胶东半岛成年人群骨密度与年龄、身高、体重、体重指数和体表面积关系的研究

目的研究胶东半岛成年人群骨密度(BMD)与年龄、身高、体重、体重指数(BMI)和体表面积(BS)之间的关系。方法采用双能X线骨密度仪(DEXA)对胶东半岛沿海地区多中心多阶段整群抽样调查3879名21～89岁居民进行骨密度测量,记录年龄,测量身高、体重,计算出BMI和BS,并进行统计学分析。不同年龄组分别按BMI大小分成3组:BMI≤20 kg/m2,(20～25)kg/m2,≥25kg/m2;BS大小分成3组:大体表面积组(LBSG),中体表面积组(IBSG),小体表面积组(SBSG)。结果男性和女性骨密度随年龄、身高、体重、BMI和BS的变化模式不同。腰椎和股骨BMD随体重、BMI和Bs增加而增高。不同年龄组骨密度均为:BMI≤20 kg/m2组IBSG>SBSG,差异有统计学意义。高龄、低体重和低体重指数者骨密度均较其他组低,差异有显著性。结论年龄、身高、体重、BMI和BS是影响骨密度的重要因素。     

成都市中老年健身女性体成分指标与骨密度和骨代谢指标的相关性研究

目的探讨体重、体重指数(BMI)等体成分指标对中老年健身运动女性骨密度的影响及体成分指标与骨代谢指标、骨密度指标的关系。方法94例成都市城区健身运动女性根据BMI不同分为三组:低体重组(BMI≤20kg/m2)、正常体重组(20kg/m225kg/m2),采用Osteospace超声骨密度仪测定跟骨的BUA、SOS、STI骨密度指标;全自动生化分析仪测定血清AKP含量;应用放射免疫法测定血清hCT、BGP、IL-6、E2、TNF含量。应用方差分析和偏相关方法进行统计学处理。结果不同BMI组的体重、体重指数、瘦体重和体脂百分比差异显著,低体重组T-score与正常体重组、超重组比较有极显著差异;低体重组SOS、STI骨密度指标显著低于正常体重组;BUA、SOS、STI骨密度指标与体重、体重指数、瘦体重和体脂百分比呈正相关,与hCT、IL-6、TNF、BGP、AKP呈正相关,与E2呈负相关。低体重组骨量减少、骨质疏松发生率最高。结论体重、体重指数等体成分指标是影响中老年健身运动女性BMD的重要因素,保持体重有利于防止骨丢失和预防骨质疏松发生。     

体重质量指数与557例绝经后妇女骨密度变化的关系研究

目的 了解不同的年龄绝经后妇女不同体重质量指数(BMI)与不同部位骨密度(BMD)的关系。方法 来自门诊健康体检的557名绝经后妇女(肝肾等疾病除外),年龄范围50~78岁。用双能X线吸收法(DEXA)测定腰椎(L2-4)、股骨颈、Ward's三角及Troch等部位的BMD,同时计算BMI。根据BMI将研究对象分为3组:低体重组(BMI≤20 kg／m2)、正常体重组(25≥BMI>20 kg/m2)及超重组(BMI>25 kg/m2)。根据年龄又分为3组(50-,60-,70~78岁),用方差分析的方法进行各组间均数的统计学分析。结果不同BMI组总体不同部位的BMD方差分析比较有极显著意义P<0.01,高BMI组的BMD均值明显增高;进一步对同一年龄组不同BMI组的不同部位的BMD均值比较,各组之间均有显著性差异(P<0.01),特别是低体重组的骨密度明显低于其他两组BMI组的BMD。结论BMI与绝经后妇女的骨密度有显著相关,但低体重的绝经后妇女作为骨折的危险人群应受到更多的关注:对于超重的绝经后妇女,通过增加体重的方式增加BMD是危险的,因为超重与高血压、冠心病、糖尿病、心肌梗死及中风有一定的关系;通过其他途径:如年轻时加强运动、多饮牛奶、不盲目减肥等,提高妇女峰值骨含量是非常重要的。     

体重、体重指数、腰围、腰臀比对绝经后2型糖尿病患者骨密度的影响

目的 探讨体重、体重指数(body mass index,BMI)、腰围、腰臀比等指标对绝经后2型糖尿病患者骨密度的影响.方法 采用双能X线骨密度仪测量162例绝经后2型糖尿病患者不同部位的骨密度,按年龄分两组(A组:＜60岁;B组:≥60岁),同一年龄段按体重指数各分为两组(L-BMI组:BMI＜25 kg/m~2;H-BMI组:BMI≥25 kg/m~2)进行分析.结果 H-BMI组多部位骨密度明显高于L-BMI组(P＜0.05或P＜0.01).年龄与骨密度呈负相关,体重与骨密度呈正相关.结论 体重及体重指数均与骨密度相关,其中体重是影响绝经后妇女骨密度的重要因素.     

广西防城地区男性人群体重指数与血清前列腺特异性抗原水平相关性研究

目的:分析体重指数(BMI)对广西防城地区男性血清PSA水平的影响。方法:选择在2009年9月至2011年12月健康体检男性作为研究对象,测量身高、体重,并计算BMI,静脉血血清检测PSA水平。将研究对象分为低体重(BMI18.5 kg/m2)、正常(BMI 18.5~22.9 kg/m2)、超重(BMI 23.0~27.4 kg/m2)、肥胖(BMI≥27.5 kg/m2)4组;进一步按年龄分为20~29、30~39、40~49及≥50岁4组,方差分析分别比较各BMI组内PSA水平差异。结果:符合标准、资料完整者2 397例,年龄(37.4±11.0)岁,BMI(23.3±3.4)kg/m2,PSA(0.98±0.93)μg/L。各BMI组PSA水平差异有统计学意义(P均0.05)。各年龄组按照BMI分组比较,除≥50岁年龄组外,其余3组中PSA水平均随BMI增加而降低,但仅30~39岁和40~49岁年龄组内各BMI组别间的PSA水平差异有统计学意义(P0.01)。结论:PSA随着BMI的增加而降低,这种趋势在中青年人群中比较明显。因此针对中青年群体,在依据PSA水平判断是否需要取前列腺组织行前列腺癌早期诊断时,更有必要考虑BMI的影响。     

探讨体重指数对绝经后老年妇女不同部位骨密度的影响

目的分析不同体重指数患者的腰椎和股骨近端、股骨颈、Ward’s三角区的骨密度及T值评分,探讨体重指数对绝经老年妇女不同部位骨密度的影响。方法以我院225例年龄均为60以上的绝经老年妇女为研究对象,计算体重指数将患者分为体瘦组、正常组和肥胖组,检测患者腰椎和股骨近端、股骨颈、Ward’s三角区的骨密度,分析各部位骨密度变化与体重指数的关系。结果体瘦组的患者各部位骨密度明显低于正常和肥胖组的患者,体瘦组与正常组或肥胖组比较,腰椎(L1～L4)、股骨颈、股骨近端、Ward’s三角区的骨密度均有显著的差异(P<0.01);正常组与肥胖组比较,仅L3和L4的骨密度有显著的差异(P<0.05),其余部位的骨密度无显著的差异(P>0.05)。结论体重和体重指数是影响骨密度的一个重要因素,体重和体重指数与绝经老年妇女不同部位的骨密度存在一定的相关性,低体重指数的绝经老年妇女,骨丢失而引起的骨量减少明显,易发生骨质疏松。     

广州地区1 403例成年女性骨密度测定分析

目的了解本地区成年女性人群腰椎、股骨近端各部位骨密度(Bone mineral density BMD)随年龄、绝经年限、体重、身高的变化规律、各部位骨密度的偏相关分析和多元线性回归分析及骨质疏松患病率情况,为骨质疏松的诊断及预防提供科学依据.方法采用美国NORLAND公司的XR-46系列双能X线骨密度仪测量1 403例成年女性人群腰椎(L2-L4前后位及L3侧位)、非优势(左)股骨近端各部位(股骨颈、大粗隆及Ward's三角)BMD值,按10岁一个年龄组分7组对数据进行统计分析.结果广州地区成年女性腰椎骨峰含量出现在30～39岁组,而股骨近端骨峰含量出现在20～29岁组,腰椎及股骨近端各部位BMD值均随年龄增长而下降,腰椎和Ward's三角部位在50～59岁和60～69岁两年龄组骨量呈快速丢失现象.各部位骨密度的偏相关分析显示各部位的骨密度均呈相关性(P＜0.01).多元线性回归分析显示年龄和体重对绝经前女性股骨颈的骨密度有影响(P＜0.01),而绝经后女性腰3侧位骨密度除了年龄和体重的影响外,身高和绝经年限均对其有影响(P＜0.01).成年女性在达到峰值骨量后随着年龄的增加,各部位骨质疏松的患病率都呈上升趋势.结论女性机体BMD随年龄而变化,年龄、体重、绝经年限及身高等对机体BMD均有一定的影响,保持合适的体重和体型,有利于BMD的增加与维持.对不同年龄段的成年女性人群,预防骨质疏松的发生应以测量不同部位的BMD作为评价手段.     

年龄和体重指数对中青年男性骨密度的影响

目的 探讨年龄和体重指数对中青年男性的腰椎2-4( L2-4)和股骨颈(Neck)、大转子(Troch )、粗隆间（InterTro)骨密度 (BMD)的影响。方法 以我院322名年龄20 ~50岁的中青年男性为研究对象,记录年龄,测量身高、体重,计算体重指数将研究对象分为正常组、超重组和肥胖组,采用双能X线骨密度仪检测腰椎、股骨颈、大转子、粗隆间的骨密度,分析年龄和体重指数与各部位骨密度变化的关系。结果 中青年男性各部位的骨密度随体重指数的增加而增高。肥胖组和超重组各部位骨 密度均比正常组高（P <0.05或P <0.01)。20 ~29岁组的骨密度明显高于30~39岁组和40~50岁组（P <0.01)。结论 年龄和体重指数是影响骨密度的重要因素,体重指数与中青年男性不同部位的骨密度存在一定的相关性,肥胖者及超重者骨密度较正常体型者高,因此,适量增加体重可以提高人体骨密度,对预防骨质疏松症将有着重要的作用。     

沈阳地区绝经后妇女绝经年限与股骨近端骨密度的关系分析

目的 探讨绝经年限与股骨近端BMD的关系。方法 随机调查沈阳地区285例健康的绝经后妇女，调查其年龄和绝经年限，测量其身高、体重、股骨近端骨密度(BMD)，应用SPSS软件统计分析。结果 随绝经年限的增加股骨近端各部位BMD有下降的趋势，随绝经年限的增加股骨近端各部位BMD下降速度减慢，并且相对而言Neck、Ward’s区的BMD下降速度高于其他部位。以年龄和体重指数(BMI)为协变量，经协方差分析显示Ward’s区BMD与绝经年限具有显著相关，而其他部位无显著相关。结论 对绝经后妇女应注意绝经早期的股骨近端BMD变化。     

南宁地区成年女性骨密度与年龄、体重指数关系的研究

目的 研究南宁地区成年女性骨密度(BMD)与年龄、体重指数(BMI)之间关系.方法 采用双能X线骨密度仪测量384例年龄20～87岁的女性腰椎正位和股骨近端的BMD;分别按年龄和BMI分组,分析各年龄组和各BMI组BMD和骨质疏松(OP)检出率的变化.结果 ①腰椎和股骨近端骨峰值均出现在30～39岁组;50岁后BMD明显降低,70岁后再次出现BMD降低加速.②OP在50岁后明显增加,并以每增加10岁OP增加20%以上的速度发展,80岁后OP发生率近100%.③与正常BMI和超BMI组相比,低BMI组BMD显著降低,OP显著增高.结论 南宁地区成年女性BMD峰值在30～39岁;绝经后、年龄70岁以上和低BMI是OP发生危险因素.     

谷康泰灵对骨质疏松模型大鼠骨形成和骨吸收功能的影响

目的　观察药物谷康泰灵对骨质疏松 (OP)模型大鼠骨形成和骨吸收功能的影响 ,为其临床治疗骨质疏松提供实验依据。方法　SD大鼠 4 4只 ,随机分为正常组 (13只 )和骨质疏松模型组 (31只 )。以维甲酸 80mg·kg- 1 ·d- 1 灌胃 15d,诱导OP模型。模型复制成功后 ,各组处死 5只 ,正常组 (8只 )继续观察 ,模型组又随机分为无措施对照组 (8只 )、谷康泰灵治疗组 (10只 ,0 0 8mg·kg- 1 ·d- 1 谷康泰灵腹腔注射 )和雌二醇治疗组 (8只 ,每只 0 0 5mg,每周 3次苯甲酸雌二醇腹腔注射 )。治疗期 30d。观察股骨松质骨区成骨细胞及破骨细胞数量和血清中AKP、TRAP活性变化。结果　与正常组相比 ,维甲酸诱导的OP模型大鼠股骨松质骨区成骨细胞功能活跃 ,数量变化不大 ;破骨细胞数量、活跃程度显著增加 ;血清中AKP和TRAP明显增高。谷康泰灵治疗后 ,OP大鼠活跃成骨细胞数量明显增加 ,破骨细胞数量显著减少 ,血清AKP活性明显增高 ,TRAP活性下降。结论　谷康泰灵对OP大鼠骨形成和骨吸收功能有显著影响 ,可刺激成骨细胞的产生增加成骨细胞的活性 ,减少破骨细胞的数量抑制破骨细胞的活性。     

异体松质骨移植治疗骨肿瘤切除后骨缺损

目的：探讨应用异体松质骨移植治疗肿瘤切除后骨缺损的生物材料填充方法。方法：总结应用深低温冷冻保存异体松质骨移植治疗骨肿瘤切除后骨缺损57例。年龄6－56岁,平均年龄17．4岁。结果：除1例因感染异体骨取出外,其余56例均取得满意的骨愈合,愈合时间平均为4．5个月。依骨腔大小或植骨量的不同愈合时间 亦有所不同。单纯异体松质骨移植与异体松质骨加自体松质骨混合移植相比,愈合时间没有明显不同。植骨量越大,骨愈合时间越长。此组患者中未见明显排异反应及并发感染者。肿瘤复发率为7％。结论：同其他骨缺损填充方法和大块异体骨的使用相比,此种方法可行性较好,安全性较高。在骨愈合率,骨愈合时间上及复发以外并发症的发生上同自体松质骨植骨无明显差异。     

Trabecular bone remodeling and bone balance in hyperthyroidism

In vivo tetracycline double-labeled iliac crest bone biopsies from 15 hyperthyroid patients were used for the reconstruction of curves describing the variation of resorption depth and formation thickness with time. The curves emerging were compared to curves reconstructed from 13 age- and sex-matched normal individuals (mean age 44 years). The median function period for resorptive cells in hyperthyroid patients (16 days) was about one-third the resorptive period in normals (51 days). No significant difference between the osteoclast-, mononuclear-, or preosteoblast-like cell resorption depths could be demonstrated between the two groups. Consequently, the median resorption rate in hyperthyroid patients (3.8 μm/day) was more than 3 times higher than the value in the control group (1.1 μm/day). Median Sigma_f, was shorter in the hyperthyroid group (109 days) than in the control group (151 days, P < 0.05), as was the median initial mineralization lag time (5 and 16 days, respectively, P < 0.01). No significant difference between the measured mean completed wall thickness (mcwT) values in the hyperthyroid groups and the control group could be demonstrated (58.1 and 60.5 μm respectively). Median initial mineralization rate in the hyperthyroid group (1.2 μm³/μm² per day) was not significantly higher than the value calculated in the control group (0.9 μm³/ μm² per day), but median initial matrix appositional rate in hyperthyroids (4.8 μm³/μm² per day) was 3 times higher than the value calculated for normals (1.6 μm³/μm² per day) (P < 0.01). Direct measurements of mean completed wall thickness in the hyperthyroid group gave results (58.1 μm) that were not in accordance with the mean completed wall thickness calculated from the growth curve (52.1 μm, P < 0.02). In normals no such discrepancy could be demonstrated. Using the mcwT value estimated from the growth curve, the bone formation period was calculated to 90 days for hyperthyroid patients. This maximal estimate for mcwT was also significantly lower than the mean resorption depth measured in the hyperthyroid group (61.7 μm, P < 0.05), which means that a net negative balance per remodeling cycle existed in the hyperthyroid group. Bone balance was preserved in the control group.     

Trabecular bone turnover, bone marrow cell development, and gene expression of bone matrix proteins after low calcium feeding in rats

Low-calcium-fed animals have been accepted as one of the experimental models showing a reduction in bone mass. However, the effects of short-term low-calcium feeding on bone turnover, the development of osteoprogenitor cells, and gene expression of bone matrix proteins have not been reported. In this study, we examined the effect of a low-calcium diet on rat tibia and analyzed the changes in the bone by histomorphometry, bone marrow cell culture, and in situ and Northern hybridization of the bone matrix proteins. Rats were fed either a low-calcium diet (0.05% Ca) or a normal calcium diet (0.5% Ca) using the pair feeding technique. They were killed at day 0, 12 h, and days 1, 2, and 3. In the low-calcium group, the serum parathyroid hormone (PTH) level was temporarily increased in 12 h after feeding the low-calcium diet. Bone mineral density in the trabecular bone was significantly decreased from 1 day after the low-calcium feeding, but cortical bone did not show any changes during the experimental period. The bone volume per tissue volume in the proximal tibia also decreased from day 1 in the low-calcium group. The number of osteoclasts and osteoblasts on the trabecular bone surface was increased in the low-calcium group compared with the normal-calcium group. An ex vivo study showed that the number of progenitors of osteoclasts and osteoblasts in bone marrow was also increased in the low-calcium group of rats. The localization of type I collagen mRNA was observed in osteoblasts in the low-calcium group. The Northern hybridization study showed that the gene expression of type I collagen, osteopontin, and osteocalcin was increased at day 3 in the low-calcium group. These results indicated that the trabecular bone surface quickly responded to the low-calcium feeding and that bone remodeling activity was activated probably by PTH. The changes in bone marrow cell populations and the gene expression of bone matrix proteins are closely associated with increased bone turnover induced by the low-calcium diet, resulting in rapid bone loss of the trabecular bone.     

Morphology of bone development and bone remodeling in embryonic chick limbs

Staged embryos from White Leghorn chicken eggs were used to assemble a detailed morphological sequence of events occurring in long bone development from Hamburger-Hamilton stage 32 through stage 44 and 2 days post hatching. The detailed patterning of osteoblasts, osteoid, mineral, and vasculature were observed at the mid-diaphysis of the tibia. At stage 32, the cartilage core is composed of hypertrophie chondrocytes and is surrounded by a continuous ring of mineralized osteoid on which osteoblasts and vasculature reside. At stage 35, the vasculature and associated cell types invade the cartilage core region. By stage 37, marrow occupies the entire cartilage core region at the mid-diaphysis. Anastamosing channels, containing vasculature, interconnect with each other and the marrow region to the inside and the periosteal region to the outside. Clearly, the cartilage is replaced by marrow, not bone.

Mineral deposition at the periosteal surface continues through stage 44 as does mineral resorption on the endosteal surface, although the rate of mineral deposition and resorption varies at different developmental stages. Vasculature plays an important role in the pattern formation of the trabeculae and their channels as can be seen in the developmental sequence within one bone (the tibia) or comparisons between two bones (the tibia and fibula). A model is presented which considers the possibility that osteoprogenitor cells are formed as early as the chondroprogenitor cells. This model also emphasizes the observation that cartilage is not replaced by bone but is replaced by marrow.     

小剂量地塞米松对生长期小鼠骨微结构及骨代谢的影响

目的 观察小剂量地塞米松对生长期小鼠骨微结构及骨代谢的影响。方法 24只4周龄雌性小鼠随机分两组（n=12）：地塞米松组（DEX,1mg/kg,肌肉注射,2次/周）,对照组。4w后处死小鼠,检测血清Ⅰ型前胶原N端肽(PINP)和骨Ⅰ型胶原交联C端肽（β-CTX）蛋白的表达水平;检测胫骨干骺端骨保护素（OPG）、核因子-κ B受体活化因子配体（RANKL）表达;抗酒石酸酸性磷酸酶（TRAP）染色方法检测破骨细胞;一侧胫骨行显微CT扫描分析。结果 DEX组小鼠胫表观骨密度和骨体积分数明显高于对照组（P<0.05）,骨小梁数量高于对照组,结构模型指数低于对照组,但无统计学意义。DEX组小鼠血清PINP及β-CTX浓度显著下降（P<0.05）。DEX组小鼠胫骨干骺端OPG表达明显增多,而RANKL表达无明显变化,相对于对照组,OPG/RANKL比值升高。TRAP染色示DEX组小鼠胫骨干骺端破骨细胞数量较对照组减少。结论 小剂量地塞米松间断给药可能通过上调OPG/RANKL比率维持生长期小鼠骨量。     

Volumetric bone mineral density and bone size in sleep-deprived individuals

Introduction Chronic sleep deprivation, which is associated with several age-related pathologies and altered endocrine function, may adversely affect bone. Our a priori hypothesis was that bone mineral density was lower in sleep-deprived (<6.5 h/night) vs. sleep-adequate (>6.5-10 h/night) individuals. Methods Cross-sectional analysis of sleep and bone data on 1,146 individuals (652 women) was performed. Measurements were obtained at the distal radius by pQCT, and the spine and hip by DXA. Bone differences between sleep-deprived and sleep-adequate groups were compared after stratifying by sex and controlling for covariates. Results Overall, 19% of the population was sleep deprived. Sleep-deprived women had lower cortical volumetric BMD (1,208±4 vs. 1,219±2 mg/cm³, P=0.03) than sleep-adequate women. Sleep-deprived men had lower pSSI, an estimate of torsional bending strength, than sleep-adequate men (358±10 vs. 382±5 mm³, P=0.04), due to a slightly smaller periosteal circumference (43.9±0.4 vs. 44.8±0.2 mm, P=0.07) and cortical area (103±2 vs. 106±1±mm², P=0.06). Conclusion Sleep deprivation is associated with some, but not all, bone outcomes. These findings may have important public health significance given the increasing prevalence of sleep deprivation.     

口服淫羊藿苷可提高大鼠的峰值骨密度和骨质量

目的研究口服淫羊藿苷(Icariin,ICA)是否能提高大鼠的峰值骨密度和骨质量,起到预防骨质疏松症的作用。方法 1月龄雌性健康SD大鼠随机分为两组,每组12只。服药组每日灌服25 mg/kg淫羊藿苷,对照组(CON)灌服给予等体积蒸馏水。每周监测大鼠体重。每月检测实验鼠的骨密度,3个月后处死所有大鼠。取血测血清骨钙素(OC)和抗酒石酸性磷酸酶5b(TRACP 5b)的含量。取双侧股骨和胫骨分别进行骨密度检测、μCT扫描和生物力学评价。剥离心、肝、胃、肾、肾上腺和子宫后称重,计算器官指数,并做常规病理学检测。结果两组大鼠的体重始终无显著性差异(P0.05);各脏器的器官指数均无明显差异,病理学观察未见异常改变。第1、第2月的全身骨密度无明显差别(P0.05),但3个月后,ICA组显著高于CON组,股骨骨密度存在相同趋势(P0.05);ICA组的血清OC水平升高,而TRACP 5b含量下降(P0.05);μCT检测结果是:ICA组的骨体积百分率、骨小梁厚度和骨小梁数量均高于CON组,但骨小梁分离度和模型系数显著低于CON组(P0.05);股骨最大载荷、弹性模量和屈服强度均是ICA组显著高于CON组(P0.05)。结论口服淫羊藿苷可通过抑制骨吸收而促进骨形成,提高大鼠的峰值骨密度和骨质量,对预防各种原因引起的骨质疏松及骨质疏松性骨折具有十分重要的意义。     

骨重建中的骨代谢指标

骨重建是破骨细胞和成骨细胞共同完成的旧骨退化,等量新骨取代的骨组织更新过程,在骨重建过程中,许多激素和细胞、体液因子以及细胞代谢产物影响骨的重建.目前国内外通过生物化学检测技术获得的骨代谢指标分为骨代谢调节激素、细胞与体液因子、骨吸收、骨形成标志物.笔者将影响骨重建生物化学指标的生理作用、临床意义进行综述.骨代谢指标虽不能作为骨质疏松诊断的金标准,但已广泛应用于临床,评价骨代谢状态、骨质疏松诊断分型、预测骨折风险、观察药物治疗的疗效,以及代谢性骨病的鉴别诊断.并且在抗骨质疏松药物的研究及流行病学研究方面具有重要应用价值.     

Peak bone mass, bone loss and risk of fracture

Both peak bone mass and bone loss contribute to subsequent fracture risk. Other variables such as architectural abnormalities, microdamage, geometric properties, and trauma probably contribute as well. Until the contribution of these other potentially important risk factors can be quantified, it will be difficult to determine precisely the relative importance of peak bone mass and subsequent bone loss in the etiology of fractures.