Introduction: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values depend on several factors such as age, sex and age at menopause. The purpose of t...Introduction: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values depend on several factors such as age, sex and age at menopause. The purpose of this study was to determine the prevalence and changes in bone mineral density in Iranian patients. Methods: Three hundred patients were selected through random sampling technique in 2009. BMD was assessed by Norland (Excell) technique at the lumbar and femoral neck. Weight and height were measured through standard methods. A thorough history was taken from each patient. The data was analyzed using SPSS software version 13.0. P-values less than 0.05 were considered statistically significant. Results: From among the 300 studied patients, 86.6% were female. their mean age was 52.7 years. Their average body mass index (BMI) was 28.14 kg/m2. Mean T-Score at lumbar spine and femoral neck was -1.07 ±1.19 and -1.75 ± 1.33 respectively. Mean BMD value at lumbar spine and femoral neck was 0.92 ± 0.19 and 0.77 ± 0.16 respectively. The prevalence of osteoporosis at lumbar spine and femoral neck was 33.7% and 16.7, respectively. There was a significant correlation between age, BMI and BMD values (P-Value Conclusion: This study shows that ageing and low BMI are risk factors associated with bone loss. it is recommended to measure BMD and implement prevention programs for high-risk people.展开更多
The aim of this study was to determine the relationship between obesity and osteoporosis. A total of 30 Saudi women, aged between 20 and 50 years, were selected randomly. We calculated each subject’s body mass index ...The aim of this study was to determine the relationship between obesity and osteoporosis. A total of 30 Saudi women, aged between 20 and 50 years, were selected randomly. We calculated each subject’s body mass index (BMI) and determined their lumbar and femur bone mineral densities using dual-energy X-ray absorptiometry (DXA). We examined the interaction between obesity and bone mineral density (BMD) using logistic regression, after adjusting for age, family history of osteoporosis, maternal fractures, smoking, and any sedentary lifestyles. BMI was shown to be the most effective independent variable with respect to bone density. We evaluated the Pearson correlation coefficients of BMI, BMD of the lumbar spine, and BMD of the femoral neck with reference to the variables of the study, and found a significant correlation (P 30 kg/m2) were at increased risk of osteoporosis at the femoral neck and severe osteopenia in the lumbar spine.展开更多
Growth differentiation factor 11 (GDF11) is an important circulating factor that regulates aging. However, the role of GDF11 in bone metabolism remains unclear. The present study was undertaken to investigate the re...Growth differentiation factor 11 (GDF11) is an important circulating factor that regulates aging. However, the role of GDF11 in bone metabolism remains unclear. The present study was undertaken to investigate the relationship between serum GDF11 level, bone mass, and bone turnover markers in postmenopausal Chinese women. Serum GDF11 level, bone turnover biochemical markers, and bone mineral density (BMD) were determined in 169 postmenopausal Chinese women (47-78 years old). GDF11 serum levels increased with aging. There were negative correlations between GDF11 and BMD at the various skeletal sites. After adjusting for age and body mass index (BMI), the correlations remained statistically significant. In the multiple linear stepwise regression analysis, age or years since menopause, BMI, GDF11, and estradiol were independent predictors of BMD. A significant negative correlation between GDF11 and bone alkaline phosphatase (BAP) was identified and remained significant after adjusting for age and BMI. No significant correlation was noted between cross-linked N-telopeptides of type I collagen (NTX) and GDF11. In conclusion, GDF11 is an independent negative predictor of BMD and correlates with a biomarker of bone formation, BAP, in postmenopausal Chinese women. GDF11 potentially exerts a negative effect on bone mass by regulating bone formation.展开更多
Objective To understand the status of the forearm bone mineral density (BMD) in older adults, and to identify the potentialfactors influencing BMD. Methods A total of 1 214 older adults were examined, in Tianlin, Fe...Objective To understand the status of the forearm bone mineral density (BMD) in older adults, and to identify the potentialfactors influencing BMD. Methods A total of 1 214 older adults were examined, in Tianlin, Fenglin and Xietu sub-districts, of Xuhui district, Shanghai. BMD was tested at the left forearm, including distal radius and ulna 1/3 total, distal radius where the distance of radius and ulna is 8 mm, ultra-distal radius, by single energy X-ray densitometer. Results The BMD at all of the four sites decreased with the age increased. The average BMD was higher in male than in female for the same age and measured site. Distal radius 1/3 total had the highest BMD among the four sites. The incidence of low BMD and osteoporosis in distal forearm 1/3 radius total ascended with the age increased. Multiplied logistic regression showed that males had a lower risk to be low BMD (OR=0. 19) compared with female. Compared with the group aged from 50 to 54, the odds ratio in the group aged from 55 to 59, 60 to 64, and 65 to 70 were respectively 3.17, 5.13, 15.03. Compared with those whose monthly salary was less than 1 000, the odds ratio was O. 70 in those whose salary was more than 1 000. Conclusion The incidence of low BMD was high in older adults, and it is related with sex, age, monthly salary.展开更多
BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk...BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk of low-energy fractures as bone quality is reduced.It was hypothesized that a decrease in the trabecular bone score(TBS),a parameter assessing bone microarchitecture,may be an early marker of impaired bone health in women with T2D.AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODS A non-interventional cross-sectional comparative study was conducted.Potentially eligible subjects were screened at tertiary referral center.Postmenopausal women with T2D,aged 50-75 years,with no established risk factors for secondary osteoporosis,were included.BMD,TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry.In women with normal BMD,a wide range of anthropometric,general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic(ROC)curves.RESULTS Three hundred twelve women were initially screened,176 of them met the inclusion criteria and underwent dual X-ray absorptiometry.Those with reduced BMD were subsequently excluded;96 women with normal BMD were included in final analysis.Among them,43 women(44.8%)showed decreased TBS values(≤1.31).Women with TBS≤1.31 were taller and had a lower body mass index(BMI)when compared to those with normal TBS(Р=0.008 and P=0.007 respectively).No significant differences in HbA1c,renal function,calcium,phosphorus,alkaline phosphatase,PTH and 25(ОН)D levels were found.In a model of multivariate linear regression analysis,TBS was positively associated with gynoid fat mass,whereas the height and androgen fat mass were associated negatively(all P<0.001).In a multiple logistic regression,TBS≤1.31 was associated with lower gynoid fat mass(adjusted odd ratio[OR],0.9,95%confidence interval[CI],0.85-0.94,P<0.001),higher android fat mass(adjusted OR,1.13,95%CI,1.03-1.24,P=0.008)and height(adjusted OR,1.13,95%CI,1.05-1.20,P<0.001).In ROC-curve analysis,height≥162.5 cm(P=0.04),body mass index≤33.85 kg/m2(P=0.002),gynoid fat mass≤5.41 kg(P=0.03)and android/gynoid fat mass ratio≥1.145(P<0.001)were identified as the risk factors for TBS reduction.CONCLUSION In postmenopausal women with T2D and normal BMD,greater height and central adiposity are associated with impaired bone microarchitecture.展开更多
Objective: Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors (AIs). We aimed to study ...Objective: Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors (AIs). We aimed to study the effect on bone mineral density (BMD) and bone formation biomarker osteocalcin level in postmenopausal breast cancer patients, for the first three years of adjuvant hormonal treatment of both groups Tamoxifen versus Anastrozol. Methods: One-hundered postmenopausal breast cancers were prospectively randomized to receive either Tamoxifen 20 rag/day (n = 50) or Anastrozole 10 mg (n = 50). Both BMD and osteocalcin were assessed initially before treatment and then at regular intervals for both groups. Results: Use of Tamoxifen was associated with significant annual decrease in osteocalcin (P = 0.001), whereas Anastrozole group had gradual increase of the annual levels (P 〈 0.01). BMD decreased significantly in Anastrozole versus Tamoxifen groups (2.6% vs. 0.4%, P 〈 0.001). Osteoporosis T 〈 -2.5 was reported significantly higher in Anastrozole group (P 〈 0.01). Women with initial osteopenia in Anastrozole group showed significant decrease in BMD (P 〈 0.05). The addition of bisphosphonate for patients with early osteoporosis markedly improved both osteocalcin level and BMD. Conclusion: Tamoxifen preserves BMD in postmenopausal breast cancer patients, whereas Anastrozole accelerates age associated fall in BMD especially in the first year of therapy, moreover, the addition of bisphosphonate can help to decrease the skeletal related events associated with treatment to ensure better quality of life with treatment.展开更多
BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To inv...BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also included.The nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean mass.Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.RESULTS The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(P<0.05).Reduced BMD was present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(P<0.001).UC patients with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(P<0.05).Male patients were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low BMD.CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases.Body fat appears to protect against the development of low BMD in these patients.展开更多
Objective To evaluate the bone mineral density (BMD) alteration of patients with nonfunctional pituitary adenoma in Chinese mainland and further to investigate the relevant factors of BMD changes. Methods 31 patients ...Objective To evaluate the bone mineral density (BMD) alteration of patients with nonfunctional pituitary adenoma in Chinese mainland and further to investigate the relevant factors of BMD changes. Methods 31 patients with nonfunctional adenoma and 255 healthy controls were enrolled in this study between December 2007 and May 2008.展开更多
Purpose: Bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton Density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the ...Purpose: Bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton Density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the present study was to measure PDFF in the lumbar spine, paraspinal muscle and subcutaneous fat tissue. Methods: Participants were comprised of 30 patients (18 males, 12 females;age range, 14 - 87 years) who underwent MRI due to low back symptoms. PDFFs for the body of the fourth lumbar vertebra (L4), paraspinal muscle, and subcutaneous fat were measured. Results: PDFFs of the vertebral body and subcutaneous fat were significantly higher than that of paraspinal muscle (p < 0.001). PDFF was significantly higher for subcutaneous fat than for the vertebral body (p < 0.001). Although no significant differences in PDFF of the vertebral body, paraspinal muscle, and subcutaneous fat between females and males, PDFFs of the vertebral body and paraspinal muscle were significantly higher in older subjects (>63 years) than in younger subjects (Conclusions: PDFF of the vertebral body was significantly higher than that of paraspinal muscle. PDFFs of the vertebral body and paraspinal muscle were significantly lower in younger subjects than in older subjects.展开更多
目的分析亚洲人骨质疏松(osteporsis,OP)自我筛查工具(osteoporosis self-assessment tool for Asian,OSTA)指数与骨密度(bone mineral density,BMD)的相关性,并探讨跟骨定量超声(quantitative ultrasound,QUS)测定BMD对中老年男性OP的...目的分析亚洲人骨质疏松(osteporsis,OP)自我筛查工具(osteoporosis self-assessment tool for Asian,OSTA)指数与骨密度(bone mineral density,BMD)的相关性,并探讨跟骨定量超声(quantitative ultrasound,QUS)测定BMD对中老年男性OP的诊断价值。方法对893例45岁以上男性研究对象行QUS-BMD检查,记录跟骨QUS-BMD及QUS-T值,测量身高、体重,计算OSTA指数,其中255例研究对象同时行双能X线(dual-energy Xray absorptionmetry,DXA)BMD测定,按OSTA分层标准将受试者分为OP高、中、低风险组。比较各组间跟骨QUS-BMD、QUS-T以及各部位DXA-BMD的差异,分析OSTA指数与髋部、腰椎DXA-BMD的相关性。根据WHO的OP诊断金标准(骨质疏松:T值≤-2.5,骨量减少:-2.5<T值<-1,骨量正常:T值≥-1)将受试者分为OP组、骨量减少组和骨量正常组,评价跟骨QUS-T值对OP的诊断价值。结果 DXA-BMD测定者中,OP者71例(27.8%),骨量减少者143例(56.1%),骨量正常者41例(16.1%)。OSTA分层高、中、低不同OP风险组中,股骨颈、全髋和全腰椎BMD逐渐升高,高危组明显低于中危组和低危组(P<0.05),而中、低危组间的差异无统计学意义(P>0.05)。OP风险高、中、低危3组中OP患病例数分别为37例(48.7%)、17例(17.5%)和17例(20.7%),高危组中OP患病例数显著高于中、低危组(P<0.05)。Spearman相关分析示OSTA指数与股骨颈、全髋及全腰椎BMD呈显著正相关(P<0.05),相应的相关系数分别为0.448、0.439和0.141。跟骨QUS-BMD和QUS-T值在不同OP风险组间的差异无统计学意义(P>0.05)。跟骨QUS-T值诊断OP的曲线下面积为0.753,最佳截断值为-1.3,相应的灵敏度和特异度分别为77.5%和61.4%。结论随着OSTA指数升高,OP风险降低,股骨颈、全髋及全腰椎的BMD升高,OSTA指数与各部位DXA-BMD成线性正相关。OSTA指数和跟骨QUST值对诊断中老年男性OP症筛查具有一定的价值。展开更多
目的研究人股骨头主要承重区骨密度(Bone Mineral Density,BMD)与骨生物力学相关性;探讨双能X线骨密度仪(Dual Energy X-Ray Absorptiometry,DEXA)对股骨颈骨折治疗的临床参考价值。方法收集2002年11月至2004年12月收治的股骨颈骨折患...目的研究人股骨头主要承重区骨密度(Bone Mineral Density,BMD)与骨生物力学相关性;探讨双能X线骨密度仪(Dual Energy X-Ray Absorptiometry,DEXA)对股骨颈骨折治疗的临床参考价值。方法收集2002年11月至2004年12月收治的股骨颈骨折患者行假体置换术取下的股骨头共42例。采用双能X线骨密度仪(Dual Energy X-Ray Absorptiometry,DEXA)测量离体股骨头主要承重区BMD值;在股骨头主要承重区取柱状试件,行纵向压缩力学试验,记录极限应力、极限能量和弹性模量。利用SPSS12.0软件对数据进行正态分布检验后,采用双变量相关性分析法(Pearson相关分析法或Spearman相关分析法)判定BMD与极限应力、极限能量和弹性模量的相关性。结果(1)BMD测量值在0.39~1.05g/cm2之间,呈正态分布,为0.71±0.17g/cm2;(2)极限应力在2.09~23.49MPa范围之间,呈非正态分布,为9.69±6.36MPa;(3)极限能量在2.04~11.76J范围之间,呈非正态分布,为5.45±2.80J;(4)弹性模量在16.59~218.58MPa之间,呈非正态分布,为88.89±48.45MPa;(5)人股骨头主要承重区BMD与极限应力具有线性正相关性,rs=0.765,P<0.001;(6)人股骨头主要承重区BMD与极限能量具有线性正相关性,rs=0.717,P<0.001;(7)人股骨头主要承重区BMD与弹性模量具有线性正相关性,rs=0.669,P<0.001;结论BMD与极限应力、极限能量和弹性模量具有线性正相关性,通过测量股骨头的BMD可以初步预测骨的抗压强度和硬度。展开更多
目的探讨围绝经期及绝经后期女性人体体成分与腰椎骨密度(bone mineral density,BMD)之间的关系,进一步分析该人群骨量减少的影响因素。方法招募2021年10月至2024年3月于首都医科大学附属北京妇产医院内分泌科就诊的围绝经期及绝经后期...目的探讨围绝经期及绝经后期女性人体体成分与腰椎骨密度(bone mineral density,BMD)之间的关系,进一步分析该人群骨量减少的影响因素。方法招募2021年10月至2024年3月于首都医科大学附属北京妇产医院内分泌科就诊的围绝经期及绝经后期女性300例为研究对象。采用定量电子计算机断层扫描技术(quantitative computed tomography,QCT)测量腰椎骨密度,根据测量结果分为骨量正常组和骨量减少组,采用肌肉功能分析仪测定所有受试者的体质量、脂肪、下肢肌肉、膝关节活动等人体成分情况,采用更年期症状全面评估量表采集所有研究对象的年龄、绝经状态及活动类型。采用单因素方差分析比较骨量正常组和骨量减少组的人体体成分之间的差异性,采用多因素Logistic回归分析探讨骨量减少的危险因素。结果300例研究对象中,围绝经期女性148例(49%),平均年龄(51.40±5.03)岁;绝经后期女性152例(51%),平均年龄(53.59±6.04)岁。绝经后期女性的骨密度低于围绝经期女性,差异有统计学意义(P<0.05)。骨量减少组118例(39%),骨量正常组182例(61%)。骨量减少组女性年龄、脂肪百分比、绝经后期占比和无锻炼占比均高于骨量正常组,差异有统计学意义(P<0.05);而下肢肌肉分布系数、下肢肌力和有锻炼占比均低于骨量正常组,差异有统计学意义(P<0.05)。Spearman相关性分析结果表明围绝经期和绝经后期女性BMD与年龄、脂肪百分比、绝经后期占比均呈显著负相关(r=-0.492、-0.125、-0.287,P<0.05),而与下肢肌肉分布系数、下肢肌力、有锻炼占比均呈显著正相关(r=0.143、0.180、0.193,P<0.05)。二元Logistic回归分析结果显示,年龄大、脂肪百分比大、下肢肌肉分布少、锻炼少是骨量减少的危险因素(P<0.05)。结论与围绝经期女性相比,绝经后期女性的腰椎骨密度明显降低,围绝经期及绝经后期女性腰椎骨密度与人体体成分及活动类型密切相关,其中年龄大、脂肪百分比大、下肢肌肉分布少、锻炼少是骨量减少的危险因素(P<0.05)。建议临床医生关注此时期女性的腰椎骨密度及人体体成分的变化,以便通过及时合理的干预措施来提高她们的生活质量,预防骨质疏松的发生。展开更多
文摘Introduction: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values depend on several factors such as age, sex and age at menopause. The purpose of this study was to determine the prevalence and changes in bone mineral density in Iranian patients. Methods: Three hundred patients were selected through random sampling technique in 2009. BMD was assessed by Norland (Excell) technique at the lumbar and femoral neck. Weight and height were measured through standard methods. A thorough history was taken from each patient. The data was analyzed using SPSS software version 13.0. P-values less than 0.05 were considered statistically significant. Results: From among the 300 studied patients, 86.6% were female. their mean age was 52.7 years. Their average body mass index (BMI) was 28.14 kg/m2. Mean T-Score at lumbar spine and femoral neck was -1.07 ±1.19 and -1.75 ± 1.33 respectively. Mean BMD value at lumbar spine and femoral neck was 0.92 ± 0.19 and 0.77 ± 0.16 respectively. The prevalence of osteoporosis at lumbar spine and femoral neck was 33.7% and 16.7, respectively. There was a significant correlation between age, BMI and BMD values (P-Value Conclusion: This study shows that ageing and low BMI are risk factors associated with bone loss. it is recommended to measure BMD and implement prevention programs for high-risk people.
文摘The aim of this study was to determine the relationship between obesity and osteoporosis. A total of 30 Saudi women, aged between 20 and 50 years, were selected randomly. We calculated each subject’s body mass index (BMI) and determined their lumbar and femur bone mineral densities using dual-energy X-ray absorptiometry (DXA). We examined the interaction between obesity and bone mineral density (BMD) using logistic regression, after adjusting for age, family history of osteoporosis, maternal fractures, smoking, and any sedentary lifestyles. BMI was shown to be the most effective independent variable with respect to bone density. We evaluated the Pearson correlation coefficients of BMI, BMD of the lumbar spine, and BMD of the femoral neck with reference to the variables of the study, and found a significant correlation (P 30 kg/m2) were at increased risk of osteoporosis at the femoral neck and severe osteopenia in the lumbar spine.
基金supported by Grant 81570806 from the National Natural Science Foundation of China
文摘Growth differentiation factor 11 (GDF11) is an important circulating factor that regulates aging. However, the role of GDF11 in bone metabolism remains unclear. The present study was undertaken to investigate the relationship between serum GDF11 level, bone mass, and bone turnover markers in postmenopausal Chinese women. Serum GDF11 level, bone turnover biochemical markers, and bone mineral density (BMD) were determined in 169 postmenopausal Chinese women (47-78 years old). GDF11 serum levels increased with aging. There were negative correlations between GDF11 and BMD at the various skeletal sites. After adjusting for age and body mass index (BMI), the correlations remained statistically significant. In the multiple linear stepwise regression analysis, age or years since menopause, BMI, GDF11, and estradiol were independent predictors of BMD. A significant negative correlation between GDF11 and bone alkaline phosphatase (BAP) was identified and remained significant after adjusting for age and BMI. No significant correlation was noted between cross-linked N-telopeptides of type I collagen (NTX) and GDF11. In conclusion, GDF11 is an independent negative predictor of BMD and correlates with a biomarker of bone formation, BAP, in postmenopausal Chinese women. GDF11 potentially exerts a negative effect on bone mass by regulating bone formation.
文摘Objective To understand the status of the forearm bone mineral density (BMD) in older adults, and to identify the potentialfactors influencing BMD. Methods A total of 1 214 older adults were examined, in Tianlin, Fenglin and Xietu sub-districts, of Xuhui district, Shanghai. BMD was tested at the left forearm, including distal radius and ulna 1/3 total, distal radius where the distance of radius and ulna is 8 mm, ultra-distal radius, by single energy X-ray densitometer. Results The BMD at all of the four sites decreased with the age increased. The average BMD was higher in male than in female for the same age and measured site. Distal radius 1/3 total had the highest BMD among the four sites. The incidence of low BMD and osteoporosis in distal forearm 1/3 radius total ascended with the age increased. Multiplied logistic regression showed that males had a lower risk to be low BMD (OR=0. 19) compared with female. Compared with the group aged from 50 to 54, the odds ratio in the group aged from 55 to 59, 60 to 64, and 65 to 70 were respectively 3.17, 5.13, 15.03. Compared with those whose monthly salary was less than 1 000, the odds ratio was O. 70 in those whose salary was more than 1 000. Conclusion The incidence of low BMD was high in older adults, and it is related with sex, age, monthly salary.
文摘BACKGROUND Osteoporosis and type 2 diabetes(T2D)have been recognized as a widespread comorbidity leading to excess mortality and an enormous healthcare burden.In T2D,bone mineral density(BMD)may underestimate the risk of low-energy fractures as bone quality is reduced.It was hypothesized that a decrease in the trabecular bone score(TBS),a parameter assessing bone microarchitecture,may be an early marker of impaired bone health in women with T2D.AIM To identify clinical and body composition parameters that affect TBS in postmenopausal women with T2D and normal BMD.METHODS A non-interventional cross-sectional comparative study was conducted.Potentially eligible subjects were screened at tertiary referral center.Postmenopausal women with T2D,aged 50-75 years,with no established risk factors for secondary osteoporosis,were included.BMD,TBS and body composition parameters were assessed by dual-energy X-ray absorptiometry.In women with normal BMD,a wide range of anthropometric,general and diabetes-related clinical and laboratory parameters were evaluated as risk factors for TBS decrease using univariate and multivariate regression analysis and analysis of receiver operating characteristic(ROC)curves.RESULTS Three hundred twelve women were initially screened,176 of them met the inclusion criteria and underwent dual X-ray absorptiometry.Those with reduced BMD were subsequently excluded;96 women with normal BMD were included in final analysis.Among them,43 women(44.8%)showed decreased TBS values(≤1.31).Women with TBS≤1.31 were taller and had a lower body mass index(BMI)when compared to those with normal TBS(Р=0.008 and P=0.007 respectively).No significant differences in HbA1c,renal function,calcium,phosphorus,alkaline phosphatase,PTH and 25(ОН)D levels were found.In a model of multivariate linear regression analysis,TBS was positively associated with gynoid fat mass,whereas the height and androgen fat mass were associated negatively(all P<0.001).In a multiple logistic regression,TBS≤1.31 was associated with lower gynoid fat mass(adjusted odd ratio[OR],0.9,95%confidence interval[CI],0.85-0.94,P<0.001),higher android fat mass(adjusted OR,1.13,95%CI,1.03-1.24,P=0.008)and height(adjusted OR,1.13,95%CI,1.05-1.20,P<0.001).In ROC-curve analysis,height≥162.5 cm(P=0.04),body mass index≤33.85 kg/m2(P=0.002),gynoid fat mass≤5.41 kg(P=0.03)and android/gynoid fat mass ratio≥1.145(P<0.001)were identified as the risk factors for TBS reduction.CONCLUSION In postmenopausal women with T2D and normal BMD,greater height and central adiposity are associated with impaired bone microarchitecture.
文摘Objective: Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors (AIs). We aimed to study the effect on bone mineral density (BMD) and bone formation biomarker osteocalcin level in postmenopausal breast cancer patients, for the first three years of adjuvant hormonal treatment of both groups Tamoxifen versus Anastrozol. Methods: One-hundered postmenopausal breast cancers were prospectively randomized to receive either Tamoxifen 20 rag/day (n = 50) or Anastrozole 10 mg (n = 50). Both BMD and osteocalcin were assessed initially before treatment and then at regular intervals for both groups. Results: Use of Tamoxifen was associated with significant annual decrease in osteocalcin (P = 0.001), whereas Anastrozole group had gradual increase of the annual levels (P 〈 0.01). BMD decreased significantly in Anastrozole versus Tamoxifen groups (2.6% vs. 0.4%, P 〈 0.001). Osteoporosis T 〈 -2.5 was reported significantly higher in Anastrozole group (P 〈 0.01). Women with initial osteopenia in Anastrozole group showed significant decrease in BMD (P 〈 0.05). The addition of bisphosphonate for patients with early osteoporosis markedly improved both osteocalcin level and BMD. Conclusion: Tamoxifen preserves BMD in postmenopausal breast cancer patients, whereas Anastrozole accelerates age associated fall in BMD especially in the first year of therapy, moreover, the addition of bisphosphonate can help to decrease the skeletal related events associated with treatment to ensure better quality of life with treatment.
文摘BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also included.The nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean mass.Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.RESULTS The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(P<0.05).Reduced BMD was present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(P<0.001).UC patients with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(P<0.05).Male patients were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low BMD.CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases.Body fat appears to protect against the development of low BMD in these patients.
文摘Objective To evaluate the bone mineral density (BMD) alteration of patients with nonfunctional pituitary adenoma in Chinese mainland and further to investigate the relevant factors of BMD changes. Methods 31 patients with nonfunctional adenoma and 255 healthy controls were enrolled in this study between December 2007 and May 2008.
文摘Purpose: Bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton Density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the present study was to measure PDFF in the lumbar spine, paraspinal muscle and subcutaneous fat tissue. Methods: Participants were comprised of 30 patients (18 males, 12 females;age range, 14 - 87 years) who underwent MRI due to low back symptoms. PDFFs for the body of the fourth lumbar vertebra (L4), paraspinal muscle, and subcutaneous fat were measured. Results: PDFFs of the vertebral body and subcutaneous fat were significantly higher than that of paraspinal muscle (p < 0.001). PDFF was significantly higher for subcutaneous fat than for the vertebral body (p < 0.001). Although no significant differences in PDFF of the vertebral body, paraspinal muscle, and subcutaneous fat between females and males, PDFFs of the vertebral body and paraspinal muscle were significantly higher in older subjects (>63 years) than in younger subjects (Conclusions: PDFF of the vertebral body was significantly higher than that of paraspinal muscle. PDFFs of the vertebral body and paraspinal muscle were significantly lower in younger subjects than in older subjects.
文摘目的研究人股骨头主要承重区骨密度(Bone Mineral Density,BMD)与骨生物力学相关性;探讨双能X线骨密度仪(Dual Energy X-Ray Absorptiometry,DEXA)对股骨颈骨折治疗的临床参考价值。方法收集2002年11月至2004年12月收治的股骨颈骨折患者行假体置换术取下的股骨头共42例。采用双能X线骨密度仪(Dual Energy X-Ray Absorptiometry,DEXA)测量离体股骨头主要承重区BMD值;在股骨头主要承重区取柱状试件,行纵向压缩力学试验,记录极限应力、极限能量和弹性模量。利用SPSS12.0软件对数据进行正态分布检验后,采用双变量相关性分析法(Pearson相关分析法或Spearman相关分析法)判定BMD与极限应力、极限能量和弹性模量的相关性。结果(1)BMD测量值在0.39~1.05g/cm2之间,呈正态分布,为0.71±0.17g/cm2;(2)极限应力在2.09~23.49MPa范围之间,呈非正态分布,为9.69±6.36MPa;(3)极限能量在2.04~11.76J范围之间,呈非正态分布,为5.45±2.80J;(4)弹性模量在16.59~218.58MPa之间,呈非正态分布,为88.89±48.45MPa;(5)人股骨头主要承重区BMD与极限应力具有线性正相关性,rs=0.765,P<0.001;(6)人股骨头主要承重区BMD与极限能量具有线性正相关性,rs=0.717,P<0.001;(7)人股骨头主要承重区BMD与弹性模量具有线性正相关性,rs=0.669,P<0.001;结论BMD与极限应力、极限能量和弹性模量具有线性正相关性,通过测量股骨头的BMD可以初步预测骨的抗压强度和硬度。
文摘目的探讨围绝经期及绝经后期女性人体体成分与腰椎骨密度(bone mineral density,BMD)之间的关系,进一步分析该人群骨量减少的影响因素。方法招募2021年10月至2024年3月于首都医科大学附属北京妇产医院内分泌科就诊的围绝经期及绝经后期女性300例为研究对象。采用定量电子计算机断层扫描技术(quantitative computed tomography,QCT)测量腰椎骨密度,根据测量结果分为骨量正常组和骨量减少组,采用肌肉功能分析仪测定所有受试者的体质量、脂肪、下肢肌肉、膝关节活动等人体成分情况,采用更年期症状全面评估量表采集所有研究对象的年龄、绝经状态及活动类型。采用单因素方差分析比较骨量正常组和骨量减少组的人体体成分之间的差异性,采用多因素Logistic回归分析探讨骨量减少的危险因素。结果300例研究对象中,围绝经期女性148例(49%),平均年龄(51.40±5.03)岁;绝经后期女性152例(51%),平均年龄(53.59±6.04)岁。绝经后期女性的骨密度低于围绝经期女性,差异有统计学意义(P<0.05)。骨量减少组118例(39%),骨量正常组182例(61%)。骨量减少组女性年龄、脂肪百分比、绝经后期占比和无锻炼占比均高于骨量正常组,差异有统计学意义(P<0.05);而下肢肌肉分布系数、下肢肌力和有锻炼占比均低于骨量正常组,差异有统计学意义(P<0.05)。Spearman相关性分析结果表明围绝经期和绝经后期女性BMD与年龄、脂肪百分比、绝经后期占比均呈显著负相关(r=-0.492、-0.125、-0.287,P<0.05),而与下肢肌肉分布系数、下肢肌力、有锻炼占比均呈显著正相关(r=0.143、0.180、0.193,P<0.05)。二元Logistic回归分析结果显示,年龄大、脂肪百分比大、下肢肌肉分布少、锻炼少是骨量减少的危险因素(P<0.05)。结论与围绝经期女性相比,绝经后期女性的腰椎骨密度明显降低,围绝经期及绝经后期女性腰椎骨密度与人体体成分及活动类型密切相关,其中年龄大、脂肪百分比大、下肢肌肉分布少、锻炼少是骨量减少的危险因素(P<0.05)。建议临床医生关注此时期女性的腰椎骨密度及人体体成分的变化,以便通过及时合理的干预措施来提高她们的生活质量,预防骨质疏松的发生。