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。     

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。     

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<...     

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.     

Evaluation of Bone Mineral Status in Adolescent Idiopathic Scoliosis

Background

Several reports have suggested low bone mineral density (BMD) in patients with adolescent idiopathic scoliosis (AIS). We determined bone mineral status in patients with AIS to evaluate the effect of brace treatment on BMD.

Methods

BMD was measured in 46 patients (mean age, 17.8 ± 4.9 years) with AIS (17 with brace and 29 without brace) by dual-energy X-ray absorptiometry scan and compared the results to an age-matched (mean age, 16.6 ± 3.9 years) control group (n = 54).

Results

The AIS group had significantly lower bone mass at the lumbar spine (Z-score, -1.500 vs. -0.832) and hip (Z-score, -1.221 vs. -0.754) except at the femoral neck. No difference in BMD was found between patients with AIS who used a brace and those who did not.

Conclusions

The results confirmed that BMD was low in AIS patients and it was not affected by brace treatment.     

Risk factors for osteoporosis for residents of Kiwa

We evaluated 207 individuals (49 men and 158 women) living in a small town in central Japan to identify the risk factors for, and the etiology of, osteoporosis. Female sex, advanced age, short stature, low body weight, and deficiencies in calcium and protein intake were associated with an increased risk of osteoporosis. Nutrition appeared to be strongly related to a decrease in bone mass, because subjects who lived solitary lives were more likely to have decreased bone mass and bone mass was similar between husbands and wives.     

2200例指骨骨密度测定分析

目的评价采用X线放射吸收法测定指骨骨密度（BMD）的结果及在适用人群普查的可行性.方法自2001年1月至2004年12月随机对2200例各年龄段男、女性进行BMD测定.结果人体40岁以后骨中BMD（患者3根手指相对BMD的平均值）逐渐减少;男性50岁以后有20.40%的人为骨量减少,22.25%的人为骨质疏松;女性50岁以后有28.99%为骨量减少,29.97%的人为骨质疏松.结论采用指骨BMD所获的测定结果符合骨质疏松症流行病学的发病率,可以对45岁以上的人群进行普查,针对骨量减少和骨质疏松症患者给予治疗.     

Influence of duration of total breast-feeding on bone mineral density in a Turkish population: does the priority of risk factors differ from society to society?

Introduction Despite numerous studies on risk factors for osteoporosis the effect of breast-feeding on bone mineral density (BMD) is unclear. In this study our aim was to determine the influence of total duration of breast-feeding on BMD, and subsequent risk of osteoporosis. Methods A total of 1,486 postmenopausal women over the age of 40 were included in the study. Women with diseases or who were under drug treatments known to affect bone metabolism were excluded. The BMD of the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry technique, using either the Norland XA-26 or Lunar DPX-IQ densitometers and were transferred to standard values. Patients were placed in groups of five with respect to the duration of their breast-feeding as never, 1–12 months, 12–24 months, 24–60 months, >60 months. Results One-way ANOVA test showed a significant difference between the lumbar spine and femoral neck BMD of these groups of women (p<0.001, p<0.001). Post hoc Bonferroni correction revealed that both the lumbar spine and femoral neck BMD results of women with longer duration of total breast-feeding were significantly lower than those of women with less duration of total breast-feeding. In subsequent analysis other potential risk factors were also considered in a multiple linear stepwise regression model. Years since menopause (p<0.001), weight (p<0.001), total duration of breast-feeding (p<0.001), and body mass index (p=0.001) were found to be the most important predictors for lumbar spine BMD; and age (p<0.001), weight (p<0.001), years since menopause (p<0.001), and total duration of breast-feeding (p<0.001) for femoral neck BMD. Conclusions This study showed significant associations between total duration of breast-feeding and BMD. In conclusion, total duration of breast-feeding might be an important risk factor besides age, weight, and years since menopause in postmenopausal osteoporosis.