groups based on their vitamin D
status: low vitamin D status (25(OH)D <12 ng/ml, n= 161, 28%) and normal vitamin D status (25(OH)D ≥12 ng/ml, n= 409, 72%). Hypovitaminosis D was found in 38.5% of all the women in the time period December–May and in 12.5% in the other
half-year; among women >70 years old 51% had hypovitaminosis D in the time period December–May and 17% in the other half-year.
PTH was significantly (p<0.05) increased, and Ca24h, OC and FBMD significantly (p<0.05) decreased in women with hypovitaminosis D. 1,25(OH)2D positively correlated with 25(OH)D (p<0.0001), but did not correlate with PTH, age or creatinine clearance. In conclusion, hypovitaminosis D is an important, underestimated
problem in Italian free-living postmenopausal women referred to an outpatient osteoporosis clinic.
Received: 9 February 1998 / Accepted: 8 July 1998 相似文献
3.
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
4.
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
5.
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
6.
The Association between Parathyroid Hormone, Vitamin D and Bone Mineral Density in 70-Year-Old Icelandic Women 总被引:4,自引:0,他引:4
G. Sigurdsson L. Franzson L. Steingrimsdottir H. Sigvaldason 《Osteoporosis international》2000,11(12):1031-1035
Parathyroid hormone (PTH) may be an important determinant of cortical bone remodeling in the elderly. Vitamin D status is
one of the determining factors in this relationship. The aim of this study was to quantify the relationship between serum
PTH, vitamin D and bone mineral density (BMD) in elderly women in Reykjavik (64° N), where daily intake of cod liver oil is
common and mean calcium intake is high. ln PTH correlated inversely with 25(OH)D (r=−0.26, p<0.01). In multivariate analysis PTH correlated inversely with whole body BMD (mostly cortical bone) (R
2= 2.2%, p = 0.04) but not with the lumbar spine BMD, reflecting more cancellous bone. No association was found between 25(OH)D levels
and BMD at any site in univariate or multivariate analysis. Osteocalcin, a measure of bone turnover, was negatively associated
with BMD and this association remained significant when corrected for PTH levels. In summary, in this fairly vitamin D replete
population with high calcium intake, PTH was negatively associated with total body BMD. We infer that suppression of PTH may
reduce cortical bone loss, but other factors are likely to contribute to age-related bone remodeling and osteoporosis.
Received: 3 January 2000 / Accepted: 10 April 2000 相似文献
7.
Z. Efstathiadou V. Kranas J. P. A. Ioannidis I. Georgiou A. Tsatsoulis 《Osteoporosis international》2001,12(4):326-331
Several genetic polymorphisms are implicated as determinants of bone mineral density (BMD) in postmenopausal women. These
include the Sp1 polymorphism of the collagen type Iα 1 (COLIA1) gene, the FokI and BsmI polymorphisms of the vitamin D receptor (VDR) gene, and the PvuII and XbaI polymorphisms of the estrogen receptor (ER) gene. The relative importance and the independence of these genetic effects
have not been studied simultaneously in the same population. We evaluated the effects of these polymorphisms on lumbar spine
BMD among 154 postmenopausal Greek women. BMD tended to differ across Sp1 genotypes (mean 0.842 g/cm2 in SS, 0.851 g/cm2 in Ss, 0.763 in ss, age-adjusted p = 0.056), mostly because ss homozygotes had lower BMD (p = 0.018 compared with SS and Ss). No other polymorphisms were associated with BMD in this population (p= 0.53 for FokI, p= 0.94 for BsmI, p = 0.80 for PvuII, p = 0.91 for XbaI). In multivariate modeling, the effect of ss homozygosity was clinically and statistically significant (–0.105 g/cm2, p= 0.013) after adjusting for age, weight, height, hormone replacement use, and the other four polymorphisms. None of the other
four polymorphisms was retained as an independent predictor of BMD in a backward elimination model and no significant synergistic
effects were observed when gene interactions were tested. When all five polymorphisms are considered simultaneously, the Sp1
COLIA1 polymorphism seems to have the most unequivocal effect on BMD, at least in postmenopausal women.
Received: 3 July 2000 / Accepted: 14 November 2000 相似文献
8.
H.-Y. ChenChen W.-C. Chen W.-C. Chen F.-J. Tsai C.-H. Tsai C.-W. Li 《Osteoporosis international》2001,12(12):1036-1041
Osteoporosis is a common disorder with a strong genetic component. Our aim was to evaluate the correlation of the vitamin
D receptor gene intron 8 BsmI polymorphism with bone mineral density (BMD) and their relationship to osteoporosis. We determined the vitamin D receptor
gene intron 8 BsmI polymorphism using polymerase chain reaction-based restriction analysis in 171 postmenopausal Chinese women in Taiwan. The
polymorphism was detected using the restriction enzyme BsmI, where the B allele indicated absence of the cuttable site and the b allele its presence. BMD of the lumbar spine and proximal
femur were measured using dual-energy X-ray absorptiometry. The allelic frequencies for postmenopausal Chinese women in Taiwan
were 12.3% for B and 87.7% for b in BsmI restriction fragment length polymorphisms. The prevalence of each genotype in the study population was: 6.4% BB, 11.7% Bb
and 81.9% bb. The three genotypic groups differed significantly in BMD at the lumbar spine and the femoral neck. These differences
corresponded to significant gene-dose effects at the lumbar spine and femoral neck (p<0.001 for both sites). The relative risk for the development of osteoporosis was about 2–3 times as great as that predicted
by the differences between genotypes in BMD, and remained significant even after adjustment for age, height and weight. The
vitamin D receptor gene intron 8 BsmI polymorphism is associated with reduced BMD and predisposes women to osteoporosis.
Received: 21 February 2001 / Accepted: 31 May 2001 相似文献
9.
Cigarette Smoking, Alcohol and Caffeine Consumption, and Bone Mineral Density in Postmenopausal Women 总被引:3,自引:0,他引:3
M. J. Grainge C. A. C. Coupland S. J. Cliffe C. E. D. Chilvers D. J. Hosking 《Osteoporosis international》1998,8(4):355-363
The aim of this analysis was to compare the effects of different measures of cigarette, alcohol and caffeine consumption
upon bone mineral density (BMD). Five hundred and eighty postmenopausal women aged 45–59 years at recruitment completed a
risk factor questionnaire that contained detailed sections on cigarette, alcohol and caffeine consumption. BMD was measured
using dual-energy X-ray absorptiometry. Measurements taken at five bone sites were used: anterior-posterior spine, femoral
neck, greater trochanter, radius/ulna and whole body. The data were analyzed using multiple linear regression, adjusting for
a number of established BMD risk factors. BMD was more strongly related to the number of months spent smoking than to pack-years
of smoking at all five sites (p <0.05 at four of the five sites). There were significant reductions in BMD when comparing smokers with non-smokers at ages
20, 30 and 40 years, but not for current smoking. Lifetime alcohol consumption and current alcohol consumption did not have
an independent association with BMD. However, the heaviest beer drinkers in the sample had a particularly low bone density.
Caffeine consumption at various ages was not associated with BMD. The results of these analyses suggest that for predicting
BMD a simple history of smoking duration is as good as trying to obtain more detailed smoking information, but that only 25%
of the variation in BMD is explained by personal characteristics, family history and lifestyle factors.
Received: 30 June 1997 / Accepted: 23 December 1997 相似文献
10.
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
11.
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
12.
The Vitamin D Receptor Start Codon Polymorphism (Fok1) and Bone Mineral Density in Premenopausal Women in Taiwan 总被引:1,自引:0,他引:1
The vitamin D receptor gene (VDRG) polymorphism as a factor of bone turnover rate or bone mineral density (BMD) is a controversial
issue, especially in different ethnic populations. In addition to intron 8 (Bsm1, Taq1) and exon 9 (Apa1), VDRG polymorphism is present at its translation initiation site on exon 2. The VDRG has two translation initiation sites.
The first shows a thymine/cytosine polymorphism and can be detected by restriction fragment length polymorphism (RFLP) using
the endonuclease Fok1. This start codon polymorphism (SCP) of the VDRG was detected by polymerase chain reaction and then by RFLP with Fok1. While the f allele was assigned for the presence of the restriction site, the F allele was assigned for the absence of
the restriction site, and the encoded vitamin D receptor is shorter by three amino acids. We examined the association between
this SCP of the VDRG and bone turnover as well as BMD in 101 premenopausal Taiwanese women aged 40–53 years. Total body bone
mineral content and BMD of proximal femur and lumbar spine were measured by dual-energy X-ray absorptiometry. We found a prevalence
of 39.6% for the f allele of the VDRG. The frequencies of FF, Ff and ff genotypes were 35.6%, 49.5% and 14.9%, respectively.
There was no statistically significant difference in BMD at any site or bone turnover markers among the three Fok1 genotypes (FF, Ff and ff). The SCP is independent of Bsm1, Apa1 or Taq1 polymorphisms of the VDRG at intron 8 and exon 9. In conclusion, the SCP polymorphism detected by endonuclease Fok1 does not significantly influence BMD or bone turnover in premenopausal women in Taiwan.
Received: 7 July 1998 / Accepted: 10 November 1998 相似文献
13.
Vitamin D Receptor Gene Polymorphisms and Bone Mineral Density in Elderly Chinese Men and Women in Hong Kong 总被引:8,自引:0,他引:8
E. M. C. Lau R. P. Young S. C. H. Ho J. Woo J. L. Y. Kwok Z. Birjandi G. N. Thomas A. Sham J. A. J. H. Critchley 《Osteoporosis international》1999,10(3):226-230
Although genetic factors have been strongly implicated in determining bone mineral density (BMD), the role of the vitamin
D receptor (VDR) polymorphism remains controversial. An overall consensus is difficult, as the populations studied have been
heterogeneous with respect to menopausal status and ethnicity. Moreover, some studies have examined only small populations,
and relatively few studies have been conducted in Asian populations. There is mounting evidence that calcium homeostasis in
Asian populations differs from that in Caucasians. This difference may be mediated, in part, through VDR effects. In a cross-sectional
study we have examined the relationship between the VDR polymorphism and BMD in 272 women (mean age 75 years) and 237 men
(mean age 73 years) of Chinese origin from Hong Kong. Consistent with other studies in Asian populations we found higher frequencies
of the T, b and a alleles compared with those reported in Caucasian populations. Moreover, no significant difference in BMD
was observed when subjects were grouped by a combination of the genotypes (bbAATT, bbAaTT, bbaaTT, BbAaTt, BbAATt). These
results suggest that VDR polymorphism is not associated with BMD in elderly Hong Kong Chinese men and women.
Received: 16 July 1998 / Accepted: 15 February 1999 相似文献
14.
R. Patel D. Collins S. Bullock R. Swaminathan G. M. Blake I. Fogelman 《Osteoporosis international》2001,12(4):319-325
Vitamin D status is known to be an important determinant of bone mineral density (BMD). There is a significant seasonal variation
in serum vitamin D, and some studies have reported an associated seasonal variation in BMD. The present study was devised
to investigate whether a seasonal variation in BMD could be detected in healthy normal subjects, along with associated variations
in serum parathyroid hormone (PTH), intestinal calcium absorption and biochemical markers of bone turnover. A second aim was
to investigate whether, if such variations were identified, they could be suppressed by vitamin D supplementation. The subjects
were 70 healthy female volunteers (mean age 47.2 years, range 24–70 years) recruited into a double-masked crossover study
and followed over 2 years. During the first year 35 subjects received a daily oral supplement containing 800 IU (20 mg) cholecalciferol
(group 1) and 35 subjects received a placebo preparation (group 2). During the second year the treatment each group received
was reversed. Lumbar spine (L1–L4), left proximal femur and total body BMD were measured by DXA at 3-month intervals. Serum
25-hydroxyvitamin D (25-OHD), serum PTH, bone markers (bone-specific ALP (BSAP) and urinary crosslinks (DYPD/creatinine))
and calcium absorption were also measured at each visit. Cholecalciferol treatment increased serum 25-OHD by 25.4 nmol/l (p <0.001), while a reciprocal decrease in serum PTH of 6.6 ng/l (p = 0.011) was seen in subjects in the lowest quartile of baseline serum 25-OHD. The treatment had no significant effect on
spine, femur or total body BMD, calcium absorption or bone markers. When Fourier analysis was used to analyze the data for
seasonal effect (defined as twice the amplitude of the 1-year period variation) a highly significant effect for 25-OHD of
18 nmol/l (p <0.001) was found. However, no effect was found for BMD, PTH, calcium absorption or bone markers. The analysis set a 95%
confidence limit to the seasonal effect of less than 0.6% for spine, total hip and total body BMD. It was concluded that in
the population of healthy women studied there was no evidence of seasonal variation in spine, femur or total body BMD, serum
PTH, calcium absorption or bone markers. Vitamin D supplementation was found to have no effect on BMD.
Received: 7 July 2000 / Accepted: 14 November 2000 相似文献
15.
Non-association of Estrogen Receptor Genotypes with Bone Mineral Density and Bone Turnover in Korean Pre-, Peri-, and Postmenopausal Women 总被引:19,自引:0,他引:19
K. Han J. Choi I. Moon H. Yoon I. Han H. Min Y. Kim Y. Choi 《Osteoporosis international》1999,9(4):290-295
Estrogen is known to play a critical role in both skeletal maturity and the rate of bone loss. This suggests the possibility
that the estrogen receptor (ER) gene is one of the candidate genes that determines peak bone density and/or bone turnover
rate. We investigated two established restriction fragment length polymorphisms (RFLPs) in intron 1 at the ER gene, represented
as PvuII and XbaI. In 598 healthy Korean women aged 20–74 years, we examined the association of these ER genotypes with bone mineral density
(BMD) and bone turnover status. The distribution of the PvuII and XbaI RFLPs was as follows: pp 205 (34.3%), Pp 308 (51.5%), PP 85 (14.2%) and xx 384 (64.2%), Xx 180 (30.1%), XX 34 (5.7%), respectively (where capital letters signify the absence of, and lower-case letters signify the presence of, the
restriction site of each RFLP). No significant genotypic differences were found in BMD and bone markers. We grouped the subjects
into three categories according to their menstrual status: 104 premenopausal women with regular menstruation, 182 perimenopausal
women who had amenorrhea of not less than 3 months and not more than 12 months’ duration, and 312 postmenopausal women whose
last menstruation was at least 12 months previously. No significant genotypic difference in either BMD or bone markers was
found in any of these three groups. Furthermore we categorized women in peri- and postmenopause into a high loser group and
a normal loser group according to the level of bone resorption markers. There was no difference in genotypic proportions between
the high and normal loser groups. Our data suggest that these ER polymorphisms are not associated with BMD or bone turnover
in Korean women.
Received: 16 March 1998 / Accepted: 17 August 1998 相似文献
16.
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
17.
Treatment of Postmenopausal Women with Osteoporosis or Low Bone Density with Raloxifene 总被引:3,自引:0,他引:3
P. J. Meunier E. Vignot P. Garnero E. Confavreux E. Paris S. Liu-Leage S. Sarkar T. Liu M. Wong M. W. Draper 《Osteoporosis international》1999,10(4):330-336
Raloxifene, a selective estrogen receptor modulator (SERM), has been shown to improved bone mineral density (BMD) and serum
lipid profiles in healthy postmenopausal women. The objective of this study was to examine the effects of raloxifene on BMD,
biochemical markers of bone metabolism and serum lipids in postmenopausal women with low bone density or osteoporosis. This
Phase II, multicenter, 24-month, double-masked study assessed the efficacy and safety of raloxifene in 129 postmenopausal
women (mean age ± SD: 60.2 ± 6.7 years) with osteoporosis or low bone density (baseline mean lumbar spine BMD T-score: −2.8). Women were randomly assigned to one of three treatment groups: placebo, 60 mg/day raloxifene-HCl (RLX 60) or
150 mg/day raloxifene-HCl (RLX 150) and concomitantly received 1000 mg/day calcium and 300 U/day vitamin D3. At 24 months, BMD was significantly increased in the lumbar spine (+3.2%), femoral neck (+2.1%), trochanter (+2.7%) and
total hip (+1.6%) in the RLX 60 group compared with the placebo group (p<0.05). The RLX 150 group had increases in BMD similar to those observed with RLX 60. A greater percentage of raloxifene-treated
patients, compared with those receiving placebo, had increased BMD (p<0.05). Serum bone-specific alkaline phosphatase activity, serum osteocalcin, and urinary type I collagen:creatinine ratio
were significantly decreased in the RLX-treated groups, compared with the placebo group (p<0.01). RLX 60 treatment significantly decreased serum levels of triglycerides, and total- and LDL-cholesterol levels (p<0.01). The rates of patient discontinuation and adverse events were not significantly different among groups. In this study,
raloxifene increased bone density, decreased bone turnover, and improved the serum lipid profile with minimal adverse events,
and may be a safe and effective treatment for postmenopausal women with osteoporosis or low bone density.
Received: 26 December 1998 / Accepted: 31 March 1999 相似文献
18.
Bone mineral density (BMD) has been shown to be different in different ethnic groups. When lifestyle and diet evolve, there
is a possibility of a change in the normal reference BMD values within an ethnic group over a period of time. As the osteoporotic
risk uses the T-score as the bench mark, it is pertinent to evaluate whether such changes do occur. Two measurements, 5 years apart, of the
BMD of the spine and the hip were made in a cohort of Chinese women in Hong Kong. A kernel function smoothing method, a nonparametric
statistical method, was employed to present the BMD data. The greatest rate of bone loss was found to occur between 50 and
59 years of age, but this rate of loss was reduced from age 60 onwards. The BMD values obtained in these two measurements
were different from the previous studies in the same population and were found to be higher at the lumbar spine and neck of
femur in women over 65 years of age. Even within the cohort, there seemed to be a reduction in the BMD values of the hip in
a span of 5 years, although the differences were statistically insignificant. These studies suggest that BMD values could
change in a population for a variety of possible reasons. Hence, the reference BMD values might need to be evaluated at regular
intervals for the T-score to be meaningful.
Received: 26 April 2000 / Accepted: 8 February 2001 相似文献
19.
Adami S Gatti D Bertoldo F Sartori L Di Munno O Filipponi P Marcocci C Frediani B Palummeri E Fiore CE Costi D Rossini M 《Calcified tissue international》2008,83(5):301-307
Compliance to osteoporosis treatment with oral bisphosphonates is very poor. Intermittent intravenous bisphosphonate is a
useful alternative, but this route is not readily available. Neridronate, a nitrogen-containing bisphosphonate that can be
given intramuscularly (IM), was tested in a phase 2 clinical trial in 188 postmenopausal osteoporotic women randomized to
IM treatment with 25 mg neridronate every 2 weeks, neridronate 12.5 or 25 mg every 4 weeks, or placebo. All patients received
calcium and vitamin D supplements. The patients were treated over 12 months with 2-year posttreatment follow-up. After 12-month
treatment, all three doses were associated with significant bone mineral density (BMD) increases at both the total hip and
spine. A significant dose–response relationship over the three doses was observed for the BMD changes at the total hip but
not at the spine. Bone alkaline phosphatase decreased significantly by 40–55% in neridronate-treated patients, with an insignificant
dose–response relationship. Serum type I collagen C-telopeptide decreased by 58–79%, with a significant dose–response relationship
(P < 0.05). Two years after treatment discontinuation, BMD declined by 1–2% in each dose group, with values still significantly
higher than baseline at both the spine and the total hip. Bone turnover markers progressively increased after treatment discontinuation,
and on the second year of follow-up the values were significantly higher than pretreatment baseline. The results of this study
indicate that IM neridronate might be of value for patients intolerant to oral bisphosphonates and unwilling or unable to
undergo intravenous infusion of bisphosphonates. 相似文献
20.
J.-F. Chiu S.-J. Lan C.-Y. Yang P.-W. Wang W.-J. Yao I.-H. Su C.-C. Hsieh 《Calcified tissue international》1997,60(3):245-249
This study examined bone density among postmenopausal Buddhist nuns and female religious followers of Buddhism in southern
Taiwan and related the measurements to subject characteristics including age, body mass, physical activity, nutrient intake,
and vegetarian practice. A total of 258 postmenopausal Taiwanese vegetarian women participated in the study. Lumbar spine
and femoral neck bone mineral density (BMD) were measured using dual-photon absorptimetry. BMD measurements were analyzed
first as quantitative outcomes in multiple regression analyses and next as indicators of osteopenia status in logistic regression
analyses. Among the independent variables examined, age inversely and body mass index positively correlated with both the
spine and femoral neck BMD measurements. They were also significant predictors of the osteopenia status. Energy intake from
protein was a significant correlate of lumbar spine BMD only. Other nutrients, including calcium and energy intake from nonprotein
sources, did not correlate significantly with the two bone density parameters. Long-term practitioners of vegan vegetarian
were found to be at a higher risk of exceeding lumbar spine fracture threshold (adjusted odds ratio = 2.48, 95% confidence
interval = 1.03–5.96) and of being classified as having osteopenia of the femoral neck (3.94, 1.21–12.82). Identification
of effective nutrition supplements may be necessary to improve BMD levels and to reduce the risk of osteoporosis among long-term
female vegetarians.
Received: 10 May 1996 / Accepted: 9 August 1996 相似文献