雌激素β受体基因与骨量关系的研究进展

雌激素受体对骨量的获得与维持有着重要的作用,近10年来关于雌激素受体研究主要集中在α受体,而β受体的研究较少。笔者回顾了国内外关于雌激素β受体基因与骨密度关系文献,主要从骨量的遗传特性、雌激素受体的作用、雌激素β受体基因多态性及其分子机制研究进展等几个方面来阐述。     

Lumbar spine peak bone mass and bone turnover in men and women: a longitudinal study

Summary  Peak bone mass is an important determinant of bone mass in later life, but the age of peak bone mass is still unclear. We found that bone size and density increase and bone turnover decreases until age 25. It may be possible to influence bone accrual into the third decade. Introduction  Peak bone mass is a major determinant of bone mass in later life. Bone growth and maturation is site-specific, and the age of peak bone mass is still unclear. It is important to know the age to which bone accrual continues so strategies to maximise bone mass can be targeted appropriately. This study aims to ascertain the age of lumbar spine peak bone mass. Methods  We measured lumbar spine BMC, estimated volume and BMAD by DXA and biochemical markers of bone turnover in 116 healthy males and females ages 11 to 40, followed up at an interval of five to nine years. Results  The majority of peak bone mass was attained by the mid-twenties. Increases in BMC in adolescents and young adults were mostly due to increases in bone size. Bone turnover markers decreased through adolescence and the third decade and the decreasing rate of change in bone turnover corresponded with the decreasing rate of change in lumbar spine measurements. Conclusions  Skeletal maturation and bone mineral accrual at the lumbar spine continues into the third decade.     

新疆维吾尔族人群雄激素受体基因CAG重复多态性与良性前列腺增生的关系

目的　初步探讨雄激素受体 (AR)基因CAG重复多态性与良性前列腺增生 (BPH)的关系。　方法　收集 80例维吾尔族BPH患者和 4 0例健康者外周血标本 ,应用PCR和直接测序法行AR基因CAG重复长度测定。分析评价CAG重复长度与BPH的关系。　结果　BPH组CAG重复次数范围 13～ 30 ,平均 2 2 .78。对照组CAG重复次数范围 14～ 2 9,平均 2 2 .38。两组比较差异无显著性意义 (P >0 .0 5 )。CAG重复长度 <2 2和≥ 2 2比较 ,其OR值为 1.0 6 (95 %CI 0 .4 6～ 2 .4 8,P >0 .0 5 )。CAG重复长度与BPH患者年龄 (γ =- 0 .0 6 ,P >0 .0 5 )、国际前列腺症状评分 (IPSS) (γ =0 .11,P >0 .0 5 )无相关性 ,而与前列腺的体积相关 (γ =- 0 .2 6 ,P <0 .0 5 )。在BPH患者 ,前列腺体积随着CAG重复次数的增加而减小 ,差异有显著性意义 (趋势检验P <0 .0 5 ) ,CAG重复长度≤ 2 0与≥ 2 5相比 ,前列腺体积差异有显著性意义 (P =0 .0 5 )。　结论　AR基因CAG重复长度与BPH腺体的增长有关。     

广西南宁地区健康人群骨密度十年前后比较

目的：比较广西南宁地区十年前后健康体检人群骨密度变化及骨质疏松患病率。方法横断面调查2011年1月－2012年6月在广西壮族自治区人民医院进行健康体检的20－80岁人群2524例的骨密度情况,并与十年前1058例横断面调查比较,骨密度检测采用同一台双能X线骨密度仪（ DEXA）。结果男性和女性骨峰值年龄均为30－39岁,与十年前的结果一致。在30－39岁人群组中,十年前后男、女在股骨颈、ward三角、大转子、腰椎（ L2、L3、L4）骨密度值比较无统计学意义;60－80岁的老年总人群、老年男性和老年女性十年前后骨质疏松患病率（16．56％对17．78％,12．30％对18．28％,19．21％对17．31％,均P＞0．05）差异均无统计学意义。结论虽然十年前后环境因素包括生活方式和人们保健意识等发生较大变化,但影响骨代谢的有利因素和不利因素共存,因此,导致男女骨峰值水平和老年骨质疏松患病率无显著性差异。     

绝经后骨质疏松人群雌激素受体基因Xba I多态性和年龄对骨密度的影响

目的 分析绝经后骨质疏松人群雌激素受体(ER)基因XbaⅠ多态性与骨密度的相关性以及在基因多态性下年龄、绝经年限及体重指数(BMI)对骨密度的影响。方法 用双能X线骨密度仪检测患者151例，以PCR-RFLP的方法检测ER基因XbaⅠ多态性，SPSS软件进行相关回归分析。结果 ER基因型的频率分布为XX型16．6％，Xx型67．5％，xx型15．9％，XX型的骨密度在腰椎、股骨颈和Ward’s三角要高于Xs型和xx型。但ER多态性与骨密度无相关性。在Xx型和XX型人群中年龄越大，绝经年限越长，腰椎和股骨上端骨密度则越低。在XX型中，BMI是影响股骨颈和Ward’s三角骨密度的主要因素。而在xx型中，腰椎和ward’s三角骨密度与年龄、BMI和绝经年限无相关性，绝经年限与股骨颈骨密度相关，大转子与BMI相关。结论 福州地区绝经后骨质疏松人群ER基因XbaⅠ基因型与骨密度无明显相关性，但在不同基因型人群中，其骨密度的丢失趋势和影响因素也各异，临床上应采用不同的防治措施。     

Association of estrogen receptor α gene polymorphisms with bone mineral density in Chinese women: a meta-analysis

Introduction and hypothesis A large number studies have examined the association between estrogen receptor alpha (ESR-α) gene polymorphisms and bone mineral density (BMD) in the Chinese population. We conducted a meta-analysis to assess their pooled effects. Methods We searched for all published articles indexed in MEDLINE, the Chinese Biomedical Database, and the Chinese Journal Full-text Database from January 1994 to April 2006. Any cross-sectional study that tested the association between ESR-α PvuII or XbaI genotypes and BMD at the femoral neck or spine in Chinese women was included in the review. Data were extracted independently by two reviewers using a standardized data extraction form. Sixteen eligible studies involving 4,297 Chinese women were identified. Results The overall frequencies of X and P alleles were 28% and 40%, respectively. The PvuII polymorphism was statistically significantly associated with BMD at the femoral neck (P = 0.038 for PP = Pp = pp) but not at the lumbar spine in all women. The BMD difference for the contrasts of PP versus Pp/pp genotypes was −0.0105 (95%CI, −0.0202 ∼ −0.0008) g/cm² (P = 0.036). The XbaI polymorphism was not associated with BMD at the femoral neck or lumbar spine. Conclusion The PvuII polymorphism had a very weak association with femoral neck BMD whereas XbaI polymorphism was unlikely to be a predictor of femoral neck or spine BMD in Chinese women.     

两种糖皮质激素导致骨质疏松过程中骨量、骨转换标志物及雌激素水平的差异

目的 对比泼尼松龙（PRE）和地塞米松（DXM）致骨质疏松过程中对大鼠骨量和骨转换标志物、雌激素水平的差异。方法 选取3月龄SPF级雌性大鼠46只,随机分成4组：基线组（BL组）6只、年龄对照组（AM组）12只、泼尼松龙组（PRE组）14只、地塞米松组（DXM组）14只。BL组于实验开始时麻醉处死,其余各组分别予常规饲养,PRE组以5mg/kg PRE每天一次皮下注射,DXM组以1mg/kg DXM每周两次皮下注射,于干预后1、2、3个月（M1、M2、M3）分3批麻醉处死取材。每次取材时立即取子宫、肾上腺称重,并收集血清以检测血清内雌激素、PINP及β-CTX水平、收集腰1-3椎体以检测腰椎骨密度（BMD）。结果 PRE组各时间点BMD值[（0.183±0.027、0.230±0.005、0.259±0.014）g/cm2]及DXM组各时间点BMD值[（0.191±0.010、0.208±0.012、0.200±0.004）g/cm2]均较AM组[（0.251±0.014、0.275±0.009、0.281±0.008）g/cm2]明显下降（P＜0.05）,其中DXM组下降更为显著（P＜0.01）,且在M2及M3,DXM组BMD值明显低于PRE组（M2：P＜0.05;M3：P＜0.01）。PRE组干预初期,其血清雌激素水平（36.54±20.40μg/L）较AM组（148.74±40.33 μg/L）明显降低（P＜0.01）,但随着干预时间延长, M3时（130.85±18.95 μg/L）增长至与AM组（126.64±69.12 μg/L）相接近水平（P＞0.05）,但在DXM干预下,雌激素水平在各时间点[（93.13±31.27、91.77±33.14、98.83±10.58）μg/L]均低于AM组[（148.74±40.33、140.01±28.46、126.64±69.12）μg/L]（P＜0.05）。两种GC干预下,PINP及β-CTX均显著高于AM组（P＜0.01）,且PRE干预后各时间点PINP水平[（1410.33±882.40、2089.23±1623.61、1546.88±644.68）μg/L]显著高于DEX组[（258.70±139.42、220.89±92.82、483.36±225.82）μg/L]（P＜0.05）。结论 地塞米松诱导骨量减少的能力明显强于泼尼松龙,这可能与其更大程度地降低血清雌激素水平以及更有效地限制成骨有关。     

广西南宁地区汉壮族人群骨密度及骨质疏松患病率研究

目的 评估广西南宁地区汉壮族健康人群骨量和骨质疏松(OP)的发病情况。方法 l084名健康人群采用双能x线骨密度仪检测腰椎正位、髋部、前臂的骨密度(BMD)值。按民族、年龄、性别进行分组，以10岁作为1个年龄段。结果 骨峰值年龄分布：男女汉壮族各部位骨峰值年龄在30-39岁，60岁后OP患病率(WHO)汉族男性23．36％，壮族男性25．00％，汉族女性31．69％，壮族女性44．44％，汉壮族男女各年龄段和总体OP患病率差异无显性。结论 广西南宁地区汉壮族男女健康人群峰值骨密度水平及骨质疏松检出率差异无显性。     

晋城地区健康人群前臂骨峰值骨量的建立

目的：建立晋城地区健康人群前臂骨密度（ BMD）的峰值骨量和标准差值,为开展周围型双能X线骨密度仪测定及骨质疏松症研究提供基础数据。方法采用韩国产双能X线骨矿测量仪（ EXA－3000）对晋城地区1400例21～55岁的健康体检人群进行左侧前臂骨密度测定,进行非优势侧（左侧）前臂远端尺桡骨的BMD值测定,并分析其年龄分布,建立晋城地区健康人群前臂远端骨密度的峰值骨量和标准差值。骨质疏松的骨量诊断以骨量峰值的均数±标准差的形式建立,均数的计算采用三次方回归方程模型进行拟合。结果男、女性前臂骨的BMD值均符合正态分布,可采用均数±标准差（ xˉ±s）的形式表示。40岁以前男、女性前臂骨的BMD值均随年龄增加而逐步上升,且各年龄段BMD值的差异有统计学意义（P＜0．05）。45岁以后男、女性前臂骨的BMD值开始下降,且50岁以后下降明显（ P＜0．05）。男、女性前臂骨的骨量峰值均出现在41～45岁年龄段。男、女性前臂远端尺桡骨的骨量峰值及标准差分别为（0．5682±0．0647）g／cm2、（0．4209±0．0689）g／cm2。结论建立了晋城地区健康人群男、女性前臂骨的骨量峰值和标准差,为周围型双能X线骨密度仪测定并开展骨质疏松症的研究提供基础数据,尤其是用于高危人群筛查,以便确定是否需要进一步开展中轴骨测量或进行药物治疗。     

Effects of the interaction between lean tissue mass and estrogen receptor alpha gene polymorphism on bone mineral density in middle-aged and elderly Japanese

Because both genetic and environmental factors influence bone mass, it is important to examine the effect of gene-environment interactions on bone mineral density (BMD) for the prevention of osteoporosis at an individual level. Estrogen receptor alpha (ER alpha) plays an important role in increasing BMD via mechanical strain and muscle mass is a reflection of the forces the muscle applies to the bone. The aim of this study is to investigate the effect of the interaction between lean tissue mass (LTM) and the ER alpha polymorphisms T-->C (PvuII) [dbSNP: rs2234693] and A-->G (XbaI) [dbSNP: rs9340799] on BMD in middle-aged and elderly individuals. Subjects were 2209 community-dwelling Japanese men and women, ages 40 to 79 years. ER alpha polymorphisms in the first intron, T-->C and A-->G were identified and lumbar spine and femoral neck BMD and LTM were measured by dual-energy X-ray absorptiometry. Both T-->C and A-->G polymorphisms were divided into two genotype groups (TT vs. TC/CC; AA vs. AG/GG). In postmenopausal women, the effect of LTM on femoral neck BMD was significantly larger for those with the TC/CC genotype than for those with the TT genotype for the T-->C polymorphism, and larger for those with the AG/GG genotype than for those with the AA genotype for the A-->G polymorphism. This gene-LTM interaction was observed at the femoral neck, but not at the lumbar spine. For men and premenopausal women, no gene-LTM interaction was found. In conclusion, there was an interaction between LTM and the ER alpha T-->C and A-->G polymorphisms with respect to their effect on femoral neck BMD in postmenopausal women and those with the TC/CC and AG/GG genotypes had larger effects of LTM than those with TT and AA genotypes.     

安徽地区绝经后妇女雌激素受体基因多态性与骨密度的相关性研究

目的探讨安徽地区绝经后妇女雌激素受体（ER）基因多态性的分布及其与骨密度的相关性。方法随机选择288名安徽合肥地区健康绝经后妇女，运用双能X线骨密度吸收法（DEXA）测定腰椎和股骨颈、大转子骨密度（BMD），并采用PCR-RFLP（聚合酶链反应-限制性片断长度多态性）法分析ER基因多态性，并分析其相关性。结果安徽地区绝经后妇女ER基因型分布频率PP（13．2％）、Pp（45．8％）、pp（40．9％），XX（5．21％）、Xx（31．6％）、xx（63．2％），联合PvuⅡ和XbaⅠ这两种基因型后得到：PPXX（5．6％），PPXx（3．8％），PPxx（6．3％），PpXX（1．4％），PpXx（23．3％），Ppxx（25％），ppxx（34．7％），未检测到ppXX及ppXx型。PvuⅡ多态性与绝经后妇女腰椎BMD相关，PP基因型腰椎BMD显著低于pp和Pp基因型（P〈0．05），ER基因P等位基因是一种有益于骨量的基因型。XbaⅠ多态性与绝经后妇女各部位BMD间无明显相关性（P〉0．05）。联合分析PvuⅡ和XbaⅠ多态性与绝经后妇女BMD相关性发现，有Px单倍型的妇女腰椎部位的BMD显著低于无此单倍型的妇女（P〈0．01）。结论ER基因PVuⅡ多态性与绝经后妇女腰椎BMD有相关性，PP基因型妇女腰椎BMD减低，而具有Px单倍型的ER基因可能对BMD有不利影响。     

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Low areal bone mass is a risk factor for fractures in men. Limited data are available on fractures and bone geometry in men, and the relation with sex steroids is incompletely understood. We investigated prevalent fractures in relation to peak bone mass, bone geometry, and sex steroids in healthy young men. Healthy male siblings (n = 677) at the age of peak bone mass (25 to 45 years) were recruited in a cross‐sectional population‐based study. Trabecular and cortical bone parameters of the radius and cortical bone parameters of the tibia were assessed using peripheral quantitative computed tomography (pQCT). Areal bone mineral density (aBMD) was determined using dual‐energy X‐ray absorptiometry (DXA). Sex steroids were determined using immunoassays, and fracture prevalence was assessed using questionnaires. Fractures in young men were associated with a longer limb length, shorter trunk, lower trabecular BMD, smaller cortical bone area, and smaller cortical thickness (p < .005) but not with bone‐size‐adjusted volumetic BMD (vBMD). With decreasing cortical thickness [odds ratio (OR) 1.4/SD, p ≤ .001] and decreasing cortical area (OR 1.5/SD, p ≤ .001), fracture odds ratios increased. No association between sex steroid concentrations and prevalent fractures was observed. Childhood fractures (≤15 years) were associated with a thinner bone cortex (?5%, p ≤ .005) and smaller periosteal size (?3%, p ≤ .005). Fractures occurring later than 15 years of age were associated with a thinner bone cortex (?3%, p ≤ .05) and larger endosteal circumference (+3%, p ≤ .05) without differences in periosteal bone size. In conclusion, prevalent fractures in healthy young men are associated with unfavorable bone geometry and not with cortical vBMD when adjusting for bone size. Moreover, the data suggest different mechanisms of childhood fractures and fractures during adult life. © 2010 American Society for Bone and Mineral Research     

Longitudinal measurement of regional and whole body bone mass in young healthy adults

The so-called peak bone mass (PBM) represents the highest amount of bony tissue achieved during life at a given site of the skeleton. It has been suggested that PBM might be achieved as late as the fourth decade, but recent data have indicated that PBM is already achieved by the end of sexual maturation, namely at the end of the second decade. The solving of this apparent controversy is of interest for a better understanding of bone homeostasis and for defining the cohort of normal subjects to be evaluated in order to establish a PBM reference range — necessary for the diagnosis of osteoporosis and evaluation of the fracture risk. To study bone mass evolution in young healthy adults and to determine whether such a cohort can be used to establish PBM reference values, we measured bone mineral density (BMD) in sixty 20- to 35-year-old young healthy adults by dual-energy X-ray absorptiometry at the levels of the lumbar spine (in both anteroposterior and lateral views), femoral neck, trochanter region, total hip and of Ward's triangle, as well as whole-body BMD and bone mineral content (BMC) in cross-sectional and longitudinal studies. In the cross-sectional analysis, none of the bone mass variables was dependent on age using linear regression analysis. The longitudinal study indicated that the mean changes in lumbar spine, proximal femur and whole body BMD or BMC determined after a 1-year interval were not statistically different from zero in either females or males aged 20–35 years. In conclusion, the present results confirm that at the levels of lumbar spine and proximal femur, two sites particularly at risk of osteoporotic fractures, PBM can be achieved before the third and fourth decades in both male and female normal subjects.     

Vitamin D receptor gene polymorphism,bone mass,body size,and vitamin D receptor density

We determined vitamin D receptor (VDR) gene alleles (based on the BsmI restriction site polymorphism), duodenal mucosal receptor density, bone mass at spine and total body, and body size in 32 healthy premenopausal females. While we found no relationship between allele and receptor density in duodenal mucosa, bone mineral content (BMC) at both spine and total body was significantly associated with VDR gene alleles. BMC was highest for the bb allele, lowest for BB, and intermediate for Bb. A similar association was noted between allele and body size variables, particularly weight. When BMC was adjusted for body weight, the association with VDR polymorphism disappeared. The VDR gene polymorphism may be affecting bone mass not through classical nutritional mechanisms (e.g., intestinal calcium absorption), but through an influence on body size.     

The polymorphic androgen receptor gene CAG repeat,pituitary-testicular function and andropausal symptoms in ageing men

The activity of androgen receptor (AR) is modulated by a polymorphic CAG trinucleotide repeat in the AR gene. In the present study, we investigated hormonal changes among ageing men, and whether the number of AR CAG triplets is related to the appearance of these changes, as well as symptoms and diseases associated with ageing. A total of 213 41-70-year-old men donated blood for hormone analyses (LH, testosterone, oestradiol and SHBG) and answered questions concerning diseases and symptoms associated with ageing and/or androgen deficiency. Of these men, 172 donated blood for the measurement of the CAG repeat length of AR. The CAG repeat region of the AR gene was amplified by polymerase chain reaction (PCR) and the products were sized on polyacrylamide gels. The repeat number was analysed as a dichotomized variable divided according to cut-off limits of the lowest (< or =20 repeats) and the highest quartile (> or =23 repeats), and as a continuous variable. The proportion of men with serum LH in the uppermost quartile (>6.0 IU/L) with normal serum testosterone (>9.8 nmol/L, above the lowest 10%) increased significantly with age (p = 0.01). There were fewer men with this hormonal condition among those with CAG repeat number in the uppermost quartile (> or =23 repeats) (p = 0.03). These men also reported less decreased potency (p < 0.05). The repeat number was positively correlated with depression, as expressed by the wish to be dead (r = 0.45; p < 0.0001), depressed mood (r = 0.23; p = 0.003), anxiety (r = 0.15; p < 0.05), deterioration of general well-being (r = 0.22; p = 0.004), as well as decreased beard growth (r = 0.49; p < 0.0001). A hormonal condition where serum testosterone is normal but LH increased is a frequent finding in male ageing. Only certain types of age-related changes in ageing men were associated with the length of the AR gene CAG repeat, suggesting that this parameter may play a role in setting different thresholds for the array of androgen actions in the male.     

Association between two types of vitamin d receptor gene polymorphism and bone status in premenopausal Japanese women

Polymorphisms in the vitamin D receptor (VDR) gene using ultrasound (US) bone mass and bone metabolic markers were investigated as potential genetic markers for osteoporosis in 126 premenopausal Japanese women aged 27.2 +/- 10.1 (mean +/- SD) years. The relationship between their VDR gene polymorphisms and bone states was determined. VDR genotypes were based on the absence (B) or presence (b) of the Bsm I restriction site (B polymorphism), and ATG (the M allele) and ACG (the m allele) sequences at the translation initiation site (M polymorphism). Genotype frequencies were 73.8%, bb; 24.6%, Bb; 1.6%, BB; 15.1%, MM; 51.6%, Mm and 33.3%, mm. The stiffness index of calcaneal bone minerals measured by an US bone densitometer was significantly higher in the mm types (P <0.05 versus MM) than in the Mm types (P <0.01 versus MM) and MM types. There was no significant difference between in B polymorphisms. Furthermore, bone mass was correlated with serum bone type alkaline phosphatase (ALP) activity and urinary deoxypyridinoline concentration in M polymorphisms. Because the distribution of B polymorphisms in each M polymorphism genotype did not differ, M polymorphisms were affected independently from B polymorphisms to bone mass or bone metabolic markers. No significant difference was observed in nutritional intake and food consumption among genotypes. In the MM and Mm types, the bone mass was closely related to the frequency of milk intake during the periods of elementary and junior high school. In contrast, bone mass was not associated with nutritional intake or the frequency of past milk intake in B polymorphisms. Therefore, the M polymorphism of the VDR gene is a stronger genetic indicator of osteoporosis than the B polymorphism in premenopausal Japanese woman.     

老年男性维生素D受体基因多态性与骨密度关系的研究

目的研究维生素D受体(vitamin D receptor,VDR)基因多态性在老年男性中的分布, 并进一步研究其与骨密度的关系。方法采用聚合酶链反应-限制性片段长度多态性(PCR- RFLP)方法,分析145例老年男性的VDR基因型,同时用双能X线吸收法测定腰椎及髋部骨密度。结果 VDR基因型分别为BB,0．014;Bb,0．117;bb,0．869。骨质疏松组与非骨质疏松组之间VDR基因型分布频率的差异无显著性(P>0．05)。比较各基因型组的骨密度,bb组及 Bb组只有在股骨颈处显示出BMD均低于BB组,差异有显著性(P<0．05),其它部位,三个基因型组的BMD均差异无显著性(P>0．05)。结论老年男性VDR基因型分布频率与某些西方国家人群分布不同,其VDR基因型与骨密度无明显相关性。VDR基因可能不是我们所研究群体 BMD的主要遗传基因。     

Interaction of interleukin-6 and estrogen receptor gene polymorphisms on bone mass accrual in Chinese adolescent girls

We assessed the main and interaction effects of interleukin-6 and estrogen receptor gene polymorphisms on bone mass accrual in Chinese adolescent girls. A total of 228 premenarche Chinese girls (9-11.5 years old) were recruited for a 2-year follow-up study. Bone mineral density (BMD) at the total body, lumbar spine (L1-L4), and total left hip were measured by dual-energy X-ray absorptiometry at baseline and follow-up. The -174G/C and -634C/G polymorphism of IL-6 gene, and PvuII and XbaI polymorphisms of the estrogen receptor (ER)-alpha gene, were determined. The -634C/G polymorphism of the IL-6 gene and PvuII polymorphism of ER-alpha gene were significantly associated with bone mass accrual after adjusting the potential confounding factors. Girls with pp genotype of ER-alpha gene had greater percentage accrual in BMD of total body (P = 0.010) and femoral intertrochanter (P = 0.038) than their PP and Pp counterparts. Girls with CC genotype of IL-6 -634G/C gene had higher percentage accrual in BMD of total body (P = 0.032) and femoral trochanter (P = 0.048) than their CG + GG counterparts. Significant interaction effects of IL-6 -634C/G polymorphism and ER-alpha PvuII polymorphism were observed on percentage change in BMD of total left hip (P = 0.009) and femoral intertrochanter (P = 0.007). The genotype CC (IL-6 -634C/G) x pp (ER-alpha PvuII) was associated with greater BMD accrual than other genotype combination in Chinese adolescent girls. We found that the IL-6 -634C/G and ER-alpha PvuII polymorphism were significantly associated with BMD accrual and that they have an interactional effect on BMD accrual in Chinese adolescent girls.     

峰值骨量及影响因素在骨质疏松诊断中价值的探讨

为了对骨质疏松进行诊断，必须建立自己实验室的峰值骨量正常值，并应考虑到对峰值骨量的各种影响因素。本文采用ＳＰＡ和ＤＥＸＡ，测定了中国３６８７９人群的挠骨、尺骨中远１／３部位的骨矿密度（ＢＭＤ）及股骨近端（股骨颈、大转子，ＷＡＲＤ’Ｓ区）ＢＭＤ。通过其中所测１０９７５人群上述部位的结果建立了峰值骨量的正常值，峰值骨量的年龄段是在２０～３９岁。本文在讨论中与国内外不同作者进行了对比，并分析了影响峰值骨量的各种因素，以便在诊断骨质疏松时恰当使用峰值骨正常值。     

Relation of height and weight to the regional variations in bone mass among Japanese-American men and women

We examined the magnitude of regional variations in bone mass among elderly, Japanese-American men and women. All subjects had bone measurements at the calcaneus, and at the distal and proximal radius sites. A subset of the women had, in addition, spine bone mass measurements. To provide a common measurement scale, the bone measurements were converted to age- and sex-specificZ-scores. TheZ-scores between pairs of bone sites were then subtracted to yield the differences in bone mass between bone sites (expressed inZ-score units). For most individuals the differences were less than 1.0Z-score; however, 12%–20% of the differences were at least 1Z-score apart. The most similar sites were the distal and proximal radius: different regions within the same bone. Among the other bone pairs, the calcaneus and spine were the most similar to one another. The magnitudes of the differences in bone mass were associated with height and weight. Heavier subjects, for instance, had greater calcaneus than radius bone mass measurements, and greater spine than radius measurements. The spine and calcaneus are more weight-bearing than the radius sites. Associations were observed up to 0.25Z-score per 10 kg difference in weight. Height was associated with bone mass differences in an opposite direction to weight. Taller subjects had greater bone mass at the radius sites than expected from their calcaneus or spine bone measurements (0.1 to 0.2Z-score difference per 5 cm difference in height). Bone width partly explained the associations with height; that is, adjusting the radius widths reduced the associations with height. Overall, our results indicate that small to moderate differences between bone sites were common among our study population, and that the magnitudes of the differences were associated with height and weight.