99Tc-MDP治疗绝经后骨质疏松的临床研究

目的:研究99Tc-MDP治疗绝经后骨质疏松的效果。方法:选择明确诊断的绝经后骨质疏松患者231例,监测99Tc-MDP治疗前及治疗后12个月血清骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)及骨密度(BMD)的变化。结果:治疗后两周患者腰背疼痛及胫膝酸软症状明显缓解。治疗后1个月80%的患者自述骨痛症状消失。治疗前血清BALP、TNF-α、BGP、IL-1和IL-6水平分别为(15.98±4.62)ng/ml、(2.51±0.52)mg/ml、(6.57±1.83)ng/ml、(0.65±0.13)pg/ml和(128.95±21.39)ng/ml;治疗后12个月血清BALP、TNF-α、BGP、IL-1和IL-6水平分别为(7.06±3.21)ng/ml、(1.36±0.43)mg/ml、(5.19±1.51)ng/ml、(0.33±0.08)pg/ml和(92.17±25.76)ng/ml,与治疗前比较,差异均有统计学意义(P<0.01)。治疗前后BMD比较差异有统计学意义(P<0.01)。结论:99Tc-MDP对骨生成区具有明显的导向性,可进入骨组织参与骨代谢调节,具有抑制破骨细胞活性、抑制骨丢失及增加BMD的作用。     

子宫内膜异位症不孕患者血清IL-6及TNF-α水平变化研究

目的:探讨血清白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)在子宫内膜异位症不孕患者中的水平变化及与子宫内膜异位症的关系。方法:选取100例子宫内膜异位症不孕患者为子宫内膜异位症组,其中I～II期患者44例,III～IV期患者56例,随机选取同期住院治疗的检查确诊非子宫内膜异位症患者80例作为对照组。以放射免疫法检测两组患者血清IL-6及TNF-α水平变化。结果:IL-6与TNF-α检测水平子宫内膜异位症组分别为(94.28±23.43)pg/ml、(1.43±0.41)ng/ml,对照组分别为(36.92±4.82)pg/ml、(0.84±0.07)ng/ml,子宫内膜异位症组明显高于对照组,两组比较差异存在统计学意义(P<0.05);IL-6与TNF-α检测水平I～II期子宫内膜异位症患者为(68.53±12.67)pg/ml、(0.94±0.04)ng/ml,III～IV期为(120.41±18.83)pg/ml、(1.76±0.11)ng/ml,III～IV期检测值明显高于I～II期,比较差异存在统计学意义(P<0.05);子宫内膜异位症组患者血清IL-6与TNF-α间存在线性正相关(r=0.96,P<0.05)。结论:子宫内膜异位症不孕患者血清IL-6与TNF-α均明显升高,可能参与了疾病的发生与发展过程,并且IL-6与TNF-α水平与疾病的严重程度呈现正相关。     

The predictive value of tumor necrosis factor-α and interleukin-6 in progressive cerebral infarction

目的 探讨早期血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)检测对进展性脑梗死(PIS)的预测价值.方法 用酶联免疫吸附法测定35例急性脑梗死(ACI)患者(ACI组)发病6h内的血清TNF-α、IL-6水平,并与30例健康体检者(健康对照组)进行比较.对ACI患者进行神经功能缺损(NDS)评定,分析TNF-α、IL-6水平与NDS程度的相关性.结果 ACI组血清TNF-α、IL-6水平均明显高于健康对照组,差异有统计学意义.ACI组中PIS患者早期血清TNF-α、IL-6水平明显高于稳定性脑梗死患者[(49.56±12.12)ng/L比(24.30±7.40)ng/L和(39.76±7.88)ng/L比(20.78±6.28)ng/L],P值均<0.01.ACI患者血清TNF-α、IL-6水平与发病6 h内的NDS评分(r=0.89、0.93)及其治疗1周后的进展值呈正相关(r=0.90、0.91),P值均<0.01.40 ng/L>TNF-α≥35ng/L、35 ng/L>IL-6≥30 ng/L预测PIS的阳性预测值分别为80.0%和71.4%.结论 ACI患者早期血清TNF-α、IL-6水平明显升高,并与病情密切相关,TNF-α、IL-6水平对PIS风险评估有一定预测价值.     

The predictive value of tumor necrosis factor-α and interleukin-6 in progressive cerebral infarction

目的 探讨早期血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)检测对进展性脑梗死(PIS)的预测价值.方法 用酶联免疫吸附法测定35例急性脑梗死(ACI)患者(ACI组)发病6h内的血清TNF-α、IL-6水平,并与30例健康体检者(健康对照组)进行比较.对ACI患者进行神经功能缺损(NDS)评定,分析TNF-α、IL-6水平与NDS程度的相关性.结果 ACI组血清TNF-α、IL-6水平均明显高于健康对照组,差异有统计学意义.ACI组中PIS患者早期血清TNF-α、IL-6水平明显高于稳定性脑梗死患者[(49.56±12.12)ng/L比(24.30±7.40)ng/L和(39.76±7.88)ng/L比(20.78±6.28)ng/L],P值均<0.01.ACI患者血清TNF-α、IL-6水平与发病6 h内的NDS评分(r=0.89、0.93)及其治疗1周后的进展值呈正相关(r=0.90、0.91),P值均<0.01.40 ng/L>TNF-α≥35ng/L、35 ng/L>IL-6≥30 ng/L预测PIS的阳性预测值分别为80.0%和71.4%.结论 ACI患者早期血清TNF-α、IL-6水平明显升高,并与病情密切相关,TNF-α、IL-6水平对PIS风险评估有一定预测价值.     

The predictive value of tumor necrosis factor-α and interleukin-6 in progressive cerebral infarction

目的 探讨早期血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)检测对进展性脑梗死(PIS)的预测价值.方法 用酶联免疫吸附法测定35例急性脑梗死(ACI)患者(ACI组)发病6h内的血清TNF-α、IL-6水平,并与30例健康体检者(健康对照组)进行比较.对ACI患者进行神经功能缺损(NDS)评定,分析TNF-α、IL-6水平与NDS程度的相关性.结果 ACI组血清TNF-α、IL-6水平均明显高于健康对照组,差异有统计学意义.ACI组中PIS患者早期血清TNF-α、IL-6水平明显高于稳定性脑梗死患者[(49.56±12.12)ng/L比(24.30±7.40)ng/L和(39.76±7.88)ng/L比(20.78±6.28)ng/L],P值均<0.01.ACI患者血清TNF-α、IL-6水平与发病6 h内的NDS评分(r=0.89、0.93)及其治疗1周后的进展值呈正相关(r=0.90、0.91),P值均<0.01.40 ng/L>TNF-α≥35ng/L、35 ng/L>IL-6≥30 ng/L预测PIS的阳性预测值分别为80.0%和71.4%.结论 ACI患者早期血清TNF-α、IL-6水平明显升高,并与病情密切相关,TNF-α、IL-6水平对PIS风险评估有一定预测价值.     

The predictive value of tumor necrosis factor-α and interleukin-6 in progressive cerebral infarction

目的 探讨早期血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)检测对进展性脑梗死(PIS)的预测价值.方法 用酶联免疫吸附法测定35例急性脑梗死(ACI)患者(ACI组)发病6h内的血清TNF-α、IL-6水平,并与30例健康体检者(健康对照组)进行比较.对ACI患者进行神经功能缺损(NDS)评定,分析TNF-α、IL-6水平与NDS程度的相关性.结果 ACI组血清TNF-α、IL-6水平均明显高于健康对照组,差异有统计学意义.ACI组中PIS患者早期血清TNF-α、IL-6水平明显高于稳定性脑梗死患者[(49.56±12.12)ng/L比(24.30±7.40)ng/L和(39.76±7.88)ng/L比(20.78±6.28)ng/L],P值均<0.01.ACI患者血清TNF-α、IL-6水平与发病6 h内的NDS评分(r=0.89、0.93)及其治疗1周后的进展值呈正相关(r=0.90、0.91),P值均<0.01.40 ng/L>TNF-α≥35ng/L、35 ng/L>IL-6≥30 ng/L预测PIS的阳性预测值分别为80.0%和71.4%.结论 ACI患者早期血清TNF-α、IL-6水平明显升高,并与病情密切相关,TNF-α、IL-6水平对PIS风险评估有一定预测价值.     

The predictive value of tumor necrosis factor-α and interleukin-6 in progressive cerebral infarction

目的 探讨早期血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)检测对进展性脑梗死(PIS)的预测价值.方法 用酶联免疫吸附法测定35例急性脑梗死(ACI)患者(ACI组)发病6h内的血清TNF-α、IL-6水平,并与30例健康体检者(健康对照组)进行比较.对ACI患者进行神经功能缺损(NDS)评定,分析TNF-α、IL-6水平与NDS程度的相关性.结果 ACI组血清TNF-α、IL-6水平均明显高于健康对照组,差异有统计学意义.ACI组中PIS患者早期血清TNF-α、IL-6水平明显高于稳定性脑梗死患者[(49.56±12.12)ng/L比(24.30±7.40)ng/L和(39.76±7.88)ng/L比(20.78±6.28)ng/L],P值均<0.01.ACI患者血清TNF-α、IL-6水平与发病6 h内的NDS评分(r=0.89、0.93)及其治疗1周后的进展值呈正相关(r=0.90、0.91),P值均<0.01.40 ng/L>TNF-α≥35ng/L、35 ng/L>IL-6≥30 ng/L预测PIS的阳性预测值分别为80.0%和71.4%.结论 ACI患者早期血清TNF-α、IL-6水平明显升高,并与病情密切相关,TNF-α、IL-6水平对PIS风险评估有一定预测价值.     

围绝经妇女雌激素与内皮素关系探讨

目的: 研究绝经妇女血清雌激素与内皮素关系, 探讨绝经相关疾病合理的治疗方案。方法: 选择 107例妇女进行研究, 其中绝经组 68例, 对照组 39例, 分别取静脉血测定血清促卵泡素 (FSH)、雌二醇 (E2 )、内皮素 (ET) 水平。结果:绝经妇女内皮素水平 59 5±16 0pg/ml, 明显高于育龄期 47 9±18 8pg/ml, P<0 05, 雌激素水平明显低于对照组。结论: 绝经妇女雌激素与内皮素水平呈负相关。     

妊娠期糖尿病与肿瘤坏死因子-α及白介素-6水平的相关性研究

目的:测定妊娠期糖尿病孕妇血清肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)的水平,探讨TNF-α及IL-2与妊娠期糖尿病的关系及其在发病中的作用。方法:测定67例妊娠期糖尿病孕妇(GDM)、38例妊娠期糖耐量受损孕妇(IGT)及42例正常妊娠妇女空腹血清TNF-α及IL-6水平。结果:与正常对照组相比,GDM组的血清TNF-α、IL-6水平明显升高,差异有显著性(P<0.01);与IGT组比较,GDM组的血清TNF-α、IL-6水平明显升高,差异有显著性(P<0.01);3组孕妇相比,血清TNF-α、IL-6水平呈逐渐上升趋势,GDM组血清TNF-α水平和血清IL-6水平显著高于其他两组(P<0.01)。结论:与正常妊娠妇女相比,妊娠期糖尿病孕妇血清TNF-α、IL-6水平明显升高,推测TNF-α、IL-6在妊娠期糖尿病的发病机制中可能起着重要作用。     

围绝经期女性血清雌二醇及卵泡刺激素变化规律及其与腰椎、髋部和股骨颈骨密度的关系

目的探索围绝经期女性血清雌二醇(E2)、卵泡刺激素(FSH)变化规律与其腰椎、髋部、股骨颈骨密度(BMD)的关系。方法选取2014年1月-2015年1月在该院进行体检的围绝经期妇女440例为研究对象,分为绝经前组(220例)和绝经后组(220例)。测定两组血清E2、FSH水平及其腰椎、髋部、股骨颈BMD值,并进行组间比较。结果绝经后组妇女血清E2与绝经前组比较明显减少,而血清FSH与绝经前组比较明显增加,差异均有统计学意义(P0.05)。绝经后组妇女腰椎、髋部、股骨颈BMD值与绝经前组比较均有明显减少,组间差异均有统计学意义(P0.05)。绝经前低骨量组和绝经后低骨量组血清E2水平均较正常骨量组明显减少,而血清FSH水平均较正常骨量组明显增加,差异均有统计学意义(P0.05)。血清E2水平与腰椎BMD、髋部BMD、股骨颈BMD均呈正相关关系(P0.05);血清FSH水平与腰椎BMD、髋部BMD、股骨颈BMD均呈负相关关系(P0.05)。结论绝经后女性BMD明显减少,雌激素水平变化可能影响骨代谢,应引起临床的高度关注。     

吉林市绝经后女性骨质疏松发病情况调查

[目的]通过对吉林市部分地区绝经后女性进行调查,研究绝经后骨质疏松的发病率,发病因素,探讨其对女性身体健康的危害。[方法]调查自2010年2月~2011年2月,选择我市45岁以上绝经后妇女960位,年龄49~89岁,平均年龄68.8岁,绝经后4～43年,平均25.2年。调查组成员均为由我院专业医生,对所有调查对象进行面对面问卷调查,并进行全面体格检查。选择DEXA(Lunar,US)骨密度仪测量左侧股骨颈近端骨密度。[结果]①调查显示随着年龄的增长,绝经后女性骨质疏松的发病率逐渐增高,从45~50岁的3.03%逐渐增加到80岁以上的55.0%。其中,60~65岁绝经后女性骨质疏松的发病率比55～60岁明显增高,有统计学差异(P﹤0.05)。②绝经后骨质疏松患者骨密度均值为(0.531±0.076)g/cm2,明显低于未发生骨质疏松的绝经后女性(0.596±0.083g/cm2),两者间有统计学差异(P﹤0.05)。绝经后骨质疏松女性骨折发生部位中以前臂远端最多见,股骨粗隆间骨折位于第2位,其他常见的部位还有椎体和股骨颈。[结论]随着年龄的增长,绝经后骨质疏松的发病率逐渐增高,严重影响的女性的健康,应该采取积极的预防和治疗措施。     

The relationship of absolute poverty and bone mineral density in postmenopausal Iranian women

Summary Objective:  It is increasingly recognized that socioeconomic inequalities play an important role in bone health, with significantly higher fracture rates being reported in lower income groups. But the relationship between absolute poverty and bone mineral density (BMD) and/or osteoporosis has not been investigated. Methods:  A total of 1135 postmenopausal women under absolute poverty lines who received financial support from the Imam Khomeini Relief Foundation (IKRF) and 406 randomly selected healthy postmenopausal women were screened for osteoporosis using BMD testing. Results:  At all BMD sites, women under the absolute poverty lines had the lowest mean BMD values (p < 0.0001). According to the WHO criteria, 252 subjects under absolute poverty lines (22.4%) and 35 healthy postmenopausal women from the general population (8.7%) were considered osteoporotic (p < 0.0001). After adjustment for lifestyle factors for osteoporosis in logistic regression models, absolute poverty was associated with the age-adjusted prevalence of femoral neck osteoporosis and lumbar osteoporosis [OR = 2.50 (CI, 1.38–4.51; p = 0.002); OR = 2.40 (CI, 1.56–3.70; p < 0.0001), respectively]. Conclusion:  Postmenopausal women under the absolute poverty lines had lower BMDs at all skeletal sites, independent of established osteoporosis risk factors. Submitted: 13 February 2008; Revised: 03 June 2008; Accepted: 09 June 2008     

Osteoporosis risk factors: association with use of hormone replacement therapy and with worry about osteoporosis

Among risk factors for osteoporosis, only family history was associated with worry about osteoporosis, while white race was the only factor associated with hormone replacement therapy use.

Abstract

Objectives: To determine whether postmenopausal women with risk factors for osteoporosis are more likely to use hormone replacement therapy (HRT) or to worry about osteoporosis than women without risk factors. Method: Cross-sectional survey of postmenopausal women at the Women Veteran Comprehensive Health Center. Statistical analysis was performed using the chi-square test and logistic regression analysis. Results: Of the 230 postmenopausal women who answered the questionnaire (mean age 55.7 years), 167 (72%) reported ever having used HRT and 113 (49%) worried about osteoporosis. Factors that were significantly associated (P < .05) with ever having used HRT were race, marital status, hysterectomy, worry about osteoporosis, and being aware that HRT reduces the risk of osteoporosis; however, no other risk factors for osteoporosis were associated with HRT use, nor was having the diagnosis of osteoporosis. Women who worried about osteoporosis were significantly more likely to be under age 60; to have a family history of osteoporosis, poor self-rated current health, and osteoporosis as a medical condition; to be aware that HRT reduces the risk of osteoporosis; and to have used HRT (P < .05). Conclusions: Among risk factors for osteoporosis, only family history was associated with worry about osteoporosis, while white race was the only risk factor associated with HRT use in our cohort of postmenopausal woman veterans. This may represent a lack of awareness and knowledge about osteoporosis and its sequelae and about the benefits of HRT. An understanding of patient awareness of risk factors for osteoporosis and their motivations to take HRT can be valuable when counseling women on their decision to use HRT or other medications to prevent osteoporosis.     

Underuse of procedures for diagnosing osteoporosis and of therapies for osteoporosis in older nursing home residents

OBJECTIVE: To investigate the prevalence of osteoporosis, the prevalence of utilization of bone mineral density (BMD) measurements for diagnosis of osteoporosis, and prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis in postmenopausal women in an academic nursing home. METHODS: The charts of all women aged 56 years and older residing in an academic nursing home were analyzed by one of the authors for the prevalence of osteoporosis, the prevalence of use of BMD measurements to diagnose osteoporosis, and the prevalence of use of calcium and vitamin D supplements and other antiresorptive therapies for treatment of osteoporosis. RESULTS: Of 136 postmenopausal women, mean age 79 +/- 10 years, 66 (49%) had measurements of BMD. Of these 66 women, 31 (47%) had osteoporosis, 21 (32%) had osteopenia, and 14 (21%) had normal BMD. Elemental calcium carbonate 1500 mg daily was prescribed to 17 of 31 women (55%) with osteoporosis, to 12 of 21 women (57%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 27 of 70 women (39%) with no BMD obtained. Any dose of calcium was prescribed to 78 of 136 elderly women (58%). Vitamin D supplements were prescribed to 13 of 31 women (42%) with osteoporosis, to 9 of 21 women (43%) with osteopenia, to 2 of 14 women (14%) with normal BMD, and to 20 of 70 women (29%) with no BMD obtained. Vitamin D supplements were prescribed to 44 of 136 elderly women (32%). Biphosphonates were prescribed to 19 of 31 women (61%) with osteoporosis. Of 20 women on medications that increased the risk of osteoporosis, 6 (30%) had BMD measured. Nine of these 20 women (45%) were on calcium supplements. CONCLUSIONS: Older postmenopausal women in an academic nursing home have a high prevalence of osteoporosis and osteopenia, a low prevalence of measurement of BMD, and underuse of calcium, vitamin D supplements, and other antiresorptive therapies for treatment of osteoporosis.     

Densitometry identifies women in whom treatment will reduce fracture risk

Despite lack of research on the effectiveness of osteoporosis screening to reduce fractures, there is sufficient evidence that bone density measurements accurately predict short-term fracture risk and that treating asymptomatic women with osteoporosis reduces fracture risk. According to this report, a reasonable recommendation is to screen all women older than 65 years and postmenopausal women younger than 65 years who have low weight (or body mass index) or who have never used hormone replacement therapy. The US Preventive Services Task Force noted that the optimal screening frequency has not been studied, but suggested a frequency of not more than every 2 years for older women or every 5 years for younger postmenopausal women. Also of note: other sources, notably the bisphosphonates package labeling, advise against monitoring therapy with repeated dual-energy x-ray absorptiometry or other methods.     

Rural Women and Osteoporosis: Awareness and Educational Needs

CONTEXT: Little is known about rural women's knowledge about osteoporosis. PURPOSE: To explore what women from high-prevalence rural communities know about osteoporosis and to assess their learning preferences. METHODS: We surveyed 437 women in rural Washington and Oregon. FINDINGS: The response rate was 93% (N = 406). The mean age of respondents was 63 years (range 16-95) and 74% (n = 301) of women were postmenopausal. While 27% over age 40 (n = 111) reported having a fracture as an adult, less than half of this group (42%, n = 47) considered themselves at risk for osteoporosis. Of the 42% (n = 171) who rated their knowledge of osteoporosis good or excellent, only 18% (n = 30) answered calcium and vitamin D questions correctly. About half (53%; n = 214) exercised 3 or more times per week. Reported sources of osteoporosis information included television, magazines, health care providers, and personal contacts. Over half of the women in this study wanted more information about osteoporosis, most wanted it before age 50, and health care providers were a preferred source. Less than half of participants reported having Internet access. CONCLUSIONS: While many participants underestimated their osteoporosis risk, most women wanted to learn more about osteoporosis and health care providers remain a preferred source of information.     

Use of calcitonin in 20 patients suffering from postmenopausal osteoporosis. A proposal for a therapeutical scheme

The treatment of postmenopausal osteoporosis has been thoroughly studied in recent years, because of the large diffusion of this condition. The therapeutic use of synthetic calcitonin from salmon, associated with oral calcium, has been successfully performed in 18 women out of 20, aged 55-65 years old, all suffering from postmenopausal osteoporosis without bone fractures. The dose used (100 MRC), the type of administration, and the duration of treatment (1 injection i.m. daily, for 30 days, and 1 every other day, for the next 60 days), can be taken as a useful therapeutical scheme, also by the general practitioner.     

Developing profiles of postmenopausal women being prescribed estrogen therapy to prevent osteoporosis

Postmenopausal women with estrogen deficiency are at high risk for osteoporosis. Estrogen therapy has been shown to be effective in preventing postmenopausal bone loss and maintaining bone mineral density. The increasing number of women at risk for osteoporosis and the high cost of treating this condition emphasizes the importance of preventing osteoporosis. This study was designed to identify trends and predictors of estrogen use for osteoporosis prevention among postmenopausal women. A retrospective, cross-sectional study was conducted using Behavioral Risk Factor Surveillance System data (1997–1999). Women 35 years and older who had passed menopause or were currently going through menopause were identified from the states including the BRFSS module that asked questions about estrogen use. Results showed an increasing prevalence in estrogen use from 1997 to 1999 for osteoporosis prevention. In 1999, almost a third of the postmenopausal women surveyed used estrogen to prevent osteoporosis. Prevalence was higher among women 45–64 years of age, whites, and those with higher education levels. Physician counseling on the benefits and risks of estrogen therapy was the strongest predictor of estrogen use for prevention of osteoporosis. Insurance coverage and compliance with other preventive behaviors such as mammograms and Pap smears were also strongly associated with greater estrogen use. However, women who were at risk for acute drinking, not married, overweight or obese, and diabetic were all less likely to receive estrogen therapy for osteoporosis prevention. The relationships demonstrated between estrogen use and demographic characteristics, lifestyle behaviors and health care access and utilization factors underline the importance of targeting specific groups of women for promoting its protective effect against osteoporosis.     

Modifiable and nonmodifiable factors associated with osteoporosis in postmenopausal women: results from the Third National Health and Nutrition Examination Survey, 1988-1994

We wished to study the relationship between modifiable and nonmodifiable factors that were correlated with osteoporosis using a national sample of women aged 50 years and older who have never been on hormone replacement therapy (HRT). We used a cross-sectional study design with a nationally representative sample with a detailed clinical examination and a home interview. Between 1988 and 1994, 1953 postmenopausal women who had never been on HRT, aged 50 years and older, were examined as part of the Third National Health and Nutrition Examination Survey (NHANES III). Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups. Bone density measurements of four proximal femur sites were assessed by using x-ray absorptiometry (DEXA). A DEXA measurement at any single femur site indicated osteoporosis if it was >2.5 standard deviations (SD) below the reference mean of 20--29-year-old women. The study demonstrated that numerous factors, both modifiable and nonmodifiable, were significantly related to the prevalence of osteoporosis. The modifiable factors identified were participation in physical activity (three to five times per week) and body mass index (BMI). Nonmodifiable factors included age, race, and mother's history. With the aging population, osteoporosis is a growing concern for the medical community. It is suggested that educational strategies are needed to increase awareness of factors that contribute to maintaining bone health among postmenopausal women. Emphasis may be placed on maintaining regular physical activity.     

The prevalence of osteoporosis risk factors and physician intervention

To determine the prevalence of osteoporosis risk factors and the probability of physician risk recognition and intervention, the medical records of a cohort of 243 women aged 40 to 65 years were reviewed retrospectively. A historical cohort design was used. Risk factors present before the start of the study were identified. Osteoporosis risk recognition (discussion, problem list), osteoporosis specific intervention (counseling about risk, or estrogen or calcium supplementation), or nonspecific intervention (dietary, exercise, smoking, or alcohol counseling) were recorded over a 3-year follow-up period. Seventy-four percent of the women had two or more risk factors. The most common were perimenopausal or postmenopausal status (73%) and absence of estrogen supplementation (ever) (65%). During the period of the study, 46 women (19%) had received an osteoporosis-specific intervention. One hundred eleven women (46%) had received one of the above or a less specific intervention. The medical records of only 25 women (10%) documented an assessment of osteoporosis risk. Only menopausal status predicted osteoporosis intervention, and the probability of intervention decreased as the total number of risk factors increased. The data identify three groups of women who could benefit from increased risk-reduction strategies: premenopausal women, perimenopausal or postmenopausal women who have never previously taken supplemental estrogens, and women with multiple risk factors.