Nutrient intake risk factors of osteoporosis in postmenopausal women

This study was conducted to assess the association between dietary nutrient intake and osteoporosis risk in post-menopausal women. Bone mineral density was measured at the lumbar spine by dual-energy X-ray absorptiometry and a structured questionnaire was administered by a trained interviewer, which included information on sociodemographics, medical and reproductive history, and dietary intake. The study sample included 134 osteoporotic and 137 non-osteoporotic subjects between the ages of 52 and 68. Nutrient variables were classified into tertiles. Odds ratios and 95% confidence intervals (CI) were calculated which compared the highest tertile with the lowest tertile as a reference group. Odds ratios for osteoporosis were 1.47 (95% CI: 1.03-2.05) for total protein, 1.62 (95% CI: 0.51-3.92) for animal protein, and 2.98 (95% CI: 1.42-4.23) for sodium. Odds ratios for osteoporosis in the highest tertile were: 0.42 (95% CI: 0.23-0.83) for vegetable protein, 0.72 (95% CI: 0.51-0.90) for Ca, and 0.65 (95% CI: 0.49-0.88) for Fe, relative to the respective lowest tertile. These findings suggest that adequate nutrient intake may be important for prevention of osteoporosis in postmenopausal women.     

广州市绝经后妇女心血管病危险因素与骨质疏松的关系

目的 评估心血管病危险因素与骨质疏松的关系.方法 2008年7月至2010年1月对2202名年龄50～73岁广州市社区妇女进行问卷调查,测量血压、血脂、血糖和血尿酸,检测体脂成分、颈动脉内膜中层厚度(IMT)等心血管病危险因素,并测量桡骨和胫骨超声骨密度.采用因子分析法对危险因素提取公因子,并进行四等分位转化.结果 共提取8个公因子,分别反映肥胖程度、瘦体成分、甘油三酯/尿酸、胆固醇、年龄、血压、IMT和体力活动.多因素logistic分析显示:年龄和IMT因子得分越高,瘦体成分因子得分越低,桡骨和胫骨骨质疏松的风险均越高(趋势检验:P<0 01).与最低四分位组相比,各因子得分最高组的OR值(95%C1),瘦体成分为0 62(0.44～0.88)和0.62(0.48～0.80)、年龄为4.02(2.72～5.94)和3.68(2.81～4.82)、IMT为1.41(1.00～2.00)和1.54(1.19～2.00).血压是桡骨骨质疏松的重要危险因素,肥胖是胫骨骨质疏松的独立危险因素.结论 IMT增厚、瘦体成分减少、肥胖、血压高等心血管病危险因素可显著增加骨质疏松风险,改善这些危险因素有助于预防骨质疏松.

Abstract：

Objective To assess the relationship between cardiovascular risk factors and osteoporosis. Methods 2202 women aged 50-73 years were included in this cross-sectional study from the communities in Guangzhou, from July 2008 to January 2010. Cardiovascular risk factors including age, years since menopause, physical activity, anthropometrics, body composition, blood pressure, fasting serum lipids, glucose and uric acid, intima-media thickness(IMT) of carotid artery were assessed. Ultrasonic bone density (speed of sound) at the radius and tibia were determined. Osteoporosis was defined as T-score≤-2.5. Common factors for the cardiovascular risk factors were extracted using the factor analysis method. Results Eight common factors representing obesity, lean mass, blood triglycerides and uric acid, cholesterol, age, blood pressure, IMT and physical activity were extracted. Data from the Multivariate logistic regression showed a dose-dependent association of greater scores of age and IMT factors and lower score of lean mass factor with the increased risk of osteoporosis at the radius and tibia. As compared with the bottom quartile, the OR (95%CI) of radius and tibia osteoporosis were 0.62 (0.44-0.88) and 0.62 (0.48-0.80) for lean mass factor, 4.02 (2.72-5.94) and 3.68(2.81-4.82) for age factor, 1.41 (1.00-2.00) and 1.54 (1.19-2.00) for IMT factors, respectively. Moreover, greater blood pressure score was associated with higher risk of radius osteoporosis while the higher obese score, was correlated with the increased risk of tibia osteoporosis. Conclusion The cardiovascular-related risk factors of greater IMT, obesity, blood pressure and lower lean mass scores were associated with increased osteoporosis risks while called for more concern among the Chinese women.     

Educational level and osteoporosis risk in postmenopausal Chinese women

Many studies have shown that better education is favorable for lowering the risks for a number of chronic diseases, but little information is available on the relation with bone health. The authors examined the association of educational level, classified as levels I-IV, with bone mineral density (BMD) and with the prevalence of osteoporosis among 685 population-based, postmenopausal, Chinese women aged 48-63 years during 1999-2001. They observed a significant dose-response positive relation between educational level and BMDs at the total-body (p = 0.011), lumbar spine, and hip sites (p < 0.001) after adjusting for age, years since menopause, and body weight. Mean BMDs of educational level IV women were higher by 4.2-11.9% at the various sites compared with level I women (analysis of covariance, p < 0.05). Similarly, the authors also observed a significant inverse dose-response relation between educational level and prevalence of osteoporosis. Women of educational level I were 3.5-8.6 times more likely to be osteoporotic compared with those of level IV at the various sites. The proportion of BMD or osteoporosis variations accounted for by educational level was attenuated by about 40% after further controlling for potentially explanatory covariates. In conclusion, a higher level of education is independently associated with better BMDs and lower prevalence of osteoporosis among postmenopausal Chinese women.     

Coexistence of osteoporosis and cardiovascular disease risk factors in apparently healthy, untreated postmenopausal women

This study aimed to determine whether apparently healthy, untreated postmenopausal women at risk of osteoporosis relative to nonmenopausal women are concomitantly at risk of cardiovascular disease (CVD) in terms of various aspects of lifestyle, personality, body shape and composition, and blood chemistry. Two homogeneous groups of 30 women having reached menopause for 3-5 years and 30 nonmenopausal controls, all non-estrogen users without apparent CVD risk factors, were compared in a cross-sectional design. Data related to physical activity, dietary intakes, personality type, anthropometry, and skinfold-thickness were collected. Plasma insulin-like growth factor (IGF-1) and serum lipids were measured and used as biochemical predictors of osteoporosis and CVD, respectively. Compared to nonmenopausal controls, postmenopausal women were at greater risk of bone loss given their lower plasma IGF-1, lower physical activity level, and even given their higher serum lipids, as recent literature suggests. Moreover, their dietary calcium intake fulfilled only 70% of the current recommendation, which may reduce protection against osteoporosis and CVD (particularly hypertension) as well. The two groups did not differ regarding energy intake, body weight and frame size, body mass index (BMI), waist circumference, and waist-hip ratio (WHR). However, postmenopausal subjects had more adipose tissue and differed in terms of lifestyle factors (lower dietary lipids and greater alcohol consumption). While neither group was at particular risk of CVD according to waist circumference, WHR, and serum triglycerides, postmenopausal women were at risk according to percent body adiposity and serum cholesterol. This study shows that several risk factors for osteoporosis and CVD can coexist in apparently healthy postmenopausal women after a few years of natural menopause. It emphasizes the need for a timely screening that would stress both heart and bone risk factors.     

轮状病毒肠炎患儿乳糖不耐受与肠炎转归的关系及其影响康复的相关因素分析

目的探讨轮状病毒肠炎患儿乳糖不耐受与轮状病毒肠炎转归的关系,并分析影响乳糖不耐受康复的相关因素。方法选择医院2015年1-12月收治163例轮状病毒肠炎患儿为研究对象,根据粪便还原糖检测结果分为乳糖不耐受组和对照组(非乳糖不耐受组),乳糖不耐受组分为康复组和未康复组,收集所有患儿临床资料。结果乳糖不耐受组和对照组脱水发生率和腹泻次数对比差异无统计学意义;治疗前和治疗后,乳糖不耐受组和对照组之间腹泻次数对比差异无统计学意义;乳糖不耐受组和对照组治疗后腹泻次数(3.32±2.78、2.98±3.12)均低于治疗前(7.86±2.87、7.34±2.93),差异有统计学意义(P<0.05);乳糖不耐受组和对照组腹泻病程和住院天数比较差异无统计学意义;康复组患儿腹泻持续时间(6.67±0.89)d低于未康复组(7.72±1.24)d,康复组患儿轻度腹泻、无肠道排毒比例均高于未康复组,差异有统计学意义(P<0.05);肠道排毒是轮状病毒肠炎乳糖不耐受患儿康复的独立影响因素(P<0.05)。结论轮状病毒肠炎患儿乳糖不耐受不影响轮状病毒肠炎的转归,肠道排毒是轮状病毒肠炎乳糖不耐受患儿康复的独立影响因素。     

绝经后妇女营养状况与骨质疏松

目的:探讨绝经后妇女膳食营养素摄入对骨密度的影响。方法:对159例健康的绝经后妇女进行膳食调查及超声骨密度仪测定桡骨远端骨密度。结果:非骨质疏松者平均每日蛋白质、脂肪、维生素A、硫胺素、核黄素、维生素C、维生素E以及钾、钙、镁、锌、磷、铁、锰、硒的摄入量均显著高于骨质疏松者(P0.05或P0.01)。结论:膳食中多种营养素与妇女的骨密度(BMD)存在一定的关系,预防骨质疏松应注意全面而合理的膳食。     

产后妇女骨质疏松的危险因素分析

目的探讨产后妇女发生骨质疏松的危险因素。方法选取2013年4月-2016年4月在广东省人民医院进行分娩的产后30 d妇女562例为研究对象。对患者进行骨密度测量,依据测量结果将产妇分为骨量正常组、骨质疏松组及骨量减少组,比较各组一般情况、BMI、钙摄入量及骨质疏松家族史等,并分析与骨质疏松发生的关系。结果 562例产妇中32例发生骨质疏松,发病率为5.69%,214例发生骨量减少(不包含骨质疏松患者),发病率为38.08%。对3组产妇年龄、身高、孕次、产次、新生儿体质量采用单因素方差分析,发现孕妇年龄、身高、孕次、产次、新生儿体质量与骨质疏松发病无明显相关性(P0.05)。BMI20 kg/m~2,骨质疏松发生率为8.36%,BMI≥24 kg/m~2,骨质疏松发生率为2.33%,产妇BMI越低,发生骨质疏松的风险越高(χ~2=59.863,P0.001)。补钙产妇骨质疏松发生率明显低于不补钙产妇(χ~2=17.462,P0.001);孕期每周摄入牛奶量≤2杯、3~4杯、5~6杯、7杯及7杯以上者,其骨质疏松发生率分别为6.54%、5.71%、4.35%、1.89%,各组差异有统计学意义(χ~2=48.833,P0.001)。对具有统计学意义的单因素进行Logistic回归分析,发现BMI、钙摄入量及骨质疏松家族史为产后妇女发生骨质疏松的独立危险因素(P0.05)。结论产后妇女发生骨质疏松及骨量减少的风险较高,而低BMI、钙摄入量不足及骨质疏松家族史为产后发生骨质疏松的独立危险因素,产后密切监测骨密度可尽早诊断骨质疏松及治疗。     

中国40岁及以上绝经后女性骨质疏松症患病率及其影响因素研究

目的:了解我国≥40岁绝经后女性骨质疏松症患病率及其影响因素,为我国骨质疏松症防控工作提供科学依据。方法:本研究数据来自2018年中国骨质疏松症流行病学调查,覆盖全国11个省（直辖市）44个县（区）,通过问卷调查、体格检查收集调查对象相关变量,并采用双能X线吸收法测量腰椎和股骨近端骨密度。应用复杂抽样加权估计我国≥40...     

Hormonal risk factors for ovarian cancer in premenopausal and postmenopausal women

Ovarian cancer is most frequently diagnosed in postmenopausal women; however, the strongest risk predictors, pregnancy and oral contraceptive use, occur in most women in their twenties and thirties. Relatively few studies have examined how reproductive risk factors vary between pre- and postmenopausal ovarian cancer. The authors used data from a population-based, case-control study of ovarian cancer (896 cases, 967 controls) conducted in North Carolina from 1999 to 2006. Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Inverse associations with ovarian cancer were observed with duration of oral contraceptive use, later age at last use, and more recent use among premenopausal women; no significant associations were found for postmenopausal women. Analyses limited to oral contraceptive users showed that duration was a more significant predictor of risk than was timing of use. Parity was inversely associated with premenopausal but not postmenopausal ovarian cancer. Later age at pregnancy was associated with reduced risk for both pre- and postmenopausal women. Analyses among parous women showed that pregnancy timing was a stronger risk predictor than number of pregnancies. Findings suggest that associations between ovarian cancer and reproductive characteristics vary by menopausal status. Additional research is needed to further elucidate risk factors for postmenopausal disease.     

Emerging risk factors and assessment of organ damage in postmenopausal hypertensive women

The numerous risk factors for acute cerebrocardiovascular events present in postmenopausal women have attracted a multidisciplinary approach. In hypertensive patients and postmenopausal intensive alike, the need for stratification of risk based on blood pressure, association of other risk factors and organ damage is becoming more and more evident. This study investigated some emerging factors, such as endothelial dysfunction, adhesion molecules and elevated homocysteine levels that may be markers of organ damage. It also examined the current importance of carotid US intima-media thickness assessment, cardiac US imaging and 24 hour ambulatory blood pressure monitoring (ABPM) in detecting organ damage. The study results indicated that the conventional stratification of cerebrocardiovascular risk in these patients is changing. The new approach in postmenopausal hypertensives tends to assess the presence of other emerging factors. Furthermore, assessment of organ damage is crucial for determining disease development and outcome that may be positively influenced by suitable pharmacological treatment.     

Prevalence of osteoporosis in postmenopausal women in family practice

OBJECTIVE: To assess the prevalence of osteopenia, osteoporosis and severe vertebral deformities in general practice. DESIGN: Cross-sectional study. METHODS: Of a randomly selected group of 712 women aged 55 to 84 years in a general practice in Noordwijk, the Netherlands, 449 (63%) participated in a study in 1996, in which Dual Energy X-ray Absorptiometry (DXA) of the femoral neck was performed: in 428 women vertebral morphometry of lateral radiographs of the spine was also done. The World Health Organization definitions of osteopenia and osteoporosis were used. RESULTS: The mean bone mineral density (BMD) was 0.866 g/cm2 (SD: 0.135). With increasing age the BMD decreased statistically significantly by 0.0073 g/cm2/year. There were 189 women with osteopenia (42%). 33 (7%) with osteoporosis and 44 (10%) with one or more severe vertebral deformities. A significantly lower mean BMD was found in those with severe vertebral deformities than in those without.     

绝经后骨质疏松症的性激素补充疗法

绝经后骨质疏松症,亦称退行性Ⅰ型骨质疏松症.其发病机理主要是由于绝经后雌激素水平骤然下降,促使骨吸收增加,骨矿含量快速丢失,骨折发生率升高.     

绝经后骨质疏松症的性激素补充疗法

绝经后骨质疏松症，亦称退行性Ⅰ型骨质疏松症。其发病机理主要是由于绝经后雌激素水平骤然下降，促使骨吸收增加，骨矿含量快速丢失，骨折发生率升高。     

Effect of milk and lactose on zinc absorption in lactose-intolerant postmenopausal women

We evaluated the effect of lactose intolerance on intestinal zinc absorption under various test conditions in a group of postmenopausal women. Fractional zinc absorption was studied with a dual-isotope technique using 65Zn and 51Cr (as nonabsorbable fecal markers). We performed four absorption tests on sixteen subjects with water (control), whole cow milk, lactose-free cow milk and lactose alone. Mean (+/- SEM) fractional zinc absorption was 0.558 +/- 0.032 with water, 0.276 +/- 0.031 with milk, 0.246 +/- 0.028 with lactose-free milk and 0.564 +/- 0.051 with lactose. No significant differences in zinc absorption were found under any of the test conditions between lactose-tolerant and lactose-intolerant subjects. Milk and lactose-free milk significantly reduced zinc absorption in both groups.     

绝经后女性椎体骨折的临床特征及危险因素分析

目的观察绝经后女性椎体骨折的临床特征,分析可能导致骨折的危险因素,为绝经后女性椎体骨折的防治提供参考。方法选取2015年3月-2018年6月天津市红桥区中医医院收治的200例绝经后椎体骨折女性患者作为骨折组,另选取同期在该院接受常规体检的绝经后健康女性100例作为未骨折组,使用该院自制绝经后女性一般问卷调查全部受检者一般资料,包括患者基本信息、日常生活习惯、骨折情况等;同时为全部受检者实施血清学实验室相关指标检查,包括常规生化指标及骨代谢特异生化指标等;为受检者实施骨密度检查,分析绝经后女性椎体骨折的临床特征,采用单因素及多因素分析找出可能导致绝经后女性椎体骨折的危险因素。结果 200例绝经后椎体骨折女性患者,骨折椎体共318个,以T11～L1椎体部位骨折发生率最高,患者椎体骨折分度多为1度,随年龄的增加骨折率呈升高趋势,患者整体骨代谢指标水平偏高、血肌酐(Cr)及血清碱性磷酸酶(ALP)表达偏低、各部位骨密度均较低、骨质疏松整体患病率高、服用抗骨质疏松药物占比低。经单因素与多因素Logistic逐步回归分析证实,高龄、整体骨密度低、既往有椎体骨折史可能是导致绝经后女性椎体骨折的危险因素(OR1,均P0. 05)。结论绝经后女性椎体骨折好发于T11～L1椎体,以老年人群为主,患者骨强度低,骨代谢指标不同程度异常,高龄、既往椎体骨折史、骨密度低可能是其主要危险因素,临床应重视绝经后女性骨密度的检测,并定期对骨折高危人群开展骨折筛查,便于绝经后女性椎体骨折的早期防治,降低骨折率。     

Tibolone therapy in postmenopausal women with a history of many risk factors

INTRODUCTION: The changes of the indications and the use of hormone replacement therapy have entered into the focus of interest. AIMS: The author studied whether hormone replacement therapy can be used in postmenopausal patients with high risk factors in their history (thromboembolic disorders, diabetes mellitus, hypertension, stroke, cardiovascular disease, pulmonary embolism). METHODS: Tibolone 2.5 mg daily was prescribed. Data of 124 patients with the above conditions were analized at the beginning and at 12, 24, 36 months follow-up visits. The frequency of exacerbation of the anamnestic risk factors, menopausal complaints, laboratory tests and instrumental tests (transvaginal sonography, mammography, bone densitometry), as well as efficacy and side effects of the therapy were studied. RESULTS: During the 36-months follow up tibolone therapy effectively reduced menopausal complaints, caused no increase in the anamnestic risk factors, or serious side effects and did not worsened the results of the laboratory tests. CONCLUSION: In the author's opinion hormone replacement therapy with tibolone can be safely performed in patients with high risk factors in the history.