Objectives Compare the effect of high doses of inhaled corticosteroids on bone loss in subjects with moderate to severe asthma or mild asthma, and examine the influence of dietary intake on bone metabolism. Design A survey on the effects of corticotherapy and nutrition on bone density was conducted in 74 subjects currently being treated for asthma in the asthma clinic of Hospital Laval (Sainte-Foy, Quebec, Canada). Fifty-eight subjects completed the study (attrition RATE=15%).
Main outcome measures In all subjects expiratory volumes were determined and urinary analysis was conducted for hydroxyproline, calcium, phosphorus, and cortisol levels. Osteocalcin, calcium, phosphorus, cortisol, alkaline phosphatase, and γ-glutamyltransferase levels were measured in blood samples. Bone density of the lumbar spine was determined by means of dual-energy x-ray absorptiometry. Nutrition evaluation was based on a 3-day food diary analyzed using progiciel Nutri 91. The nutritional parameters examined were calcium; phosphorus; magnesium; zinc; vitamins A, C, and D; protein; total fiber; oxalates; energy; caffeine; and alcohol in relation to bone density.
Subjects Thirty-one patients with moderate to severe asthma who had been taking more than 1,000 μg beclomethasone per day or the equivalent for more than 2 years and 27 patients with mild asthma who were taking less than 500 μg beclomethasone per day or the equivalent.
Statistical analyses performed Four factor analysis of variance with hierarchized interactions of four levels, Duncan's test, Pearson correlation coefficients.
Results Blood levels of osteocalcin and protein intake were lower in patients with moderate to severe asthma than in those with mild asthma (P<.05). Significant correlations (P<.02) were observed between bone density and calcium intake (r=.40), phosphorus intake (r=.35), protein intake (r=.30), and serum alkaline phosphatase level (r=−.30). Bone density was not significantly different between the two groups of patients with asthma.
Applications A follow-up of patients with asthma who are taking inhaled corticosteroids is needed to assess bone density, osteocalcin levels, and dietary intakes of calcium. Verify if osteocalcin level decreases over time in patients with moderate to severe asthma, monitor possible modifications in bone density, and verify if the correlation between dietary calcium and bone density is maintained. J Am Diet Assoc. 1997;97:1401–1406. 相似文献
The Southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES) was conducted by the National Center for Health Statistics (NCHS) in 1982 and 1983. The survey population was Mexican-Americans residing in five Southwestern states. This report presents data on the prevalence of total tooth loss, dental caries, and periodontal diseases in 3860 Mexican-American adults aged from 18 to 74. Results show that 4.3% of this group was edentulous. Among the dentate, Mexican-Americans had lower overall DMF scores but higher numbers of untreated decayed teeth than did residents of the same region seen in the NHANES I survey in 1971-1974. Caries of the smooth surfaces in both posterior and anterior teeth was more pronounced in the older than in the younger age groups. Mexican-Americans had more gingivitis but fewer periodontal pockets than did the general population in the Western states during NHANES I. The caries pattern in the Mexican-Americans suggests that caries among adults may remain a problem in the future, with the possibility of increased involvement with the aging, although modest, of smooth tooth surfaces. 相似文献
Reduced bone mineral density (BMD) was sporadically reported in patients with Marfan syndrome. This may or may not place the
Marfan patient at increased risk for bone fracture. In comparing the BMDs of our patients with those reported in the literature,
it seemed that agreement between values, and hence the degree of osteoporosis or osteopenia reported, was dependent on the
instrumentation used. The objective of this study was to statistically assess this impression. Bone mineral density measurements
from our previously published study of 30 adults with Marfan syndrome performed on a Lunar DPXL machine were compared with
studies published between 1993–2000 measured using either Lunar or Hologic bone densitometry instruments. The differences
of our measurements compared with those made on other Lunar machines were not statistically significant, but did differ significantly
with published results from Hologic machines (P < 0.001). Before progress can be made in the assessment of BMD and fracture risk in Marfan patients and in the evidence-based
orthopedic management of these patients, standardization of instrumental bone density determinations will be required along
with considerations of height, obesity, age, and sex. 相似文献