大连地区汉族成年女性腰椎骨密度定量CT测量分析

目的:探索大连地区健康成年女性骨密度及其峰值随年龄变化规律,为女性骨质疏松症的防治提供科学依据,同时为建立中国北方成人女性的正常骨密度值数据库积累数据.方法:采用定量CT技术测量分析大连500例汉族健康女性腰椎各椎体骨密度.腰椎骨密度随年龄的变化用三次回归模型拟合来描述.结果:大连地区女性成人腰椎骨密度平均值(156.4±12 09)mg/ml,平均峰值(167.16±4.90)mg/ml,出现在20～29岁年龄段.40～49岁腰椎骨量丢失有统计学意义,与前组比较平均骨量丢失10.38%; 30～39岁、50～59岁与前组比较,平均骨量丢失2.98%、 4.10%.第5腰椎在4个年龄组里,骨量丢失改变有统计学意义.大连地区20～59岁汉族女性骨密度正常参考值范围为(164.07±30.23)mg/ml.结论:大连地区汉族成人女性从40岁起进入绝经过渡期,腰椎骨量丢失明显.     

不同年龄女性人群血液中的Dkk-1水平与骨密度相关性的分析研究

目的:探讨不同年龄女性人群血液中的Dickkopf-1(Dkk-1)水平与骨密度之间的相关性。方法:选取2013年3月~2014年6月在我院行体检的100例年龄处于20~80岁之间的女性志愿者,按照不同年龄分为青年组(20~39岁)、中年组(40~59岁)和老年组(60~80岁),从中年女性组中抽取45~55岁25人,分为绝经期女性组和未绝经女性组。采用酶联免疫吸附法测3组志愿者血清Dkk-1的表达水平,采用双能X线骨密度测量仪测定3组志愿者全身矿含量,分析不同年龄女性以及绝经与否女性血清Dkk-1水平的差异及Dkk-1水平与骨密度的关系。结果:随着年龄的增长,人群血清Dkk-1水平相应增高(P0.05),骨密度相应降低(P0.05);3组志愿者中,血清Dkk-1水平与骨密度均呈负相关(P0.05)。45~55岁年龄范围内,绝经组女性血清Dkk-1与未绝经妇女相比,Dkk-1水平与骨密度降低的相关性更为密切(P0.05)。结论:人体随着年龄的增加,血清Dkk-1水平会上升,并出现骨密度下降,有发生骨质疏松症的风险。相同年龄范围妇女中,绝经后妇女Dkk-1水平表达较高,骨密度降低更明显,有更大的发生骨质疏松症危险。Dkk-1表达的增加同时可抑制骨形成和促进骨吸收,有望成为预防和治疗骨质疏松症治疗的一个新靶点。     

广西瑶族健康女性骨密度的研究

目的获取广西瑶族健康女性骨峰值(PBM)。方法选取瑶族健康女性469名采用单光子二维骨密度仪检测左侧桡骨、尺骨超远端的骨密度(BMD)值,按年龄进行分组,以5岁作为1个年龄段。结果①瑶族女性骨峰值年龄在40～岁。②瑶族桡骨、尺骨PBM值(g/cm2)分别为0.3317±0.0538、0.3458±0.0579。结论应用二维骨密度超远端测定,获得瑶族正常女性PBM,对骨质松症的诊治具有重要意义。壮瑶族间PBM值差异有显著(P<0.05)。     

中国广西苗族与仫佬族成年女性血脂异常的差异及危险因素分析

目的：探讨中国广西壮族自治区苗族和仫佬族成年女性血脂异常的检出率、民族差异及危险因素。方法2012年7月—2013年8月随机整群抽取广西壮族自治区融水苗族自治县偏僻村寨的苗族和罗城仫佬族自治县偏僻村寨的仫佬族成年女性共444人,进行问卷调查,抽血检测总胆固醇( TC)、三酰甘油( TG)、低密度脂蛋白( LDL-C)和高密度脂蛋白( HDL-C),并采用生物电阻抗法测定体成分;比较两民族的血脂水平、血脂异常的类型及检出率的差异,分析血脂异常与体成分等因素的关联及民族差异。结果苗族和仫佬族女性的TC、TG和LDL-C水平存在明显的差异,除LDL-C外,均为苗族高于仫佬族(P<0.01)。苗族血脂异常的总检出率为35.25%(86/244),高于仫佬族的25.00%(50/200),差异有统计学意义(χ2=5.420,P<0.05);其中高TC血症是苗族最常见的血脂异常类型,高LDL-C血症是仫佬族最常见的血脂异常类型。相同民族血脂异常组的年龄、脂肪量、内脏(皮下)脂肪含量、体脂肪率、BMI、腰臀比、绝经年限、生育子女数等高于正常组,差异均有统计学意义(P值均<0.05);不同民族的血脂异常组比较,苗族的体质量、脂肪量、细胞外液、内脏(皮下)脂肪含量、体脂肪率、BMI、腰臀比及绝经年限均高于仫佬族,差异均有统计学意义(P值均<0.01)。 logistic回归分析显示年龄、BMI、腰臀比、体脂肪率、绝经年限和生育子女数均与苗族和仫佬族血脂异常呈正相关(OR>1,P值均<0.05)。结论苗族和仫佬族成年女性的血脂异常类型及检出率存在差异;年龄、BMI、腰臀比、体脂肪率、绝经、绝经年限和子女数是两民族女性血脂异常的危险因素;腰臀比和体脂肪率比BMI能更好的预测血脂异常。     

广西瑶族中老年人骨密度与体成分的相关性分析

目的:分析探讨广西瑶族中老年人身高、体质量、脂肪率、脂肪、体质量指数与骨密度的规律及其相关性。方法:随机抽取343名(男性123名,女性220名)广西瑶族健康中老年人作为研究对象,检测受试者的体质量、脂肪率、脂肪量、体质量指数、身高和右足跟骨密度。结果:广西瑶族中老年人身高、体质量、脂肪率、脂肪量、体质量指数与骨密度均随着年龄的增长逐渐降低,不同性别间身高、脂肪率和骨密度差异明显。男性的身高、脂肪率和骨密度均大于同龄段女性,男性骨密度减少的幅度小于女性。男、女性的身高、体质量、体质量指数与骨密度均显著相关。结论:广西瑶族中老年人身高、体质量、体质量指数和骨密度随年龄的增长逐渐降低,且身高、体质量、体质量指数对骨密度起决定性作用。     

广西百色地区苗族健康女性骨密度及骨质疏松患病率的研究

目的了解广西百色地区苗族健康女性骨峰值(PBM)和骨质疏松(OP)的发病情况。方法选取苗族健康女性506名采用单光子二维骨密度仪检测左侧桡骨、尺骨超远端的骨密度(BMD)值,按年龄进行分组,以5岁作为1个年龄段。结果①百色地区苗族女性骨峰值年龄在40岁以上至45岁。②苗族桡骨、尺骨PBM值(g/cm2)分别为0.3347±0.0490、0.3340±0.0585。③60岁后OP患病率为25.23%。结论应用二维骨密度超远端测定,获得百色地区苗族正常女性PBM,对骨质松症的诊治具有重要意义。老年人有较高的骨质疏松检出率,他们是骨质疏松性骨折的高危人群。     

女性2型糖尿病患者的骨密度变化

目的：探讨女性2型糖尿病与骨质疏松的关系。方法：应用双能X线骨密度仪（DEXA）对56例女性2型糖尿病患者及52例女性健康对照者进行骨密度（BMD）测定,并测定糖尿病患者的空腹胰岛素及餐后2h胰岛素（2h Ins）水平,结合病程、年龄等相关因素进行分析。结果：52例健康对照组中低骨量8例,骨质疏松5例,骨密度减低的发生率为25%;56例2型糖尿病患者中,低骨量16例,骨质疏松23例,骨密度减低的发生率为69.7%,明显高于对照组,差异有显著性（P〈0.01,χ^2=21.524）,骨密度减低者胰岛素水平相对更低。结论：女性2型糖尿病患者的骨质疏松发生率高,且与年龄、病程、胰岛素水平相关。     

上海市高知女性跟骨骨密度测定：197个结果分析

背景：研究表明,女性骨峰值低于男性,而不同地区人群骨矿含量存在差异,因此有必要建立各地区不同人群的峰值骨密度。 目的：调查上海市高知女性骨密度随年龄、体质量指数等变化规律。 方法：纳入27~62岁高知女性受试者共197例,5岁为一个年龄段,共分为7组。准确记录各组受试者年龄,身高及体质量,并采用超声波骨密度仪测定各组受试者跟骨骨密度。用逐步回归分析各组骨峰值与年龄、体质量和握力的相关性。 结果与结论：研究结果显示上海市女性骨量峰值出现在38~39岁年龄段。骨密度值的下降率在31~35岁和41~45岁下降幅度最大。逐步回归分析结果显示,上海高知女性骨峰值与年龄、体质量、握力成正相关,年龄对骨峰值的影响最为明显,峰值骨量越低或出现越早,发生骨质疏松的危险越大。结果表明上海市高知女性群体发生骨质疏松的危险性较大。     

广西百色地区壮族和汉族健康女性骨密度的研究

目的　了解百色地区骨峰值 (PBM)的基本情况 ,为骨质疏松 (OP)的诊断及防治效果评估提供依据。方法　选取健康女性 838名 (壮族 4 15 ,汉族 4 2 3) ,进行二维骨密度测定 ,检测左侧桡骨、尺骨超远端的骨密度 (BMD)值。按民族、年龄进行分组 ,以 5岁作为 1个年龄段。结果　①百色地区女性骨峰值年龄均在 4 0～岁。②壮族桡骨、尺骨PBM值 (g/cm2 )分别为0 35 35± 0 0 4 6 2、0 3384± 0 0 6 6 0。③汉族桡骨、尺骨PBM值 (g/cm2 )分别为 0 3433± 0 0 6 81、0 330 4± 0 0 5 97。④壮汉族间PBM值差异无显著 (P >0 0 5 )。结论　应用二维骨密度超远端测定 ,获得百色地区壮汉族正常人群PBM ,对骨质疏松症的诊治都具有重要意义。壮汉族间PBM值差异无显著。     

女性Graves病患者行131Ⅰ治疗前后骨密度及血清骨代谢指标变化的研究分析

目的 分析女性Graves病患者行131Ⅰ治疗前后骨密度及血清骨代谢指标的变化.方法 收集经131Ⅰ治疗的86例女性Graves病患者的资料,根据绝经情况随机分为绝经组和未绝经组,各43例,分别于治疗前、治疗后测量两组的腰椎、髋部骨密度(BMD)及血钙(Ca)、磷(P),甲状旁腺激素(PTH),碱性磷酸酶(ALP),血骨钙素(BGP)等骨代谢指标.结果 131Ⅰ治疗前,两组的BMD及骨代谢指标均有不同程度的改变,组间对比差异无统计学意义(P＞0.05);治疗后,两组的BMD明显上升,骨代谢指标ALP、BGP水平明显降低,未绝经组变化更加明显(P＜0.05),但两组血Ca、P、PTH水平差异无统计学意义(P＞0.05).结论 131Ⅰ治疗可以改善女性Graves病患者的骨密度及骨代谢情况.     

广西百色地区壮族妇女脂联素基因单核苷酸多态性与骨密度的关系

目的 探讨脂联素(APN)基因5个单核苷酸多态性(SNPs)与广西百色地区壮族妇女骨矿物质密度(BMD)的关系.方法 选取壮族女性239例跟骨骨量减少患者(LBM)和83例正常骨量组(NBM)进行病例对照研究,采用多重单碱基延伸SNP分型技术对壮族女性脂联素基因的5个位点(rs1063539、rs12495941、rs266729 、rs3774261 及rs710445)进行了基因分型,采用法国生产的Osteospace干式超声骨密度仪测量右侧跟骨超声振幅衰减(BUA).结果 仅rs1063539、rs12495941、rs266729及rs710445多态性分布符合Hardy-Weinberg遗传平衡定律(P>0.05).除rs3774261在骨量正常组的分布不符合Hardy-Weinberg平衡(P<0.05)之外,其余位点在正常组和骨量减少组基因型分布均符合Hardy-Weinberg平衡(P>0.05).其中,只有rs1063539 基因型在NOR和LBM组差异存在显著性(P=0.003),CG基因型者在LBM组人数明显多于GG型(P<0.01).调整年龄、体重、身高及体质指数后,以5个多态性位点作为自变量的多元 Logistic回归显示,仅rs1063539多态性与跟骨BUA相关性有统计学意义(adjusted OR=3.210,95%CI:1.631～6.137,P=0.001),并独立于骨量减少的传统危险因素.结论 APN基因第3外显子rs1063539多态性与壮族女性 BMD有一定关联,其中GG型对BMD具有一定的保护作用,CG型是BMD降低的危险因素.rs12495941、rs266729、rs3774261及rs710445多态性与壮族女性BMD无相关性.     

运动联合福善美对去卵巢大鼠骨密度和神经传导的影响

目的: 观察运动是否可增强福善美对卵巢切除大鼠骨质疏松的治疗作用。方法: 将90只6月龄雌性SD大鼠随机分为假手术组(sham,18只)和卵巢切除模型组(OVX,72只)。大鼠卵巢切除8周后,测定大鼠第4腰椎骨密度(BMD)和血清雌二醇含量。随后,存活的OVX大鼠分为模型组(OVX)、福善美治疗组(OVX+FOX)、运动治疗组(OVX+EX)和福善美与运动联合治疗组(OVX+FOX+EX),分别给予1 mg·kg^-1·d^-1福善美灌胃和(或)跑台运动干预治疗12周后,双能X线骨密度仪测定各组大鼠第4腰椎BMD;肌电图机检测大鼠左侧股神经传导速度(MCV)、运动末端潜伏期(ML)和复合肌肉动作电位(CMAP);ELISA法测定大鼠血清Ⅰ型前胶原羧基端前肽(PICP)及Ⅰ型胶原羧基端交联端肽(ICTP)含量。结果: 卵巢切除大鼠福善美和(或)运动干预治疗12周后,OVX组与sham组相比,BMD显著降低(P<0.05),血清PICP和ICTP明显增高(P<0.05),左侧股神经ML未见明显改变。福善美和运动均可显著提高骨质疏松大鼠BMD,降低ICTP;福善美可显著降低骨质疏松大鼠ICTP,而运动对ICTP无明显影响。运动可明显缩短模型组左侧ML(P<0.05),福善美对ML无显著改善作用。运动与福善美联合对BMD、PICP、ICTP及ML的改善作用较两者单用效果显著(P<0.05);福善美与运动两治疗组间未见明显差异。各组大鼠左侧股神经MCV和CMAP未见明显差异。2×2析因设计的方差分析显示,福善美与运动2种处理方式之间不存在交互作用(P>0.05)。结论: 福善美和运动可能通过抑制破骨细胞的骨吸收而抑制大鼠卵巢切除对骨密度的影响。     

A long-term study of bone mineral density in patients with phenylketonuria under diet therapy

Introduction

Dietary control of classic phenylketonuria (PKU) needs restriction of natural proteins; adequate protein intake is achieved by adding low phenylalanine (phe) formulae. The adequacy of this diet for normal bone mineralization had not been sufficiently evaluated. Our aim was to evaluate and follow up bone mineral density (BMD) in children and adolescents with PKU within a 2-year time interval to assess the adequacy of a phenylalanine restricted diet for bone mineralization and to search for a possible relationship between BMD, dietary control and blood phenylalanine (phe) concentrations.

Material and methods

Thirty-two patients with classic PKU (3-19 years) were evaluated for their bone mineral status using dual energy X-ray absorptiometry (DEXA) both at the beginning (baseline) and the end (follow-up) of the study.

Results

Low BMD was detected in 31.25% at the start and in 6.25% of patients after 2 years follows-up. No relationship was found between BMD and the duration of diet compliance and phe level as well.

Conclusions

In this study the low BMD detected in our patients was both at baseline and follow-up independent of diet restriction. A yearly DEXA would be highly beneficial for early detection and treatment, thus preventing osteoporosis and decreasing the risk of fractures. We also suggest the importance of searching for new emerging therapies such as enzyme substitution or gene therapy as low protein diet compliance was not enough to maintain normal bone mineral density.     

Multifactorial analysis of risk factors for reduced bone mineral density among postmenopausal women

Introduction

The study aimed to determine the risk factors for reduced bone mineral density (BMD) among postmenopausal women.

Material and methods

Two hundred and fifty-three postmenopausal women were included to the study. The study group consisted of 85 women with osteoporosis (mean age: 59.9 years) and 168 with osteopenia (mean age: 57.8 years). Patients were assigned to groups according to their BMD measured in the lumbar spine, hip and femoral neck by dual X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorption by measuring serum C-terminal type I α-collagen chain telopeptide.

Results

Multiple regression analysis for lumbar spine showed association of age (p = 0.001), parental history of fracture (p = 0.05), use of hormone replacement therapy (p = 0.034), bisphosphonates therapy (p < 0.001), calcium and vitamin D supplements therapy (p = 0.001), oestradiol level (p = 0.007) and body mass index (p < 0.001). Multiple regression analysis for femoral neck and hip total showed association of age (p = 0.001), parental history of fracture (p = 0.049), use of bisphosphonates (p < 0.03)) use of calcium and vitamin D supplements (p = 0.039), oestradiol level (p = 0.047). All the variables together explain 40.4% of variance in BMD for the lumbar spine and 25.6% of variance in BMD for femoral neck and hip total.

Conclusions

The present study demonstrated correlations between the variables and BMD, which are known and widely described in the literature. Osteoporosis and osteopenia in Polish subjects appear to be associated with several known risk factors that are well described in the literature.     

Effect of natural early menopause on bone mineral density

OBJECTIVES: Early menopause (EM) is included among the risk factors for osteoporosis. Several studies have shown that women with early menopause have lower bone mineral density (BMD) than those with normal expected age of menopause. The aim of our cross-sectional study was to investigate the effects of time of menopause on vertebral bone mass in healthy postmenopausal women and to evaluate if early menopause is a risk factor for lower vertebral BMD. METHOD: We studied 782 who had never received drugs acting on bone mass. The study population was divided into three groups: women with early, normal (NM), and late (LM) menopause. Our study population was further categorized in 5-year age segments between 45 and >75. RESULTS: The three groups examined did not differ for age, age at menarche, body mass index (BMI), and vertebral BMD, while there were significant differences in age at menopause and years since menopause. Our study showed that women with EM presented significantly lower vertebral BMD than NM and LM in 50-54 age segments. Beyond 55 years, EM, NM, and LM women had no differences in lumbar BMD values. CONCLUSIONS: In conclusion, controversial data demonstrated that the absolute amount of bone loss is greater after early menopause than after normal or late menopause, even if a slight effect of early menopause on bone mass cannot be excluded.     

广西罗城仫佬族中老年人跟骨超声骨密度检测分析

目的:调查广西罗城仫佬族中老年人骨密度,探讨该人群骨质疏松(OP)发病率及影响因素。方法:随机抽取45岁以上广西罗城世居仫佬族中老年健康人群,测量其跟骨超声骨密度,身高、体质量、体质量指数(BMI)。测试对象每5岁为1组,分析每组骨密度、骨质疏松患病率及相关影响因素。采用SPSS 17.0软件对数据进行分析。结果:罗城仫佬族中老年骨密度随年龄增长而降低。男性75以上年龄组与45岁年龄组对比差异有统计学意义,女性55岁以上各个年龄组与45岁年龄组对比差异有统计学意义,70岁年龄组,75岁以上年龄组与其余年龄组相比BUA值差异有统计学意义。从45岁年龄组至75岁以上年龄组,骨质疏松发生率在男性由0增至19%,女性则由0增至50%。骨密度与年龄呈负相关,与身高、体质量、BMI呈正相关。结论:罗城仫佬族男性骨密度降低程度较女性平缓。男性在75岁之后,女性55岁之后骨密度下降明显,发生时间早于男性。在该人群中倡导健康生活方式,积极干预,及早诊治对于防治骨质疏松具有重要意义。     

Meta-analysis of genome-wide linkage studies for bone mineral density

Genome-wide linkage studies have shown several chromosome loci that may harbor genes that regulate bone mineral density (BMD), but results have been inconsistent. A meta-analysis was performed to assess evidence for linkage of BMD across whole genome scan studies. Eleven whole-genome scans of BMD or osteoporosis containing 3,097 families with 12,685 individuals were included in this genome scan meta-analysis (GSMA). For each study, 120 genomic bins of ~30 cM were defined and ranked according to maximum evidence for linkage within each bin. Bin ranks were weighted and summed across all studies. The summed rank for each bin was assessed empirically for significance using permutation methods. A total of seven bins lie above the 95% confidence level (P=0.05) and one bin was above the 99% confidence level (P=0.01) in the GSMA of eleven linkage studies: bins 16.1 (16pter-16p12.3, Psumrnk <0.01), 3.3 (3p22.2-3p14.1), 1.1 (1pter-1p36.22), 18.2 (18p11.23-18q12.2), 6.3 (6p21.1-6q15), 20.1 (20pter-20p12.3), and 18.1 (18pter-18p11.23). GSMA was performed with seven studies with linkage scores of LOD >1–1.85 for sensitivity test, confirming the linkage on chromosome 16p and 3p and revealing evidence of new linkage in bins 10.2 (10p14-10q11.21) and 22.2 (22q12.3-22pter). In conclusion, the meta-analysis of whole-genome linkage studies of BMD has shown chromosome 16pter-16p12.3 to have the greatest evidence of linkage as well as revealing evidence of linkage in chromosomes 1p, 3p, 6, 10, 18, 20p, and 22q across studies. This data may provide a basis with which to carry out targeted linkage and candidate gene studies particularly in these regions.