中老年人群骨密度与人体测量指标及体成分相关性的研究

目的 了解北京市中老年人群骨密度和体成分检测情况,并探讨骨密度与人体测量指标及体成分之间的关系。方法 采用SPT(磷化存储高精度数字成像技术）骨密度分析仪（MetriScan）测定255例40岁以上中老年人的骨密度,利用体成分分析仪测定体脂肪、肌肉量等,并进行人体测量获得身高、体重、握力等数据。结果 (1)每10岁作为一个年龄段,共4个年龄段（70岁以上为1个年龄段）,随着年龄增加骨密度逐渐下降,尤其是女性60～69岁年龄段骨密度值与前一个年龄段测定值相比,差异有统计学意义,60岁以上同年龄段受试者的骨密度在不同性别之间差异有统计学意义(P<0.05),女性骨骼健康状况与男性相比明显较差;(2)骨密度与身高、体重、左右手握力、肌肉量、去脂体重、蛋白质和无机盐均呈正相关,而与体脂肪率呈显著负相关（P<0.01）。结论 身高、体重、左右手握力、体脂肪率、肌肉量、去脂体重、蛋白质和无机盐水平均与骨密度密切相关,也可以作为评价骨骼健康状况的间接参考指标,去脂体重和肌肉量是骨密度主要的决定因素。     

正常体重中年人体脂含量与腰椎和髋部骨密度相关性研究

目的探讨正常体重中年人体脂含量与腰椎和髋部骨密度(bone mineral density,BMD)相关性。方法选取499名成年受试者(平均年龄48.7岁),通过双能X线吸收测定法测量受试者BMD和体脂含量,采用多元线性回归分析和协方差分析评估BMD与体脂含量之间的关联。结果按体脂百分比截止值进行分组。体质量指数为18.5～22.9 kg/m2的男性临界值分别为20.6%和25.7%,而女性的临界值分别为33.4%和36%。体脂百分比往往与BMD呈负相关。身体脂肪百分比的增加与正常体重中年人的BMD降低有关。正常体重人群体脂百分比对BMD的影响在男性中比女性更明显。结论体重正常的中年男性和女性体脂百分比与骨密度呈负相关,这种关联在男性中比在女性中更为突出。     

绝经后女性握力与骨密度的相关性研究

目的研究绝经后女性握力和骨密度的相关性。方法对120例绝经后女性进行握力测量和骨密度测定,观察≤60岁组、61~70岁组和70岁组的握力和骨密度变化,应用单因素Person相关性分析和散点图研究握力与骨密度的相关性。结果最大握力:≤60岁组25.86±4.77 kg,61~70岁组23.37±4.64 kg,70岁组16.63±5.40 kg。骨密度测定提示:65例股骨颈T值≤-2.5;90例腰椎T值≤-2.5。最大握力与骨密度均随年龄增加而减少。握力与股骨颈和腰椎骨密度呈非常显著正相关。结论绝经后女性握力越大,股骨颈和腰椎骨密度越高。     

上海地区不同性别、年龄人群骨密度与双手握力间的相关性研究

目的：研究上海地区不同性别、年龄人群骨密度与双手握力之间的相关性。方法：前瞻性选取2021年8月至2021年12月行骨密度检查的1137例受试者作为研究对象,其中男性中位年龄为61岁（23～84岁）,女性中位年龄为62岁（23～87岁）。使用双能X线吸收法测定腰椎、股骨颈及全髋部的骨密度,使用握力计测定双手握力。对一般资料作描述性统计并比较组间差异,使用相关性分析、多元线性回归和趋势检验等统计学方法分析三个部位骨密度与双手握力之间的关系。结果：男性受试者优势手握力平均值显著高于女性[（36.26±7.88）kg vs.(22.76±4.52)kg,P<0.001]。绝经前女性受试者优势手握力平均值显著高于绝经后女性[（24.67±5.13）kg vs.(22.36±4.28)kg,P<0.001]。校正年龄和体重指数后,绝经前女性和绝经后女性腰椎、股骨颈及全髋部的骨密度均与优势手及非优势手握力呈正相关,但在男性研究对象中未能观察到。结论：握力可以作为女性骨质疏松症高风险人群的辅助筛查手段,用于评估骨质疏松症的患病风险。     

维生素D与2型糖尿病患者握力的相关性研究

目的分析2型糖尿病患者的握力与维生素D的相关关系,探讨维生素D对握力的影响。方法对126名2型糖尿病患者及121名健康人群进行研究,测定体重指数、股骨颈的骨密度、25(OH)D_3水平,应用握力计测定双手握力。分析维生素D水平对握力的影响。结果与正常对照组相比较:2型糖尿病患者维生素D水平偏低[男:(12.45±6.93)ng/m L对(16.25±6.73)ng/m L;女:(10.67±6.23)ng/m L对(13.29±6.24)ng/m L,均P0.05],握力低于正常对照组[男:(35.34±8.86)kg对(37.67±10.27)kg;女:(23.30±5.95)kg对(35.34±8.86)kg,均P0.05],女性股骨颈密度低于对照组[(0.89±0.13)kg对(1.05±0.16)g/cm~2,P0.05];(2)126名糖尿病患者平均年龄58.7±11.7岁,男女比例65:61,男女患者分别按照25(OH)D_3水平分为3组:严重缺乏组(10 ng/m L);缺乏组(≥10 ng/m L而20 ng/m L);不足组(≥20 ng/m L而30 ng/m L)。男性患者中,与维生素D不足组相比较,严重缺乏组的骨密度降低,握力减少,差异具有统计学差异[(33.54±7.77)kg对(39.34±5.91)kg,P0.05]。女性患者中,与维生素D不足组相比较,维生素D缺乏组、严重缺乏组的骨密度减低,握力降低[(18.03±5.32)kg对(22.68±6.78)kg、(28.10±0.07)kg,P均0.05];(3)多元直线逐步回归分析显示2型糖尿病患者中25(OH)D_3与握力呈正相关(r=0.239,P=0.031),且独立于年龄、性别、股骨颈骨密度。结论 2型糖尿病患者维生素D水平同握力之间存在独立正相关。     

胶东半岛成年人群骨密度与年龄、身高、体重、体重指数和体表面积关系的研究

目的研究胶东半岛成年人群骨密度(BMD)与年龄、身高、体重、体重指数(BMI)和体表面积(BS)之间的关系。方法采用双能X线骨密度仪(DEXA)对胶东半岛沿海地区多中心多阶段整群抽样调查3879名21～89岁居民进行骨密度测量,记录年龄,测量身高、体重,计算出BMI和BS,并进行统计学分析。不同年龄组分别按BMI大小分成3组:BMI≤20 kg/m2,(20～25)kg/m2,≥25kg/m2;BS大小分成3组:大体表面积组(LBSG),中体表面积组(IBSG),小体表面积组(SBSG)。结果男性和女性骨密度随年龄、身高、体重、BMI和BS的变化模式不同。腰椎和股骨BMD随体重、BMI和Bs增加而增高。不同年龄组骨密度均为:BMI≤20 kg/m2组IBSG>SBSG,差异有统计学意义。高龄、低体重和低体重指数者骨密度均较其他组低,差异有显著性。结论年龄、身高、体重、BMI和BS是影响骨密度的重要因素。     

失能老年人社会支持与生活质量的相关性研究

目的分析失能老年人的社会支持与生活质量状况及其相关性,探讨提高失能老年人生活质量的有效途径。方法应用简明健康调查量表（SF-36）和社会支持评定量表（SSRS）对529名失能老年人进行生活质量与社会支持状况调查。结果失能老年人与一般老年人群SF-36评分比较,差异有统计学意义（均P〈0.01）;失能老年人获得的社会支持评分显著低于正常人（P〈0.01）。社会支持与失能老年人生活质量呈正相关（P〈0.05,P〈0.01）。结论失能老年人生活质量较低,获得的社会支持也较低,社会支持与失能老年人的生活质量密切相关。社区医护人员应重视社会支持系统对提高失能老年人生活质量的作用,拓宽失能老年人现有的社会支持渠道,提高其生活质量。     

失能老年人社会支持与生活质量的相关性研究

目的分析失能老年人的社会支持与生活质量状况及其相关性,探讨提高失能老年人生活质量的有效途径。方法应用简明健康调查量表(SF-36)和社会支持评定量表(SSRS)对529名失能老年人进行生活质量与社会支持状况调查。结果失能老年人与一般老年人群SF-36评分比较,差异有统计学意义(均P0.01);失能老年人获得的社会支持评分显著低于正常人(P0.01)。社会支持与失能老年人生活质量呈正相关(P0.05,P0.01)。结论失能老年人生活质量较低,获得的社会支持也较低,社会支持与失能老年人的生活质量密切相关。社区医护人员应重视社会支持系统对提高失能老年人生活质量的作用,拓宽失能老年人现有的社会支持渠道,提高其生活质量。     

胃肠减压患者胃管置入长度及与身高关系的研究

目的探讨胃肠减压胃管置入的适宜长度及其与患者身高的关系。方法将120例择期行开腹手术患者随机分为对照组、观察1组、观察2组、观察3组各30例,术前留置胃管的长度分别为45～55cm、50～60cm、55～65cm及60～70cm;术中测量鼻胃管前端与贲门的距离,术后按照常规进行胃肠减压护理。结果术中测量胃管前端距贲门的长度,各观察组显著长于对照组(均P0.05);术后1d、2d胃肠减压引流量及患者腹胀程度四组比较,差异有统计学意义(均P0.05);达到最佳胃肠减压效果的患者,胃管的实际置入长度与其身高呈正相关(P0.05)。结论胃管置入长度55～65cm时,能达到最佳引流效果,根据患者身高选择置入长度能提高胃肠减压效果。     

身高、体重及体重指数对辽宁地区正常中老年人骨矿含量的影响

目的　调查分析身高、体重及体重指数 (BMI)对辽宁地区正常中老年人群骨矿含量的影响。方法　在辽宁地区年龄在 40～ 79岁的中老年人群中随机抽样 173 1例 ,除外可能导致继发性骨质疏松症的各种疾病 ,应用美国lunar公司生产的双能X线骨密度仪 ,分别测试受试者的腰椎及股骨上段的骨密度 (BMD) ,全部资料输入微机 ,用SPSS软件进行统计学处理。结果　身高与腰椎及股骨上段的BMD相关性较差 (r=0 0 87～ 0 197,P <0 0 5 ) ,体重与腰椎及股骨上段的BMD相关性较好(r=0 2 2 6～ 0 3 5 2P <0 0 1)。体重指数与腰椎的相关性最好 ,其次是大转子。腰椎及股骨颈的BMD在超体重组 (BMI>2 5kg/m2 )明显大于低体重组 (BMI≤ 19kg/m2 ) ,其差异有显著性 ,该特点在腰椎最为明显。结论　体重是影响中老年人骨矿含量的重要因素。对低体重的中老年人 (BMI≤ 19kg/m2 )可作为骨质疏松症的易发人群 ,及时监测BMD ,早期预防及治疗     

The Patterns of Limb Length,Height, Weight and Body Mass Index Changes after Total Knee Arthroplasty

The objective of this retrospective review of 466 patients was to document changes in limb length, leg length discrepancy (LLD), height, weight, and body mass index (BMI) 1 year after TKA and the patterns of height, weight, and BMI during 5 years. To determine change patterns over 5 years, the data of 291 patients were analyzed and compared with those of age and gender-matched normal subjects. Limb length, height, and weight increased, BMI remained unchanged, and LLD decreased 1 year after TKA. The bilateral group had a greater height increase and lower rate of LLD. Preoperative mechanical tibiofemoral angle was related to limb length increase, and patients with a smaller preoperative BMI showed more weight gain. During the 5 years, weight and BMI at 1 year were maintained, but height diminished, while the healthy population showed a decreasing trend in weight.     

Relationships Between Body Composition, Muscular Strength, and Bone Mineral Density in Estrogen-Deficient Postmenopausal Women

The purpose of this study was to examine relationships between muscular strength, body composition, and bone mineral density (BMD) in untrained postmenopausal women who are not on hormone replacement therapy (HRT). Fifty-five women (age: 63.3 ± 0.6 yr) completed menstrual history, physical activity, and calcium intake questionnaires. Total and regional body composition and total body, anteroposterior lumbar spine, nondominant forearm, and right proximal femur BMD were measured using dual-energy X-ray absorptiometry (DXA) (GE Lunar Prodigy, Prodigy enCORE software version 10.50.086, Madison, WI). Participants performed strength tests for 3 upper body and 5 lower body resistance exercises. Women with a relative skeletal muscle mass index (RSMI) value less than 5.45 kg/m² were defined as a sarcopenia group (SAR). SAR had significantly (p < 0.05) lower total body and forearm BMD compared with those who were not sarcopenic. BMD sites were significantly correlated with upper body strength (UBS) and lower body strength (LBS) (r = 0.28–0.50, p < 0.01), with the strength of relationship being site specific. Strength and fat mass (FM) significantly predicted total body BMD (R² = 0.232–0.241, p < 0.05), FM variables predicted spine BMD (R² = 0.109–0.140, p < 0.05), and LBS and RSMI predicted hip BMD sites (R² = 0.073–0.237, p < 0.05). Body composition variables failed to significantly predict LBS. In conclusion, the contribution of body composition and strength variables to BMD varied by site as FM was more important for total body, forearm and spine BMD, and LBS exerted greater influence on the hip sites.     

Diazepam and Body Weight in Myelopathy Patients

Abstract

Because diazepam appeared to affect body weight, spastic myelopathy patients for whom this drug had been prescribed but in whom the dose was altered were compared with similar patients without changes in antispastic medication. A retrospective survey averaging 10 months was conducted for these two groups to determine weight changes of 10 pounds or more.

After reduction or discontinuation of diazepam in seven patients, all lost weight-12 to 35 lbs at rates of 0.9 to 3.5 lb per month. On unchanged medication, only one of twelve patients lost as much as 10 lb, p<0.001.

After partially or fully restoring diazepam in iour patients, all gained weight-7 to 26 lbs-at rates of 1.8 to 4.3 lbs per month. Three of the four patients and two of the 12 without medication change gained as much as 10 pounds, p = 0.03.

We conclude that body weight in myelopathy patients is affected by the use of diazepam. The effect of other medications used for spasms was not assessed. (J Spinal Cord Med, 18:200–202)     

Association Among Age, Height, Weight, and Body Mass Index with Discordant Regional Bone Mineral Density

Patients with osteoporosis have a body mass index (BMI) that is significantly lower than patients with normal bone mineral density (BMD). This study was conducted to examine the associations among age, height, weight, and BMI in patients with discordant regional BMD. For the purpose of this study, discordant regional BMD was defined as having a BMD result that is in the osteoporotic range at one site while being normal at the other sites. Data from 7513 qualifying bone densitometry scans from a suburban Detroit osteoporosis testing center were analyzed. A patient was classified as having generalized osteoporosis if the T-score was < 2.5 at the lumbar spine, femoral neck, and distal radius and normal if the T-score was > 1 at the same three sites. Patients were determined to have discordant low BMD when the T-score was < 2.5 at one site while the T-score was > 1 at the other two sites. Patients with generalized osteoporosis were older (mean age: 72.2 vs 54.7 yr; p < 0.001), shorter (height: 153.1 vs 161.7 cm; p < 0.001) and had lower BMI (23.7 vs 28.5 kg/m(2); p < 0.001) compared with patients with normal BMD. The distal radius was the site where discordant osteoporosis was most prevalent (70 patients, 0.9%). Patients with isolated low distal radius BMD were similar in age (mean age: 70.4 vs 72.2. yr; p = NS), but were taller (height: 158.6 vs 153.1 cm; p < 0.001) and had BMI values that were significantly higher (BMI: 28.7 vs 23.7 kg/m(2); p < 0.001) than patients with generalized osteoporosis. Patients with discordant BMD at the distal radius had anthropometric characteristics that were significantly different from patients with generalized osteoporosis. These differences may represent differences in the etiology of osteoporosis and differential effects on cortical vs trabecular bone.     

Birth Weight and Perceived Stress Reactivity in Older Age

Stress reactivity is a disposition that underlies individual differences in stress responses, thereby affecting vulnerability for the development of disease. Besides genetic and early postnatal environmental factors, stress reactivity has been shown to be influenced by an adverse prenatal developmental environment, but it is unclear if such effects persist into older age. We tested associations between fetal growth and perceived stress reactivity in 421 participants from the Hertfordshire Cohort at age 66–75 years. Regression analysis showed a U‐shaped association between birth weight and perceived stress reactivity with increased levels of stress reactivity at the lower and upper end of the birth weight distribution. These effects were stable after adjustment for markers of early adversity and recent adversity and chronic stress. Although the effects were small, they are consistent with findings from studies in younger cohorts, and demonstrate that such effects can persist into older age. Copyright © 2012 John Wiley & Sons, Ltd.     

Gender-Related Differences in the Relationship Between Densitometric Values of Whole-Body Bone Mineral Content and Lean Body Mass in Humans Between 2 and 87 Years of Age

The mineral, lean, and fat contents of the human body may be not only allometrically but also functionally associated. This report evaluates the influence of muscle mass on bone mass and its age-related changes by investigating these and other variables in both genders in the different stages of reproductive life. We have analyzed the dual-energy X-ray absorptiometry (DEXA)-determined whole-body mineral content (TBMC), lean body mass (LBM), and fat body mass data (FBM) of 778 children and adolescents of both genders, aged 2–20 years [previously reported in Bone 16(Suppl.):393S–399S; 1995], and of 672 age-matched men and women, aged 20–87 years. Bone mass (as assessed by TBMC) was found to be closely and linearly associated with muscle mass (as reflected by LBM) throughout life. This relationship was similar in slope and intercept in prepubertal boys and girls. However, while keeping the same slope of that relationship (50–54 g increase in TBMC per kilogram LBM): (1) both men and women stored more mineral per unit of LBM within the reproductive period than before puberty (13%–29% and 33%–58%, respectively); (2) women stored more mineral than age-matched men with comparable LBM (17%–29%) until menopause; and (3) postmenopausal women had lower values of bone mineral than premenopausal women, similar to those of men with comparable LBM. Men showed no age effect on the TBMC/LBM relationship after puberty. Multiple regression analyses showed that not only the LBM, but also the FBM and body height (but not body weight), influenced the TBMC, in that decreasing order of determining power. However, neither the FBM nor body height could explain the pre/postpubertal and the gender-related differences in the TBMC/LBM relationship. Accordingly: (1) calculated TBMC/LBM and FBM-adjusted TBMC/LBM ratios were lower in girls and boys from 2–4 years of age until puberty; (2) thereafter, females rapidly reached significantly higher ratios than age-matched men until menopause; and (3) then, ratios for women and age-matched men tended to equalize. A biomechanical explanation of those differences is suggested. Sex hormones or related factors could affect the threshold of the feedback system that controls bone remodeling to adapt bone structure to the strains derived from customary mechanical usage in each region of the skeleton (bone “mechanostat”). Questions concerning whether the mineral accumulation in women during the reproductive period is related or not to an eventual role in pregnancy or lactation, or whether the new bone is stored in mechanically optimal or less optimal regions of the skeleton, are open to discussion.     

Relationships Between Tensile Strength, Ascorbic Acid, Hydroxyproline, and Zinc Levels of Rabbit Full-Thickness Incision Wound Healing

Purpose This work was carried out to follow up the healing of full-thickness incision wounds opened on the back skin of rabbits in order to gain insight into the periodical correlation among such factors as ascorbic acid, collagen (hydroxyproline), the zinc content, and tensile strength of wound tissue. The need to provide vitamin C or zinc supplements after such wound incisions is also discussed.Methods Full-thickness incision wounds and the ascorbic acid and hydroxyproline levels were measured in 24 rabbits by spectrophotometric methods on day 0 and on the 3rd, 5th, 7th, and 15th days after operation. The tensile strength was measured by a polygraph using a force displacement transducer. The zinc levels of the wounds were measured by atomic absorption spectrophotometry.Results The zinc and hydroxyproline levels reached the peak levels on the 5th day, but the tensile strength of wound increased sharply on the 7th day after wounding while the zinc levels did not change. These results indicated that in the first 7 days of wound healing, high levels of ascorbic acid, hydroxyproline, and zinc cumulation occurred in the wound tissue, and the tensile strength reached its highest level on the 15th day without any supplementation.Conclusion The supplementation of zinc and/or ascorbic acid should therefore be given just at the beginning of the wounding period, especially if there is deficiency of these nutrients.