内蒙古西部地区蒙古族骨质疏松症的发病及其危险因素分析

目的：探讨内蒙古西部地区蒙古族骨质疏松症（ OP）的发病及其危险因素,以便针对性地进行干预。方法连续抽取内蒙古医科大学附属医院体检中心300名蒙古族健康人群进行OP患病率调查,发现OP 43例,为病例组,未发生OP的257名中随机抽取86名为对照组。对2组的年龄、身高、体重指数和性别等17项予以比较分析。所得资料在单因素分析的基础上,又做多因素logistic回归。结果 OP的患病率为14．33％。 OP发生的相关因素分析,排除进入模型的其他作用因素后,年龄每增加1岁和体重指数每增加1个单位,促使OP发生的危险性分别是原来的1．10倍和1．21倍（ OR分别是1．10和1．21,其95％可信区间内均不包含1, P均＜0．05）;城市居住和进食蔬菜少促使发生OP的危险性分别是农牧区居住和进食蔬菜多的3．85倍和3．82倍（OR分别是3．85和3．82,其95％可信区间内均不包含1, P均＜0．05）,促进发病。而男性和饮酒多促使发生OP的危险性分别是女性和饮酒少或无的0．41倍和0．11倍（ OR分别是0．41和0．11,其95％可信区间内均不包含1, P均＜0．05）,女性更易发生OP,饮酒多可阻止发病。结论增龄、体重指数增高、城市居住、进食蔬菜少和女性是发生OP的危险因素,而饮酒多为其保护因素。     

2型糖尿病患者合并骨量减少及骨质疏松症相关影响因素分析

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者合并骨量减少及骨质疏松症(osteoporsis,OP)相关影响因素。方法采用双能X线骨密度仪(DXA)测定617例住院T2DM患者股骨颈(N)及腰椎1~4(L1-4)的骨密度(bone mineral density,BMD),按BMD分为骨量正常、骨量减少及骨质疏松组,采用SPSS软件比较各组之间年龄、性别、病程及生化指标之间的差异性,分析T2DM骨密度相关影响因素。结果 OP组及骨量减少组女性比例、年龄均高于骨量正常组(P0.05),BMI低于骨量正常组(P0.05)。OP组T2DM病程大于骨量减少组及骨量正常组(P0.05),FPG、2h PG、糖化血红蛋白低于骨量正常组(P0.05),空腹C肽水平低于骨量正常组(P0.05)。血钙低于骨量减少组及骨量正常组(P0.05),骨量减少组空腹胰岛素水平低于骨量正常组(P0.05)。将上述结果进行Logistic回归分析结果显示:高龄、低FC-P水平、低Hb A1C、低BMI与T2DM合并骨量减少及OP有相关关系(P0.05)。结论老龄、低空腹C肽水平、低BMI的2型糖尿病患者易出现骨量减少及骨质疏松症。     

强骨胶囊治疗原发性骨质疏松症、骨量减少的疗效及安全性评价

目的探讨强骨胶囊治疗原发性骨质疏松症、骨量减少的有效性及临床应用的安全性。方法采用多中心、开放的临床试验,对原发性骨质疏松症、骨量减少患者给予强骨胶囊治疗共12周,治疗前、后用中医证候进行分级评分,检测血压、心率、血常规、尿常规、心电图及肝肾功能。部分患者治疗后复查骨密度。结果共入组2062例,年龄范围45～75岁。治疗后患者腰背疼痛、下肢无力、畏寒肢冷、抽筋、夜尿频多等证候明显改善,临床症状缓解率93.8%。治疗12周后,未发现腰椎2-4及股骨颈的骨密度有明显变化。全部不良事件发生率7.6%(157/2061),无严重不良事件及罕见不良反应发生。药物相关不良事件有:口干5.19%(107/2061)、便秘2.33%(48/2061)、胃部不适0.24%(5/2061),没有因与药物有关的不良事件而退出试验的病例。结论强骨胶囊能明显改善原发性骨质疏松症、骨量减少患者的腰背疼痛、下肢无力、畏寒肢冷、抽筋、夜尿频多等临床症状,同时具有良好的安全性。     

糖尿病性骨量减少及其影响因素探讨

检测了220例糖尿病患者的桡骨骨密度(BMD)、血钙(ca)、磷(P)、硷性磷酸酶(ALP)、空腹血糖(FBG)、C肽、甲状旁腺激素(PTH)、降钙索(CT)、24小时尿Ca和羟脯氨酸(HOP)。结果显示骨量减少有94例．为42．7％，其中BMD1SD44例，占20％，-2SD50例，占22．7%。BMD减少组24小时尿Ca、HOP、ALP明显高于骨量正常组(P＜0.01)；年龄、病程、血糖控制水平及伴糖尿病肾病是BMD变化的主要影响因素。在NIDDM组中，BMD与C肽／FBC的比值呈正相关(r=0．546，P＜0.01)。     

1331例高职院校女生原发性痛经危险因素分析

目的 探究湖南省高职院校女生原发性痛经的患病率及危险因素。方法 回顾性分析2022年 9月-10月高职院校1331例女生的相关信息,比较社会人口信息、月经模式和生活习惯的高职院校女生原 发性痛经发生率,分析原发性痛经的影响因素。结果 湖南省高职院校女生原发性痛经患病率为76.11%, 单因素分析显示,不同月经初潮年龄、母亲痛经史、喝含糖饮料的频次、吃早餐的频次的女大学生的痛 经发生率比较,差异有统计学意义（P＜0.05）;Logistic回归分析显示,母亲痛经史是痛经的危险因素 （OR=0.346,95%CI=0.261~0.459）。结论 湖南省高职院校女生原发性痛经多与母亲有痛经史有关,且患 病率较高。     

南京地区老年人骨质疏松症危险因素分析研究

目的 探索骨质疏松症发病的危险因素,为预防骨质疏松提供临床依据.方法 选取238例经过确诊的60岁以上骨质疏松症病例,以及200例参加健康体检的且无该疾病的老年人;对研究对象采用问卷调查,然后采用非条件Logistic回归分析方法进行危险因素分析.结果 研究结果显示性别、年龄、户内劳动、体育锻炼、饱食程度、服用钙剂、糖尿病史、甲亢史、骨折史以及绝经年龄均为骨质疏松症发病的危险因素.结论 老年人群骨质疏松症发病的危险因素较多,但有效控制这些因素对预防骨质疏松症具有重要意义.     

右归丸对绝经后骨量减少肾阳虚型的临床研究

摘要：目的 观察右归丸对绝经后骨量减少肾阳虚型的临床研究。方法 选取2020年10月-2021年6月在陕西中医药大学附属医院康复医学科接受治疗的绝经后骨量减少肾阳虚型患者81人,通过随机数字法分为治疗组（n=40）和对照组（n=41）,对照组口服碳酸钙维D3片及行温针灸,治疗组在对照组基础上加服右归丸,总疗程为12周。对比治疗组及对照组治疗后总有效率、治疗前和治疗后骨代谢标志物[（血清骨钙素（BGP）、25-羟维生素D3、β胶原降解产物（β-CTX）、Ⅰ型前胶原氨基端前肽（PINP）]、性激素[促黄体生成素（LH）、血清雌二醇（E2）、促卵泡激素（FSH）]水平变化、生活质量量表躯体健康总评分（PCS）、左髋关节和L1~4的骨密度（BMD）、中医证候评分和不良反应率。结果 治疗后对照组与治疗组总有效率分别为71.05 %、86.84 %（P<0.05）;治疗后两组患者骨代谢标志物水平、中医证候评分均显著低于治疗前,且治疗组较对照组显著降低（P<0.05）;治疗后两组患者BMD、LH、E2、FSH水平、PCS评分均较治疗前显著提高,且治疗组显著高于对照组（P<0.05）;治疗组不良反应发生率为（3/38）7.89 %,对照组为（2/38）5.26 %（P>0.05）。结论 右归丸治疗绝经后骨量减少肾阳虚型患者疗效较好,能够降低中医证候评分,增加骨密度,调节骨代谢,提高PCS评分,改善生活质量,且不良反应较少,值得临床推广。     

北京郊区青春期学生全身骨量影响因素的研究

目的 了解青春期学生全身骨量的影响因素，为从生命早期预防骨质疏松提供科学依据。方法 调查了北京市怀柔区学生共337人，年龄为11．4～16．1岁，男生172人，女生165人。采用24h回顾法了解膳食摄入、体力活动问卷了解体力活动情况。采用双能量X线骨密度测量仪（DEXA）测量全身骨量及体脂百分比。用Tanner五分期法评价第二性征发育。采用身高标准体重评价研究对象的营养状况。结果 多元逐步回归分析表明：与男生全身BMD关系最大的是体重，其次是体脂百分比、吸烟、体力活动能量消耗、营养正常和膳食钙摄入量，与BMC关系最大的是体重，其次是身高、肥胖、吸烟和体力活动能量消耗；与女生全身BMD关系最大的是体重，其次是乳房发育分期、月经初潮、脂肪摄入量和年龄，与BMC关系最大的体重，其次是身高、乳房发育分期、磷摄入量、膳食钙摄入量和月经初潮。结论 影响北京市郊区学生全身骨量主要决定因素为体重、青春发育状况和身高，体力活动和膳食钙对男生全身骨量的影响大于对女生的影响。     

武汉地区FES患者骨质疏松状况及危险因素分析

目的 研究分析武汉地区首发精神分裂症(first-episode schizophrenia, FES)患者患骨质疏松症(osteoporosis, OP)状况及危险因素。方法 将2020年1月至2021年6月于武汉地区精神科专科联盟机构就诊的450例FES患者纳入观察组;另选择同期健康体检的443例正常人作为对照组。统计观察组患者OP发生情况,比较观察组与对照组骨密度测量结果和骨代谢指标水平,分析影响FES患者OP发生的危险因素。结果 观察组骨量正常比例低于对照组,骨量减少及OP比例高于对照组(P<0.05);骨代谢指标水平低于对照组(P<0.05);血糖指标水平高于对照组(P<0.05),两组血脂指标比较差异无统计学意义(P>0.05);单因素分析结果显示性别、年龄、精神分裂症病程、体质量指数(body mass index, BMI)、吸烟史、日均运动时长、合并糖尿病、高血脂、冠心病均与首发精神分裂症患者OP的发生相关(P<0.05);多因素Logistic回归分析结果显示女性、年龄≥60岁、精神分裂症病程≥2年、BMI≥24 kg/m^2<...     

儋州农村地区老年人群骨质疏松症的患病率及其危险因素分析

目的了解儋州农村地区老年人群骨质疏松症(OP)的患病率,并分析其相关危险因素,为有效预防和干预提供依据。方法采用美国GE公司生产的Lunar Prodigy Advance PA+300164型双能X线骨密度仪测量儋州农村地区老年人群的右侧跟骨骨密度。通过对受试者进行调查问卷,记录其一般资料及骨质疏松症相关因素等。单因素Logistic分析,有统计学意义的因素(P0.05)进一步行二分类非条件Logistic回归分析,计算OR值及其95%置信区间(95%CI)。应用受试者工作特征(ROC)曲线评价Logistic回归模型的效果。结果在2186名调查对象中,OP总患病率为31.6%(691/2186),其中男性占21.4%(148/691),女性占78.6%(543/691)。随着年龄的增长,男、女性骨质疏松症患病率均明显增加,差异有统计学意义(P0.05)。在男性,单因素及二分类非条件Logistic回归分析显示,年龄、饮酒次数、OP家族史、骨折次数是OP发生的独立危险因素(P0.05),体质指数、饮用牛奶、每天锻炼时间、对骨质疏松症的认识程度可能是OP保护因素(P0.05)。在女性,单因素及二分类非条件Logistic回归分析显示,年龄、OP家族史、骨折次数、婚姻状况、绝经状态是OP发生的独立危险因素(P0.05),体质指数、饮用牛奶、每天锻炼时间、对骨质疏松症的认识程度可能是OP保护因素(P0.05)。ROC曲线评价Logistic回归模型预测效果的曲线下面积(AUC)及95%CI为0.895(0.842~0.974)。结论儋州农村地区老年人群骨质疏松症的患病率较高,影响骨质疏松症的危险因素较多,需积极采取预防措施,以减少或延缓骨质疏松症的发生。     

Prevalence of osteoporosis and its reproductive risk factors among Jordanian women: a cross-sectional study

Extensive differences in the osteoporosis epidemiological pattern among geographic and ethnic groups have been reported. The evidence concerning association of multiple pregnancies, lactations, and other menstrual history factors with low bone mineral density (BMD) remains inconclusive. Previous local studies addressing these issues in Jordan are very restricted. We present a cross-sectional study of Jordanian women who visited outpatient clinics between August 2000 and August 2002 at two community hospitals in Amman City. BMD measurement was performed for all subjects, while comprehensive appraisal of clinical issues related to reproductive status and past medical history was carried out using a structured questionnaire administered to 50% of the subjects. We also attempted to examine the current hypothesis of possible influence of hyperlipidemia and thyroid abnormalities on decreased BMD. According to WHO criteria, 119 (29.6%) were identified as having osteoporosis, 176 (43.8%) were osteopenic, and 107 (26.6%) had normal BMD. The multiple-linear regression analyses at different bone sites revealed that age, years of menopause, low-density lipoprotein (LDL), and follicle-stimulating hormone (FSH) have strong independent associations with decreased BMD at all lumbar and femoral neck regions. The negative effect associated with number of children (live births) and frequency of lactations was only evident at femoral neck. Although years of menstruation, age at menopause, days of menstrual cycle, number of pregnancies, and duration of hormone replacement therapy (HRT) were positively correlated with BMD, they had weaker associations than previous variables. Moreover, in the final multivariable logistic regression model, variables which rendered significantly independent risk factors after adjustment for age and BMI were: current smokers of more that 25 cigarettes/day, postmenopausal women irrespective of HRT use, menopausal years of 5 year intervals, natural early menopause, gastrointestinal disease, rheumatoid arthritis, osteoarthritis, hypertension, and thyroid replacement therapy. Ever-lactation, frequent lactation of 4 or more times, duration of lactation interval of 1–6 months and clinical hyperthyroidism were significant protective factors. Hysterectomy with or without oophorectomy, premature ovarian failure, gravidity, menstrual flow pattern, family history of osteoporosis, clinical hypothyroidism, hyperlipidemia, HRT, and corticosteroids therapy were not independent predictors of osteoporosis among our population. It was concluded that the prevalence of this worldwide public health problem among the Jordanian female population is extremely high, and is even found in younger age categories compared to previous international surveys. Though, the number of pregnancies in our multiparous female population showed a negative impact on femoral neck BMD, no evidence of increased risk of osteoporosis among ever-pregnant women was noted. Conversely, the current data analysis highlight many potential risk factors including associated medical illnesses, and other hormonal alterations experienced during menopausal period. Therefore, increased health awareness and intensive screening programs are mandatory for early detection of low bone mass.     

Lenke 5型青少年特发性脊柱侧凸患者前路选择性融合术后腰椎后滑脱的发生率及危险因素分析

目的 ：分析Lenke 5型青少年特发性脊柱侧凸（AIS）患者行前路选择性融合术后腰椎后向滑脱的发生率及其危险因素。方法：回顾性分析2005年1月～2010年12月在我院接受前路选择性胸腰椎融合手术的49例Lenke 5型AIS患者的临床资料。在术前、术后3个月及末次随访时的站立位全脊柱正侧位X线片上测量胸腰弯Cobb角、胸弯Cobb角、腰椎前凸角（lumbar lordosis,LL）、胸椎后凸角（thoracic kyphosis,TK）、胸腰段后凸角（thoracolumbar junctional kyphosis,TJK）、骶骨倾斜角（sacral slope,SS）、骨盆倾斜角（pelvic tilt,PT）、骨盆入射角（pelvic incidence,PI）、C7矢状位垂直距离（C7 sagittal vertical axis,SVA）。统计患者性别、年龄、Risser征、随访时间、融合椎体数、下端固定椎位置。按照Roussouly分型对患者术前矢状面形态进行分型。根据末次随访时发生腰椎后滑脱与否将患者分为滑脱组与非滑脱组。对两组患者术前、术后3个月及末次随访时的各参...     

The effects of the calcium-restricted diet of urolithiasis patients with absorptive hypercalciuria type II on risk factors for kidney stones and osteopenia

The calcium (Ca)-restricted diet of urolithiasis patients with absorptive hypercalciuria type II may decrease Ca excretion but increase biochemical markers of risk for osteopenia. We randomly allocated 25 patients from six hospitals into an experimental group (Ca restriction to 500 mg/day, oxalate-rich products discouraged and normalization of animal protein and sodium) and a control group (no restrictions) for one month. The urinary Ca excretion did not decrease significantly, but the oxalate excretion decreased, although not significantly. The hydroxyproline:creatinine ratio in fasting urine seemed to increase and the calcium:creatinine ratio to decrease. The deoxypyridinoline:creatinine ratio in fasting urine did not change. We conclude that our Ca-restricted diet, which is lower in Ca, animal protein and table salt due to the omission of dairy products, may be of benefit for absorptive hypercalciuria type II patients without enhancing the risk for osteopenia. However, a long-term clinical trial is required. Received: 12 September 1996 / Accepted: 31 July 1997     

原发性骨质疏松的病因学及危险因素

原发性骨质疏松症是以人体内骨量下降、骨组织显微结构破坏导致骨脆性增加而发生骨折为特征的一种常见病,随着我国社会人口老龄化,患有骨质疏松症的病人不断增加,由此引发的社会问题日益突出。原发性骨质疏松症的发生与饮食及生活习惯、内分泌激素、维生素、微量元素及遗传因素等密切相关。     

Relationship between vitamin D status, body composition and physical exercise of adolescent girls in Beijing

Summary  Little is known about the prevalence of actual vitamin D deficiency in healthy school-aged adolescents, particularly in China. The aim of this study was to examine the prevalence of hypovitaminosis D and to identify whether there was any association between vitamin D status, body composition and physical exercise in 323 Chinese adolescent girls in Beijing, China (40°N). Introduction  It is well recognized that persistent severe vitamin D deficiency is associated with the bone abnormalities of rickets and osteomalacia. However, there is now evidence suggesting that low vitamin D status, not previously considered to be a state of deficiency is associated with secondary hyperparathyroidism, increased bone remodelling and other clinical signs thought only to be found in severe vitamin D deficiency. Hypovitaminosis D in healthy children and adolescents has been reported frequently in many countries, especially in winter. Methods  We performed a cross-sectional analysis of 323 Chinese adolescent girls in Beijing in winter. Mean age of the subjects was 15.0 (±0.4) years. About 32.8%, 68.4% and 89.2% of the subjects were at risk of vitamin D deficiency when defined as plasma concentrations of 25(OH)D of 25, 37.5 or 50 nmol/L, respectively. Results  This cross-sectional analysis of 323 Chinese adolescent girls in Beijing in winter showed that hypovitaminosis D was common in these subjects. In addition, body mass index, milk intake, participation in organized sports and total physical activity were all significant independent determinants of vitamin D status. An inverse association was found between plasma 25(OH)D and intact-parathyroid hormone (iPTH) concentration. Body mass index (BMI), milk intake, participation in organized sports and total physical activity all emerged as major independent determinants of vitamin D status as assessed by plasma 25(OH)D concentration. Vitamin D status was positively associated with lean body mass (LBM), but there was no association with the degree of body adiposity. Regardless of the concentration of 25(OH)D in blood used to define vitamin D deficiency, hypovitaminosis D was common in these subjects. Conclusion  It is recommended that policies be developed to prevent vitamin D deficiency in adolescent girls. Further studies are needed to identify the mechanisms whereby vitamin D status is related to exercise and to body composition during growth.     

广州地区中老年人群骨量减少及骨质疏松患病率的调查

目的：了解广州地区中老年人骨量减少（Osteopenia）及骨质疏松（Osteoporosis,OP），患病率的变化规律，为防治OP提供科学依据。方法：居住广州市内及郊区农村20年以上的40岁以上人群进行整群随机抽样，样本共1160人，准确记录其性别和年龄后，用美国Lunar公司的DEXA测试受试者L2－4和髋部的骨密度（BMD），然后进行统计、比较与分析。结果：40岁组女性L2－4及Ward‘s区BMD高于男性，该组骨量减少患病率男女性都超过样本数的1／3，50岁以男性高于女性，男性70岁组L2－4下降才明显，女性L2－4及髋部BMD从50岁起加速下降，L2－4BMD70岁以后减慢，男性60岁以后髋部BMD下降明显，不论男、女性髋部BMD下降直到80岁以上都较显著，骨质疏松患病率随年龄的增长而增加，女性50岁组起变化开始明显，60岁组OP患病率85％，并一起以重度OP占多数，农村患病率高于城市，男性在70岁组起OP患病率显著上升，结论：广州地区中老年人骨量减少及OP患病率与北京、上海、成都等地区近似，老年女性以重度OP占多数，50岁以上男性OP患病率达到30％，应得到足够的重视。     

Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density

Sarcopenia, the decline of muscle mass with age, causes impaired gait, disability and falls. It may therefore increase the risk of fracture for osteoporotic women. The aims of this study were to determine the prevalence of sarcopenia in osteopenic and osteoporotic women, and to determine if hormone replacement therapy (HRT), diet, or physical activity (PA) has a role in the prevention of sarcopenia. One hundred and thirty-one premenopausal and 82 postmenopausal (54 taking HRT) healthy women (17–77 years) volunteered for the study. Body composition was measured by dual X-ray absorptiometry (DXA). Sarcopenia was defined as a relative skeletal muscle index (RSMI) (appendicular skeletal muscle mass divided by height) below 5.45 kg/m². Osteopenia was defined by a densitometric t -score for bone mineral density (BMD) (g/cm²) below –1.0 and osteoporosis by a t -score below –2.5. Nutrient intake was assessed using 3-day food records and physical activity (PA) was measured using the Baecke Physical Activity Questionnaire. Pearson chi-squared, independent t -tests, simple correlation and multiple regression were used to analyze the data. In premenopausal osteopenic women the prevalence of sarcopenia was 12.5%. In postmenopausal women it was 25% for those with osteopenia, and 50% for those with osteoporosis. PA was independently related to RSMI (=0.222, p =0.0001), but diet and HRT were not. After adjusting for PA, RSMI was not significantly related to BMD. These data suggest that the relationship between RSMI, BMD and risk of osteoporosis may largely be mediated through participation in PA. Sarcopenia screening simultaneous to BMD examinations by DXA, may be of value in identifying osteoporotic women with sarcopenia, a group that may be most in need of exercise interventions to increase muscle and BMD.