老年男性骨质疏松患者血清胰淀素与骨密度及骨转换生化指标的关系

目的探讨老年男性骨质疏松患者血清胰淀素(Amylin)水平的变化及其与骨密度(BMD)及骨转换生化指标的关系。方法采用酶联免疫法(ELISA)测定89例老年男性骨质疏松患者和50例正常男性老年人血清Amylin、骨碱性磷酸酶(BAP)、骨钙素(BGP)、I型胶原氨基末端肽(NTX),采用美国NORLAND XR-46 Excell-plus双能X线骨密度测定仪分别测定正位腰椎(L2-L4)及左侧股骨颈BMD。结果老年男性骨质疏松患者正位腰椎及左侧股骨颈BMD、血清Amylin、BAP、BGP水平较正常男性老年人明显降低(均P<0.01),血清NTX水平较正常男性老年人明显升高(P<0.01)。老年男性骨质疏松患者血清Amylin水平与患者正位腰椎及左侧股骨颈BMD、血清BAP、BGP水平呈明显正相关(r=0.598,r=0.652,r=0.576,r=0.584,均P<0.01),与患者血清NTX水平呈明显负相关(r=-0.673,P<0.01)。结论血清胰淀素水平降低在老年男性骨质疏松的发病中可能发挥重要作用。     

血清SM4D水平与绝经后骨质疏松症患者骨密度和骨代谢指标的相关性研究

目的探讨绝经后骨质疏松症(postmenopausal osteoporosis,POP)患者血清4D同型二聚体(SM4D)水平与骨密度(bone mineral density,BMD)和骨转换指标的关系。方法通过双能X线吸收测定法对257例POP患者和90例健康对照者进行BMD测量。通过酶联免疫吸附测定法测定受试者血清SM4D、BAP、BGP和TRACP-5b水平。使用自动电化学发光系统测量I型血清交联N端肽(NTX)、25-羟基维生素D[25(OH)D]和骨钙素的N-mid片段水平(N-MID-OT)。结果与健康对照组相比,POP妇女的SM4D水平显著升高[(1.40±0.33)μg/L vs.(0.58±0.18)μg/L,P=0.006]。SM4D水平与血清TRACP-5b和NTX水平呈正相关,与腰椎和股骨颈BMD、血清BAP和BGP水平呈负相关。SM4D水平与年龄、体质量指数以及血清25(OH)D和N-MID-OT水平之间无相关性。腰椎和股骨颈骨密度(β=-0.354,P<0.001;β=-31.234,P<0.001)和血清BAP水平(β=0.127,P=0.019)是POP患者血清SM4D水平的独立预测因子。结论绝经后骨质疏松症女性SM4D与骨密度和骨转换指标密切相关。     

绝经后骨质疏松症女性血清IL-31和腰椎、股骨颈骨密度相关性研究

目的探索绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)患者血清白介素31(IL-31)水平与骨密度(bone mineral density,BMD)相关性。方法采用双能X线吸收法对80例OP患者(50~75岁)和90例健康对照者(50~75岁)进行腰椎和股骨颈BMD检测。血清IL-31、BAP、BGP和TRACP-5b水平通过酶联免疫吸附法检测。使用自动电化学发光系统测量血清I型胶原交联N-末端肽(NTX-1)和25-羟基维生素D[25(OH)D]水平。结果OP妇女的IL-31水平明显高于健康对照组[(45.12±6.65)μg/L vs(27.58±5.09)μg/L,P=0.002]。绝经后骨质疏松患者血清IL-31水平与年龄、BMI、BAP、BGP、TRACP-5b、NTX和25(OH)D呈正相关。腰椎和股骨颈骨密度与年龄、IL-31、BAP、TRACP-5b和NTX之间有显著的负相关。在偏相关分析中调整年龄和BMI后,IL-31和腰椎和股骨颈骨密度之间存在显著负相关。结论绝经后骨质疏松症患者血清IL-31水平升高,与BMD呈负相关。     

Biochemical Markers of Bone Turnover in Camurati–Engelmann Disease: A Report on Four Cases in One Family

Moderate increases in ``classical' biochemical markers of bone turnover have been described only in some patients with Camurati–Engelmann disease. However, the determination of the following ``new' markers has not been previously performed: serum osteocalcin (BGP), bone alkaline phosphatase (BAP), carboxyterminal propeptide of type I procollagen (PICP), aminoterminal propeptide of type I procollagen (PINP), tartrate-resistant acid phosphatase (TRAP), telopeptide carboxyterminal of type I collagen (ICTP), urinary pyridinoline (PYR), crosslinked N-telopeptides of type I collagen (NTX), and Crosslaps (CL). Such a determination may improve the evaluation of the disease activity. To evaluate the usefulness of biochemical markers of bone turnover reflecting Camurati–Engelmann disease activity we measured the levels of all these markers in four affected patients. The results were compared with bone scintigraphic indices of disease activity. Except for PICP and TRAP, bone formation and resorption markers were abnormal in all patients and were related to bone scan indices of disease activity. Among the markers of bone formation PINP, BAP, and BGP showed the highest values, whereas NTX and CL were the most sensitive markers of bone resorption. These results suggest that the determination of NTX or CL, and PINP or either BAP and BGP, associated with bone scan evaluation, provides the best assessment of Camurati–Engelmann disease activity. Received: 14 June 1996 / Accepted: 31 December 1996     

Apparent bone mineral density estimated from DXA in healthy men and women

The aim of this study was to measure bone mineral density (BMD) in healthy people and examine the influence of age, anthropometry, and postmenopause on calculated bone mineral apparent density (BMAD). The study included 541 healthy subjects (249 men and 292 women), aged 20 to 79 years. Anthropometric measurements included height, weight, and body mass index (BMI). Bone mineral content (BMC) and areal BMD were measured at the lumbar spine and proximal femur, using dual-energy X-ray absorptiometry (DXA). The calculation of volumetric density relied on the formula BMAD=BMD/BA (where BA = bone area). Association between densitometric parameters and age, height, weight, and postmenopause was analyzed with multiple regression. BMC and BMD decreased with age, especially in postmenopausal women. The average annual bone loss in spine was 0.2% in both sexes, whereas femur loss was 0.5% in men and 0.3% in women. Bone area slightly increased with age in both sexes, and BMD loss after the age of 50 could be attributed to bone area increase. To minimize the effect of bone size on bone density, volumetric density and areal density were regressed to age, anthropometry, and postmenopause. Age and postmenopause were significantly associated with BMD and BMAD in the spine and femur. Furthermore, BMD showed a stronger association with height and weight than BMAD, in both regions. Weaker association of body height and weight with BMAD than with BMD suggests that BMD depends on the bone size and body size and that the different BMDs could be the consequence of the difference in those parameters.     

Characteristics and course of bone mineral densities among fast bone losers in a rural Japanese community: the Miyama Study

The aim of this study was to clarify and compare the temporal course of bone mineral density (BMD) between fast bone losers and normal residents in Miyama Village, a rural Japanese community. BMD was measured over a 10-year period in a cohort study in Miyama Village, Wakayama Prefecture, Japan, to provide information on rate of bone loss in the mature and elderly population. Subjects (n=400) were selected by sex and age stratum from the full list of residents born in 1910–1949, with 50 men and 50 women in each age decade. Baseline BMD of the lumbar spine and proximal femur was measured using dual energy X-ray absorptiometry in 1990, 1993, 1997 and 2000. In the cohort, 171 men and 189 women completed the follow-up survey performed in 1993. After calculating the rate of bone loss between 1990 and 1993, the greatest tertile from the distribution of bone loss was categorized as fast bone losers, with the remainder considered as normal subjects. Changes in BMD were compared between normal subjects and fast bone losers over the 10-year period. Mean rate of change for BMD at both lumbar spine and femoral neck in fast bone losers recovered to levels similar to those in normal subjects over 7 years of observation. By contrast, BMD at the lumbar spine and femoral neck decreased steeply over the 10-year period in both groups, and mean BMD for fast bone losers was significantly lower than that of normal subjects (P<0.05). These differences were apparent only at the lumbar spine in both men and women, even after adjusting for age. These results indicate that fast bone loss is a transient phenomenon rather than a fixed status, although individuals who have been categorized as fast bone losers at some stage continue to display low BMD in the lumbar spine.     

Biochemical Markers of Bone Turnover and Bone Loss at the Lumbar Spine and Femoral Neck: The Taiji Study

The purpose of this study was to ascertain whether biochemical markers of bone turnover predict bone loss. The survey was carried out in Taiji, Wakayama Prefecture, Japan. From a list of inhabitants aged 40–79 years, 400 participants (50 men and 50 women in each of four age groups) were selected randomly. Bone mineral density (BMD) was measured, and blood and urine samples of all participants were examined to obtain values for eight biochemical markers: alkaline phosphatase (ALP), bone Gla protein (BGP), type I procollagen (carboxyterminal peptide of type I procollagen; PICP), cross-linked carboxyterminal telopeptide region of type I collagen (ICTP), and urinary excretion of calcium (Ca), phosphate (P), pyridinoline (Pyr), and deoxypyridinoline (D-Pyr). Each marker was evaluated as a predictor of the rate of bone change in lumbar spine and femoral neck BMD over a 3-year period. The value of Pyr was significantly related to the change of lumbar spine BMD in men (P= 0.009), and that of BGP was found to be significant in women (P= 0.045). By contrast, none of the bone markers significantly correlated with bone loss at the femoral neck. The coefficient of determination at the lumbar spine was 5% and 7% at the femoral neck only. We conclude that biochemical markers of bone turnover cannot predict bone loss rates in middle-aged or elderly Japanese men and women over a 3-year period with sufficient accuracy for use in clinical decision making. Received: 26 January 1998 / Accepted: 9 July 1998     

Changes of basic bone turnover parameters in short-term and long-term patients with spinal cord injury

The bone mineral density (BMD), the cross- links (PYD, DPD and NTx) and the bone specific alcaline phosphatase (BAP) was investigated in a cross-sectional study in 62 male patients with spinal cord injury (SCI), n = 28 short-term (0–1 year after SCI) and n = 34 long-term SCI patients (> 5 years after SCI). Knowledge about this parameters are necessary to find an adequate therapy for this special kind of osteoporosis. Immobilisation osteoporosis in SCI patients is a well-known problem that may lead to pathological fractures. Little is known regarding the extend of the osteoporosis as well as the causative factors. Measurements of the BMD in the proximal femur and the lumbar spine were performed with dual-energy-X-ray-absorptiometry (DEXA), of the osteoblast marker BAP (bone specific alkaline phosphatase) from serum and the osteoclast markers PYD (pyridinoline), DPD (desoxy-pyridinoline) and NTx (N-telopeptide of collagen type I) from urine. We found a significant decrease of BMD in the proximal femur and no relevant change in the lumbar spine compared to an age- and sex correlated control group (Z-score) in short-term and long-term SCI patients. There was a significant bone loss at the proximal femur between short and long-term SCI patients, whereas at the lumbar spine the BMD even slightly increases. Bone resorption (cross-links) was increased in both groups, though in long-term SCI patients it is significantly decreased compared to short-term SCI patients (DPD from 211.7 u/g creatinine to 118.1 u/g creatinine; NTx from 215.1 nmol/mmol creatinine to 83,6 nmol/mmol creatinine). The bone formation marker BAP is slightly below normal range in both groups (12.3 U/l in short-term, 9.7 U/l in long- term SCI patients). Only the proximal femur is affected by the immobilisation osteoporosis of SCI patients, therefore the BMD measurements in these patients should be performed at the lower limb. The problem of the immobilisation osteoporosis in SCI patients is the striking increase of bone resorption and the missing reaction of the bone formation.     

Population-based geographic variations in dxa bone density in Europe: The evos study

The purpose of this study was to investigate variations in bone density between 16 European populations, 13 of which were participants in the European Vertebral Osteoporosis Study (EVOS). Men and women aged 50–80 years were recruited randomly from local population registers, stratified in 5-year age bands. The other three centres recruited similarly. Random samples of 20–100% of EVOS subjects were invited for dual-energy X-ray absorptiometry (DXA) densitometry of the lumbar spine and/or proximal femur using Hologic, Lunar or Norland pencil beam machines or, in one centre, a Sopha fan-beam machine. Cross-calibration of the different machines was undertaken using the European Spine Phantom prototype (ESPp). Highly significant differences in mean bone density were demonstrated between centres, giving rise to between-centre SDs in bone density that were about a quarter of a population SD. These differences persisted when centres using Hologic machines and centres using Lunar machines were considered separately. The centres were ranked differently according to whether male or female subjects were being considered and according to site of measurement (L2–4, femoral neck or femoral trochanter). As expected, bone mineral density (BMD) had a curvilinear relationship with age, and apparent rates of decrease slowed as age advanced past 50 years in both sexes. In the spine, not only did male BMD usually appear to increase with age, but there was a highly significant difference between centres in the age effect in both sexes, suggesting a variability in the impact of osteoarthritis between centres. Weight was consistently positively associated with BMD, but the effects of height and armspan were less consistent. Logarithmic transformation was needed to normalize the regressions of BMD on the independent variates, and after transformation, all sites except the femoral neck in females showed significant increases in SD with age. Interestingly, the effect of increasing weight was to decrease dispersion in proximal femur measurements in both sexes, further accentuating the tendency in women for low body mass index to be associated with osteoporosis as defined by densitometry. It is concluded that there are major differences between BMD values in European population samples which, with variations in anthro-pometric variables, have the potential to contribute substantially to variations in rates of osteoporotic fracture risk in Europe.     

Relationship of circulating MMP–2, MMP–1, and TIMP–1 levels with bone biochemical markers and bone mineral density in postmenopausal Chinese women

Introduction Osteoblast-derived matrix metalloproteinase (MMP)–2, MMP–1 and tissue inhibitor of metalloproteinase (TIMP)–1 have been shown to play a role in bone metabolism by degrading the bone matrix. Methods The present study was performed to investigate the relationships between serum MMP–2, MMP–1, or TIMP–1 levels and bone mineral density (BMD), as well as bone biochemical markers, in 297 Chinese postmenopausal women aged 42–80 years. Results We found a significant negative weak correlation between MMP–2 and BMD at various skeletal regions. After adjustment for age and BMI, the correlation with BMD at the femoral neck and total hip disappeared. Multiple linear stepwise regression analysis showed that MMP–2 was not a determinant factor for BMD. The significant positive correlations between MMP–2 and bone cross-linked N–telopeptides of type I collagen (NTX), alkaline phosphatase (BAP), and osteocalcin (OC) and were found, and remained significant after adjustment for age and BMI. Moreover, serum MMP–2 concentrations were significantly higher in postmenopausal women with osteoporosis than in age-matched normal controls. There were no significant correlations between MMP–1, TIMP–1 and BMD. There were no significant relationships between MMP–1 and BAP, OC, and NTX. The associations between TIMP–1 and BAP and OC were not specific and constant. Conclusions In conclusion, our results suggest that circulating MMP–2 and markers of bone turnover are correlated, and serum MMP–2 levels may rise with increase in bone turnover.     

绝经后股骨颈骨折股骨头骨铁含量、血清铁蛋白与骨密度相关性研究

 目的 探讨女性绝经后股骨颈骨折股骨头骨铁含量、血清铁蛋白与髋部骨密度的相关性。方法 2010年6月至2013年3月,收集156例股骨颈骨折行髋关节置换的绝经后女性患者资料,年龄56~92岁,平均(72.40±8.97)岁;按每10岁年龄段分组,共分5组,即≤ 60岁组、61~70岁组、71~80岁组、81~90岁组、≥91岁组。患者入院后第2天留空腹血清标本测定血清铁蛋白和骨代谢指标;对髋关节置换术后留取的股骨头组织行骨铁含量检测和骨铁染色,术后第10天行髋部和腰椎骨密度(DXA)检测。结果 5组之间骨铁、血清铁蛋白、转铁蛋白、总铁结合力、Ⅰ型原胶原氨基端延长肽、Ⅰ型胶 原C端肽β降解产物、髋部和L1~4骨密度存在组间差异。髋部和L1~4骨密度随年龄增加而下降,骨铁和血清铁蛋白随年龄增 加而升高,骨铁和血清铁蛋白检测值均在81~90岁年龄组达到峰值,156例患者的平均骨铁量为96.81 μg/g,平均血清铁蛋白为235.66 μg/L。156例患者中,血清铁蛋白＞200 μg/L的患者为100例(100/156,64.1%)。骨铁、血清铁蛋白、年龄、体重指数可进入髋部骨密度回归模型,股骨颈R2=0.443,Wards三角R2=0.397,大转子R2=0.322,全股骨R2=0.379;控制年龄、体重、体重指数等因素,骨铁和血清铁蛋白与髋部骨密度呈负相关,与腰椎骨密度无明显相关性。结论 发生股骨颈脆性骨折的绝经后女性患者体内存在铁蓄积,股骨头骨铁含量随年龄增加而升高,骨铁增加和血清铁蛋白升高可能是髋部骨密度下降的独立危险因素,铁蓄积与绝经后骨质疏松症存在相关性。     

Menopause-related changes in bone mineral density in Japanese women: A longitudinal study on lumbar spine and proximal femur

We investigated 2-year longitudinal changes of bone mineral density (BMD) in lumbar spine and proximal femur in 64 Japanese women aged 38–67. Forty subjects were premenopausal (mean age 44.9) and 24 postmenopausal (mean age 54.6) at enrollment of the study. Six subjects experienced menopause during the 2-year study period and were defined as the perimenopausal group. Measurements of BMD were performed using dual-energy X-ray absorptiometry at L2–4, femoral neck, greater trochanter, and Ward's triangle. Paired t test revealed no significant decrease in BMD at any site in the premenopausal group. Significant annual decrease in BMD was observed in the perimenopausal group at L2–4, femoral neck, and greater trochanter. A similar tendency was observed in Ward's triangle, but did not reach statistical significance. In the postmenopausal group, significant decrease in BMD was found at the proximal femur, but not at L2–4. Significant inverse correlation between age and change rate of BMD was found at L2–4, but not at the proximal femur, in premenopausal women. In postmenopausal women, there was a significant association between body weight (BW) change and change rate in BMD at L2–4, femoral neck, or greater trochanter. This association was not found in the premenopausal group. These results suggest that effect of menopause on BMD may be different in individuals and sites of the skeleton. BW change may affect change in BMD in postmenopausal women. However, the limited variability in both BW and BMD changes among premenopausal women in this study may explain the poor association between change in BW and change in BMD in the premenopausal group. As individual differences in each group is considerably large, annual measurements of BMD may be necessary to find possible candidates for early intervention.     

Comparison between menopause-related changes in bone mineral density of the lumbar spine and the proximal femur in Japanese female athletes: A long-term longitudinal study using dual-energy X-ray absorptiometry

This longitudinal study examined whether bone mineral density (BMD) of the lumbar spine and the proximal femur is maintained in pre-, peri-, and postmenopausal women by regular exerise. BMD was measured using dualenergy X-ray absorptiometry (DXA). Twenty-six Japanese women (mean age 47.8 years) were followed 4–5 years. Twenty-two subjects from volleyball or jogging clubs had participated in the same exercise for more than 5 years at the initial BMD measurement. Longitudinally, for these 22 athletes, the rate of change per year in BMD of the lumbar spine was -0.17% in the premenopause group and -2.60% in the perimenopause group. In the proximal femur of the athletes, BMD increased (rate of increase per year 1.80%) in the premenopause group, but decreased (rate of decrease per year 1.07%) in the perimenopause group. In the premenopause group, BMD of the proximal femur increased in all athletes. However, in the proximal femur, the nonexercise group showed a 0.31% decrease, a significant difference (P <0.05) compared with the athletes. These findings suggest that women can achieve continuous gains in bone mass in the proximal femur before menopause by regular intense exercise. However, continued high-level physical activity in the perimenopausal women was not able to prevent bone loss.     

Assessment of age and risk factors on bone density and bone turnover in healthy premenopausal women

The influence of age and risk factors on bone density and bone turnover was evaluated in 249 healthy premenopausal women. Risk factors were assessed by standardized questionnaires and included reproductive history and lifestyle factors (intake of calcium and vitamin D supplements, consumption of caffeine, smoking habits and physical activity). Bone mineral density (BMD) measurements were obtained in the distal forearm, the lumbar spine and the proximal femur. Bone turnover were assessed by plasma bone Gla proteins (pBGP) and fasting urinary hydroxyproline corrected for creatinine (fUHPr/Cr). Peak bone density seems to be achieved before the age of 30 years, whereafter we found no appreciable bone loss at any skeletal site. Accordingly, the levels of pBGP and fUHPr/Cr were increased before the age of 30, whereafter the values stabilized at a lower level. A dairy calcium intake above 660 mg/day significantly increased BMD in the spine and proximal femur by 3%–5%. Physical activity alone had no influence on BMD, but in combination with calcium intake an additive effect was observed. Women who had an active lifestyle (corresponding to at least 1 h of daily walking) and a dairy calcium intake above 660 mg/day had a 3%–7% increase in BMD compared with more sedentary women with a calcium intake below this limit. Vitamin D supplements, caffeine, smoking and reproductive history did not consistently influence BMD or bone turnover. Only pBGP was selectively reduced by smoking and current use of oral contraceptives, respectively. We conclude that there is no appreciable change in BMD before the menopause once skeletal maturity has been reached. Dietary calcium intake increases peak bone density and this positive effect can be potentiated by an active lifestyle. Other putative risk factors had no influence on premenopausal BMD.     

妊娠期亚临床甲状腺功能减退女性骨密度及骨代谢生化指标分析

目的研究妊娠期亚临床甲状腺功能减退(subclinical hypothyroidism,SCH)女性骨密度及骨代谢生化指标变化。方法比较正常孕妇与妊娠期SCH女性的骨密度、血清钙(calcium,Ca),血清镁(magnesium,Mg),血清磷(phosphorum,P),总胆固醇(total cholesterol,TC),甘油三酯(triglyceride,TC)维生素D(vitamin D,VD),甲状旁腺素(parathyroid hormone,PTH),骨钙素(bone gamma-carboxyglutamic-acid-containing proteins,BGP),Ⅰ型前胶原羧基末端肽(procollagen type I carboxy-terminal peptide,PICP)。结果妊娠期SCH女性的P、TC、TG、PICP、BGP、骨密度均与正常孕妇在孕晚期有统计学差异。结论妊娠期SCH会导致骨密度下降。     

双能X线骨密度仪测定成都市城区771例健康人骨密度结果分析

目的观察成都市城区健康人群骨密度变化规律,建立该型骨密度仪成都地区骨密度正常值,为骨质疏松诊断、防治提供参考依据。方法①采用EXPERT-XL双能X线骨密度仪(美国 LUNAR公司生产)测定成都市城区健康体检者771例,其中男性300例,女性471例,测量部位包括腰椎1～4和髋部;②按年龄、性别分别输入数据,以10岁为一年龄组,分别计算各组骨密度值,结果以x-±s表示。结果男性腰椎及股骨近端骨密度峰值出现在30～39岁,女性腰椎及股骨近端骨密度峰值出现在20～29岁,随着年龄增加,骨密度逐渐降低,男性在70岁后腰椎骨密度有反弹,而女性在50～59岁间骨密度下降迅速。结论本组健康人群骨密度数据将为成都地区骨质疏松诊断、防治提供参考依据;分析男性腰椎骨密度时应结合股骨近端骨密度;女性50岁后应注意预防、治疗骨质疏松,男性骨质疏松不容忽视。     

Characteristics of biochemical markers for bone formation in the elderly

Currently, several promising biochemical markers for bone metabolism have been postulated and expected to be applied to their clinical use. Among these markers, circulating levels of bone Gla-protein (BGP) and carboxyterminal peptide of type I procollagen (P1CP) have been established as non-invasive indices to assess bone turnover, especially bone formation. We investigated age-related effects on serum levels of both peptides and relationships between loss of bone mass and biochemical indices in the elderly. Fasting blood sample were obtained from 330 healthy volunteers to simultaneously measure serum BGP, serum P1CP and serum tartrate-resistant acid phosphatase (TRACP) as a marker for bone resorption. Serum BGP levels were found almost stable throughout life in men with a tendency to decrease in the elderly. Serum P1CP levels linearly decreased towards 50 to 60 years of age in men, followed by its constant increase with aging afterwards. Although a constant increase in serum P1CP levels were noted in women with aging, serum BGP levels were found remarkably elevated during menopausal periods of 50 to 70 years of age, followed by its wide distribution in the elderly. Both serum BGP and P1CP levels were elevated accompanied with age-related decrease in glomerular filtration rates in the elderly. In addition, a bone specific index, TRACP/BGP ratio consolidated the negative correlation between serum TRACP and % changes of bone mineral density (BMD). However, TRACP/P1CP ratio had nothing to do with % change of BMD. In conclusion, loss of bone mass could be predicted by bone specific indices, particularly in elderly women with widely distributed bone turnover. The data in this paper were reported in part in International Coference on Osteoporosis, Kobe, November 1991.     

Bone mineral density and osteoporosis among a predominantly Caucasian elderly population in the city of São Paulo, Brazil

This cross-sectional study covered 301 individuals over 70 years of age—207 women (W) and 94 men (M)—living in the city of São Paulo, Brazil. Our aims were to evaluate the prevalence of low bone mineral density (BMD) in this population and the possible factors that influence BMD. The subjects were submitted to a bone densitometry scan (DXA) to evaluate the BMD at lumbar spine (LS), femoral neck (FN), trochanter (T), total femur (TF) and total body composition. At the time, the participants filled in a questionnaire about lifestyle habits, diet and medical history, as well as having blood samples taken to check hormone and biochemical levels. Anthropometric parameters were measured. Osteopenia and osteoporosis were defined in accordance with the criteria suggested by the World Health Organization. In the different sites studied, the prevalence of osteopenia and osteoporosis varied, in men ranging 33.3–57.4% and 6.4–16.1%, respectively, and in women ranging 36.6–56.5% and 22.2–33.2%, respectively. Weight was the variable that most strongly correlated with BMD at the proximal femur in both sexes (men, r =0.44–0.52; women, r =0.48–0.52) and with BMD at LS in women ( r =0.44). Height was the parameter that best correlated with BMD at LS in men ( r =0.34). In men follicle-stimulating hormone, growth hormone and glycemia correlated with BMD at T and TF, while plasma albumin only correlated with BMD at T. In women glycemia correlated with BMD at LS, and follicle-stimulating hormone correlated with BMD at FN, T and TF. In conclusion, we found a high prevalence of osteopenia and osteoporosis in this population, with weight being the best predictor of BMD. The prevalence of osteoporosis and osteopenia at FN was as high in men as that observed in women.     

Relationship between bone mineral density of the proximal femur and lumbar spine and quadriceps and hamstrings torque in healthy Japanese subjects

The purpose of this study was to examine the corelations between the muscle torque of the leg extensors (quadriceps femoris) and leg flexors (Hamstrings) and the bone mineral density (BMD) of the proximal femur and lumbar spine. To investigate the decline in BMD of proximal femur and lumbar spine, we examined the relative importance of muscle torque, age, and body weight in the prediction of BMD in 340 healthy volunteers (109 males, and 231 females). Age and body weight were independent predictors of femoral BMD in men. Body weight and quadriceps torque were independent predictors of femoral BMD in premenopausal women. Body weight and years after menopause were independent predictors of BMD in postmenopausal women. The BMD was greatly affected by menopause, whereas the muscle torque was independent of the menopause, and showed the negative relationship to age. These results suggest that muscle-building exercise may have the potentiality to elevate the BMD in the proximal femur in premenopausal women.     

Bone metabolic marker levels in residents of a rural community in Japan

The sex and age distributions of values of bone metabolic markers were investigated among the inhabitants of a mountain village in Wakayama Prefecture, Japan. The survey was carried out in Miyama village, which has a population of 2372 (1129 men and 1243 women) based on the resident registration of 1990. In this village, all residents aged 40 years or over are eligible for general mass health examinations once a year. In the present study, bone metabolic markers were measured in recruited participants in the health examinations conducted in 1992 in each of four age strata: 40–49, 50–59, 60–69, and 70–79 years. The bone metabolic markers measured were osteocalcin (BGP), carboxyterminal peptide of type I procollagen (PICP), alkaline phosphatase (ALP), crosslinked carboxyterminal telopeptide region of type I collagen (ICTP), pyridinoline (Pyr), and deoxypyridinoline (D-Pyr). In men in their 40s, 50s, 60s, and 70s, the mean serum BGP level was 6.15, 7.04, 7.65, and 7.69 ng/ml, respectively; the level in men in their 40s was significantly lower than that in those in their 60s. The serum PICP level in the 40- to 49-year age group was significantly higher than those in the other age groups, while that of serum ICTP tended to increase with age. The mean values of urinary Pyr and D-Pyr were higher in the older groups. In women, the mean values of all bone metabolic markers were all higher among those in the 50–59, 60–69, and 70–79 age groups compared to those in the 40–49 age group. These findings suggest that active bone metabolic turnover occurs even in the older age groups in both men and women.