鲑鱼降钙素对骨质疏松患者骨密度的影响

目的 观察肌注鲑鱼降钙素对骨质疏松患者骨密度的治疗效果。方法 双能X线骨密度测定确诊的骨质疏松患者,自愿分组。降钙素(sCT)组共50例,予鲑鱼降钙素肌肉注射,每次50IU,隔日1次;同时每日口服1片钙尔奇-D。钙(Ca)组共65例,每日予相等剂量钙尔奇-D治疗。两组均治疗24周。治疗前后测定腰椎L2～4侧位、股骨近端骨密度(BMD)及血清骨钙蛋白(BGP)、碱性磷酸酶(ALP)等指标。结果 sCT组治疗后腰椎各椎体BMD增加3.47％～3.74％,股骨近端各部位BMD增加1.44％～1.72％;Ca组则分别下降1.29％～1.83％和1.98％～2.11％(P<0.02)。结论 鲑鱼降钙素可有效增加腰椎、股骨近端骨密度或减少骨质丢失,其中对腰椎的治疗效果较股骨近端佳。     

鲑鱼降钙素对绝经后骨质疏松症的影响

目的观察鲑鱼降钙素对绝经后骨质疏松症的作用。方法鲑鱼降钙素治疗组９２例,隔日肌注５０Ｕ,每日加服元素钙３００ｍｇ,单用钙剂治疗的对照组２３例,每日服元素钙３００ｍｇ。疗程６个月。结果用药组腰２～４椎骨密度分别升高９．３％,１０．６％和８．９％,髋部骨密度无改变,与此同时,血骨钙素明显升高,尿羟脯氨酸／肌酐比值明显降低。对照组用药前后无明显改变。结论鲑鱼降钙素有改善绝经后骨质疏松病人腰椎骨密度作用,其机理与增加骨合成和降低骨吸收有关。     

益钙宁治疗绝经后骨质疏松的骨密度和骨转换指标的改变

目的为观察绝经后骨质疏松妇女应用益钙宁长期治疗４８周至７２周对骨密度（ＢＭＤ）及骨转换生化指标的影响。方法３３例患者应用益钙宁（２０单位／次，１次／周）加乳酸钙（元素钙，５００ｍｇ／日）治疗，另３５例患者单纯用乳酸钙（元素钙５００ｍｇ／日）治疗。结果应用益钙宁加钙治疗组患者腰椎２～４ＢＭＤ在治疗２４周始即有明显增加并持续至７２周；股骨近端的ＢＭＤ增加，Ｗａｒｄｓ三角区部位见于２４周到４８周；股骨颈部位见于４８周和７２周；大转子部位仅在７２周。血ＢＧＰ水平治疗２４周呈增高的改变，而血ＴＲＡＰ和尿ＨＹＰ／Ｃｒ比值的改变于治疗２４周、４８周和７２周均有明显的下降。单纯用钙对照组于治疗后与治疗前比较未见明显改变。结论本研究结果提示益钙宁长期治疗可抑制骨吸收并可能刺激骨形成，预防骨量丢失并增加骨量     

绝经后骨质疏松患者体质指数、骨转换指标与骨密度和骨折的相关性

目的探讨绝经后骨质疏松(POP)患者骨转换指标、体质指标与骨密度(BMD)和骨折的相关性。方法选择78例48~74岁POP妇女,用双能X线吸收法(DEXA)测定腰椎L_(1~4)(正位)、股骨颈及髋部BMD,测量患者身高、体重,计算体重指数(BMI)。采集空腹血后测定血清Ⅰ型胶原氨基端前肽(PINP)、Ⅰ型胶原羧基末端肽(CTX)、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)。结果 1年龄与CTX、ALP、身高和BMI存在明显相关性,相关系数(r)分别为0.302、0.334、-0.229和0.325。2年龄与腰椎、股骨颈及髋部BMD间均存在负相关,r分别为-0.280、-0.364和-0.390。3校正年龄因素影响后,PINP与股骨颈和髋部BMD间存在负相关,r分别为-0.434和-0.304;ALP与股骨颈BMD存在负相关,r为-0.209。4脆性骨折组腰椎BMD、体重和BMI较无骨折组都有非常显著的差异。5脆性股骨颈骨折组PINP和ALP均显著高于无骨折组、脆性非股骨颈骨折组。结论年龄是影响BMI、BMD和骨转换指标的重要因素,骨转换指标和BMD间存在负相关。肥胖、腰椎BMD降低及PINP和ALP等骨转换指标的升高都可增加POP患者发生脆性骨折的风险。     

鲑鱼降钙素对社区糖尿病合并骨质疏松患者骨密度的影响

目的观察社区糖尿病(DM)合并骨质疏松(OP)患者给予鲑鱼降钙素治疗的效果。方法社区卫生院就诊的123例DM合并OP患者按照治疗药物不同分为对照组67例,研究组56例。对照组常规应用钙尔奇(1片/次,1次/d),研究组则在此基础上给予鲑鱼降钙素(50 U/次,3次/d)。结果研究组治疗后血骨钙素(BGP)、骨密度(BMD)、甲状旁腺素(PTH)明显改善,且研究组疗效(92.86%)明显优于对照组(73.13%)(P0.01)。结论社区DM合并OP患者在口服钙尔奇基础上应用鲑鱼降钙素效果显著。     

绝经后2型糖尿病患者骨质疏松影响因素及骨转换特点

目的 探讨绝经后2型糖尿病(T2DM)人群骨质疏松影响因素及骨转换特点及其防治策略.方法 150例绝经后T2DM住院患者测定骨密度(BMD)后分为骨量正常(NP)、骨量减低(DP)和骨质疏松(OP)组.登记年龄(Age),绝经年限(LOP),糖尿病病程(YSM),计算体重指数(BMI),测定空腹血糖(FPG)、餐后2 h血糖(PPG),空腹胰岛素(FIns)、餐后2 h胰岛素(2 h Ins),血Ⅰ型胶原C端肽(CTX-Ⅰ)、抗酒石酸酸性磷酸酶5b(TRACP5b)、骨特异性碱性磷酸酶(BALP)、雌激素(E2).结果 ①绝经后T2DM人群OP发病率54%;②绝经后T2DM并发OP患者与骨量减少和骨量正常组比较绝经年限、糖尿病病程及血糖水平明显增高,胰岛素和E2水平明显降低(P<0.05);③OP组患者与骨量减少和骨量正常组比较CTX-Ⅰ、TRACP5b、BALP等骨转换指标明显升高(P<0.05);④CTX-Ⅰ与腰椎2～4、股骨颈BMD呈明显负相关(P<0.05),与大转子、粗隆间BMD无明显相关性;TRACP5b、BALP与腰椎2～4、股骨颈、大转子、粗隆间BMD呈明显负相关(P<0.05).结论 LOP、血糖、YSM、FIns和E2水平可影响绝经后T2DM患者骨量;该人群骨重建特点为高转换型,骨吸收标记物TRACP5b可作为早期预测绝经后T2DM骨量减少及OP的敏感指标.     

鲑鱼降钙素治疗糖尿病合并骨质疏松症的疗效观察

52例糖尿病合并骨质疏松症患者随机分成两组,均用药5个月。鲑鱼降钙素治疗组（26例）,单用钙剂口服治疗组（26例）。结果：治疗5个月后,治疗组骨痛症状明显改善,疼痛缓解率达89．76％,骨密度显著增加（P〈0．05）。结论：鲑鱼降钙素治疗糖尿病合并骨质疏松症,能有效缓解骨痛,提高患者骨密度,效果良好。     

中老年妇女骨转换生化指标和骨密度的变化

目的 探讨中老年妇女骨转换生化指标与骨密度随绝经的变化.方法 408名符合条件40 ～80岁的女性志愿者,同一时间段留取血清和晨尿,统一用酶免方法 测定血清骨碱性磷酸酶(BAP)、骨钙素和尿I型胶原氨基末端肽(uNTX);用舣能X线骨密度仪测定前后位腰椎1-4(L1-4)、左侧股骨颈的骨密度.结果 (1)BAP、骨钙素和uNTX与年龄、孕次、生育次数和绝经年限呈正相关(均P相似文献   

鲑鱼降钙素联合碳酸钙治疗原发性Ⅱ型骨质疏松症的临床观察

目的:探讨鲑鱼降钙素联合碳酸钙对老年人骨质疏松症(OP)的治疗效果。方法:回顾性分析78例老年OP患者的临床资料,随机分为2组,使用鲑鱼降钙素联合碳酸钙剂为治疗组42例;使用单纯口服碳酸钙为对照组36例,以定量CT(QCT)测定2~4腰椎的骨密度(BMD),比较治疗前及治疗6个月后BMD和临床症状的改善情况。结果:治疗组总有效率90.5%;腰2~4椎BMD升高,同时骨痛症状明显改善。对照组总有效率41.7%,治疗前、后BMD无明显改变。结论:鲑鱼降钙素能改善OP患者腰椎的BMD,其机制与增加骨合成和降低骨吸收有关。     

鲑鱼降钙素治疗老年男性骨质疏松症临床观察

目的 观察鲑鱼降钙素对老年男性骨质疏松症患者的疗效.方法 将60例老年男性骨质疏松症患者分为治疗组和对照组各30例.对照组服用维D钙咀嚼片+骨化三醇软胶囊;治疗组在此基础上应用鲑鱼降钙素鼻喷剂,疗程均为6个月.检测治疗前及治疗后骨密度、生化指标和骨代谢标志物;计算总有效率,观察不良反应发生情况.结果 治疗组治疗前后骨密度分别为(0.307±0.083)、(0.355±0.098) g/cm2,对照组分别为(0.298±0.096)、(0.303±0.092) g/cm2;治疗组治疗后骨密度高于治疗前及同期对照组,血清1,25双羟基维生素D3[1,25(OH)2D3]、骨特异性碱性磷酸酶(BALP)水平高于治疗前及同期对照组,血清抗酒石酸酸性磷酸酶5b(TRACP5b)水平低于治疗前及同期对照组(P均＜0.05).治疗组、对照组骨痛缓解总有效率分别为93.33％、36.67％,治疗组总有效率高于对照组(P＜0.01).结论 鲑鱼降钙素可明显改善老年男性骨质疏松症患者的骨密度,有效缓解骨痛,促进骨形成,抑制骨吸收.     

Comparison of the effects of alendronate and risedronate on bone mineral density and bone turnover markers in postmenopausal osteoporosis

The aim of the study was to compare the effects of once-weekly alendronate sodium and daily risedronate sodium treatment on bone mineral density (BMD) and bone turnover markers in postmenopausal osteoporotic subjects. For this purpose, 50 patients were included in this study and randomly classified into two groups. Group I (n=25) received risedronate (5 mg/day) and group II (n=25) received alendronate Na (70 mg/week). The study duration was limited to 12 months. The efficacy of the treatment was evaluated by BMD measurements at spine and hip at 6th and 12th months of the treatment, as well as by the measurement of bone turnover markers such as serum osteocalcin (OC), bone-specific alkaline phosphatase (BASP), urine deoxypyridinoline (DPD) and calcium/creatine ratio in 24-h urine at 1st, 3rd, 6th and 12th months. The evaluation of the changes in BMD in all regions revealed a significant increase in BMD in both groups compared to baseline values except for spine (L2–L4) in alendronate group at 6th and 12th month and femoral neck in risedronate group at 6th month. However, the difference in percentage increase in BMD measurements was not statistically significant between the two groups at 6th and 12th months. In both groups, serum OC, BSAP and urine DPD were found to be significantly attenuated at 1st month of the treatment period, and continued to be lowered throughout the 3rd, 6th and 12th months (P<0.05). However, there was no statistically-significant difference between both groups of patients (P>0.05). In conclusion, our results suggest that both treatment protocols provide treatment options of similar efficiencyfor postmenopausal osteoporosis, and have almost-similar effects in enhancing the BMD and in slowing the bone turnover. Risedronate seems to havea more potent effect in the spinal region than that of alendronate, although this potency was not statistically significant.     

Bone mineral density and bone turnover in patients with psoriatic arthritis

Psoriasis is a common inflammatory skin disease, and conflicting data have been published about osteoporosis and bone turnover markers in patients with psoriatic arthritis. The aim of this study was to assess bone mineral density (BMD) and bone turnover markers in psoriatic patients with and without peripheral arthritis and to investigate the relationship between clinical parameters and markers of bone turnover. Forty-seven patients (24 women, 23 men) with psoriasis were included to the study. Demographic data and clinical characteristics were recorded. Erythrocyte sedimentation rate and C-reactive protein were assessed as disease activity parameters. BMD was determined for lumbar spine and total hip by dual X-ray absorptiometry (DXA). Serum Ca, P, alkalen phosphatase (ALP), and serum type I collagen cross-linked C telopeptide (CTX) were measured as bone turnover markers in all patients. The patients were divided into two groups according to their peripheral arthritis status. The clinical and laboratory variables, as well as bone mass status of the groups, were compared with each other. Eighteen patients had peripheral arthritis. All the female patients were premenopausal. None of the patients had radiologically assessed axial involvement. There was no significant difference between the BMD levels of psoriatic patients with and without arthropathy. One patient (5%) had osteoporosis, and nine (50%) patients had osteopenia in arthritic group, while eight (27.5%) patients had osteopenia in patients without arthritis. Serum CTX, ALP, Ca, and P levels were not significantly different in arthritic than in non-arthritic patients (p > 0.05). In patients with psoriatic arthritis, the duration of arthritis was negatively correlated with BMD values of lumbar spine and total femur and serum CTX levels, suggesting an association of increased demineralization with the duration of joint disease. In conclusion, psoriatic patients with peripheral arthritis with longer duration of joint disease may be at a risk for osteoporosis, which can require preventative treatment efforts.     

阿伦膦酸钠对绝经后骨质疏松症患者骨密度、细胞因子及骨代谢指标的影响

目的观察阿伦膦酸钠治疗绝经后骨质疏松症（PMO）患者,其骨密度（BMD）、IL-6、TNFα、胰岛素样生长因子-Ⅰ（IGF-Ⅰ）及骨代谢指标的变化。方法选择年龄55—60岁的PMO患者共185例,随机分为：阿伦膦酸钠组69例,替勃龙组66例,钙剂组50例和年龄相匹配的正常妇女20例作为对照组。各组均于用药前和用药后24、48周测定BMD（采用DEXA骨密度仪）、雌二醇（E2）、碱性磷酸酶（ALP,放免法）、骨钙素（BGP）、Ⅰ型胶原N末端肽（NTX）、IL-6、TNFα、IGF-Ⅰ（ELISA）。结果阿伦膦酸钠组和替勃龙组BMD较治疗前均有不同程度的提高,腰椎BMD增幅分别为2．53％、3．65％（P〈0．05）,非优势侧股骨近端增幅分别为7．17％、3．01％（P〈0．001）。替勃龙组E2水平明显上升（P〈0．01）,IL-6、TNFα、NTX下降（P〈0．01）;阿伦膦酸钠组E2水平无变化（P〉0．05）,ALP、BGP水平上升（P〈0．05）,NTX水平下降（P〈0．05）,IGF-Ⅰ、IL-6、TNFα水平无明显变化（P〉0．05）;钙剂组和对照组各部位BMD、E2、IGF-Ⅰ、ALP、BGP继续下降（P〈0．05）,而IL-6、TNFα、NTX升高（P〈0．05）。结论阿伦膦酸钠组治疗PMO疗效显著,与替勃龙相仿。单纯服用钙剂不能治疗PMO．且继续骨量丢失。     

The study of bone mineral density and bone turnover markers in postmenopausal women with active rheumatoid arthritis

Abstract

The aim of this study was to investigate determinants of reduced bone mineral density (BMD) in postmenopausal women with active rheumatoid arthritis (RA) and to evaluate whether there are common markers of bone loss. We evaluated BMD of the femoral neck using dual-energy X-ray absorptiometry, and the measured biochemical markers included serum bone-specific alkaline phosphatase (BALP), serum osteocalcin (OC), and serum cross-linked N-telopeptidases of type I collagen (NTx). Serum BALP and NTx concentrations were measured by enzyme-linked immunsorbent assay, and OC was measured using an immunoradiometric assay. One hundred and forty postmenopausal Japanese women who had not received treatment with bisphosphonates or hormone replacement therapy were entered into the study. Thirty-four patients (41.0%) had femoral osteopenia (T score ?1 to ?2.5) and 23 patients (27.7%) had osteoporosis (T < ?2.5). The body mass index of patients with normal BMD (T score ≥ ?1.0) was significantly higher (P < 0.01) than in patients with osteoporosis at the femoral neck. The T score exhibited a significant negative correlation with age and the duration of RA disease. Serum BALP and serum OC, markers of osteoblast function, were negatively related to erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and matrix metalloproteinase-3 (MMP-3). However, serum NTx, a marker of resorptive function, exhibited a positive correlation with ESR, CRP, and MMP-3. From these results, this study suggests that generalized bone loss occurs in active RA and is characterized by evidence of bone resorption that is correlated with the high levels of inflammation. Body mass index, disease duration, and high serum NTx level were common risk factors in osteoporosis of postmenopausal women with RA.     

The study of bone mineral density and bone turnover markers in postmenopausal women with active rheumatoid arthritis

The aim of this study was to investigate determinants of reduced bone mineral density (BMD) in postmenopausal women with active rheumatoid arthritis (RA) and to evaluate whether there are common markers of bone loss. We evaluated BMD of the femoral neck using dual-energy X-ray absorptiometry, and the measured biochemical markers included serum bone-specific alkaline phosphatase (BALP), serum osteocalcin (OC), and serum cross-linked N-telopeptidases of type I collagen (NTx). Serum BALP and NTx concentrations were measured by enzyme-linked immunsorbent assay, and OC was measured using an immunoradiometric assay. One hundred and forty postmenopausal Japanese women who had not received treatment with bisphosphonates or hormone replacement therapy were entered into the study. Thirty-four patients (41.0%) had femoral osteopenia (T score −1 to −2.5) and 23 patients (27.7%) had osteoporosis (T < −2.5). The body mass index of patients with normal BMD (T score ≥ −1.0) was significantly higher (P < 0.01) than in patients with osteoporosis at the femoral neck. The T score exhibited a significant negative correlation with age and the duration of RA disease. Serum BALP and serum OC, markers of osteoblast function, were negatively related to erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and matrix metalloproteinase-3 (MMP-3). However, serum NTx, a marker of resorptive function, exhibited a positive correlation with ESR, CRP, and MMP-3. From these results, this study suggests that generalized bone loss occurs in active RA and is characterized by evidence of bone resorption that is correlated with the high levels of inflammation. Body mass index, disease duration, and high serum NTx level were common risk factors in osteoporosis of postmenopausal women with RA.     

绝经前妇科手术对绝经后妇女骨量的影响

目的探讨绝经前不同术式切除子宫、卵巢与绝经后妇女骨量的关系。方法对2002年4月至2006年3月绝经20年内的妇女绝经前行一侧卵巢切除术18例、单纯子宫切除术者63例,子宫加单侧卵巢切除术者44例,子宫加双侧卵巢切除术者87例,以及同期自然绝经101例妇女进行骨密度测定,并对各组的骨密度和骨质疏松症的发生率进行比较。骨质疏松症的诊断标准为骨密度值低于或等于正常年轻妇女平均骨密度峰值减去2.5个标准差。结果自然绝经组与一侧卵巢切除术组平均年龄分别59.8±6.8,56.5±5.5岁;平均绝经年龄分别为49.8±3.2、49.5±3.9,两组在腰椎、股骨颈、大转子、华氏三角区骨密度差异无统计学意义,且两组骨质疏松症发生率分别为61.4%、50%,两组差异无统计学意义（P〉0.05）。单纯子宫切除术组、子宫加单侧卵巢切除术组、子宫加双侧卵巢切除术组腰椎骨密度分别为0.91±0.17、0.88±0.18、0.80±0.14（g/cm^2）,股骨颈骨密度分别为0.75±0.11、0.77±0.14、0.70±0.12（g/cm^2）,大转子骨密度分别为0.60±0.10、0.62±0.12、0.56±0.10（g/cm^2）,华氏三角区骨密度分别为0.56±0.13、0.59±0.16、0.50±0.12（g/cm^2）。子宫加双侧卵巢切除术组骨密度在腰椎、股骨颈、大转子、华氏三角区明显低于单纯子宫切除术组和子宫加单侧卵巢切除术组;后两组组间差异无统计学意义。单纯子宫切除术组、子宫加单侧卵巢切除、子宫加双侧卵巢切除术组骨质疏松症发生率分别为34.9%、38.6%、62.1%。子宫加双侧卵巢切除术组明显高于单纯子宫切除术组、子宫切除术加单侧卵巢切除术组（P〈0.01）,后两组间差异无统计学意义。结论1.绝经前行单侧卵巢切除后不影响绝经后妇女骨量、骨质疏松症的发生率;2.绝经前子宫切除术者尽可能保留单侧或双侧卵巢,以避免远期骨量降低,骨质疏松症发生率增加。     

女性绝经后骨质疏松患者雌激素受体基因Px单倍型对骨密度的影响

目的探讨女性绝经后骨质疏松症患者雌激素受体(ER)基因Px单倍型对骨密度的影响。方法采用聚合酶链反应方法检测197例患者ER基因Xba I和PvuⅡ多态性,双能X线骨密度仪检测腰椎和股骨上端的骨密度。结果基因型分布:XX、xx、Xx、PP、pp、Pp型分别为18．8％、13．2％、68％、19．3％、34％、46．7％;Xba I、PvuⅡ单个多态位点与骨密度无相关性(P>0．05),2个位点联合有Px单倍型组Ward’s区骨密度(0．47±0．10)g／cm2明显低于无Px单倍型组(0．51±0．13) g／cm2(P<0．05);影响腰椎骨密度的自身主要因素:有Px单倍型组为体重,无Px单倍型组为身高。结论ER基因Px单倍型可能对绝经后骨质疏松症骨密度有不利影响,Px单倍型有助于临床判断身高和体重对骨密度的影响。     

Bone mineral density and bone remodelling in Tunisian patients with ankylosing spondylitis: A cross-sectional study

Aim of the workTo assess the bone turnover markers and bone mineral density (BMD) in ankylosing spondylitis (AS) patients and to evaluate their association with clinical variables.Patients and methodsForty-seven AS patients were compared with 47 matched control. Clinical features and inflammatory parameters were assessed. C-terminal telopeptide fragments of type I collagen (CTX), alkaline phosphatases (ALP), N-terminal propeptide of type I procollagen (PINP) serum levels, and BMD of the lumbar spine and femoral neck were evaluated. The Bath AS disease activity and functional indices (BASDAI and BASFI) were assessed.ResultsMean serum levels of C-reactive protein, ALP and CTX were higher in AS patients than control (p = 0.001, p = 0.001 and p = 0.027 respectively). Osteopenia and osteoporosis were significantly more frequent in AS patients (57.4%) than control (21.3%) (p < 0.001). The PINP and ALP significantly correlated with disease duration (r = 0.33, p = 0.02 and r = 0.3, p = 0.04 respectively). BMD of the femoral neck was significantly lower in AS patients with history of coxitis than AS patients without (p = 0.02). Patients on anti-tumour necrosis factor (TNFα) therapy had higher T score (lumbar spine) compared to those not. Multivariate regression showed that CRP levels and disease activity were independently associated with low BMD and T score (lumbar) was significantly associated with anti-TNF use (p = 0.007).ConclusionsAn increase in bone turnover markers and decrease of BMD were observed in AS patients. Inflammatory activity of AS was associated to hyper bone remodelling and decrease of BMD. Anti-TNF use seems to be beneficial on AS inflammation and therefore on the BMD.