Relationship of serum GDF11 levels with bone mineral density and bone turnover markers in postmenopausal Chinese women

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.

Study on Bone Mineral Density and its Influencing Factors among 1214 Older Adults in Xuhui District,Shanghai

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.

Skeletal events of Anastrozole versus Tamoxifen on bone mineral density and bone biomarker osteocalcin in postmenopausal women with early breast cancer

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.

Microcomputed Tomography Applications in Bone and Mineral Research

Microcomputed tomography (μCT) has evolved as a development of simple X-ray imaging into an indispensable technique used in both laboratory research and clinical diagnostics. Commercially available systems are capable of creating images at sub-micrometer resolutions to map out the complex web of trabecular bone in small animals, and offer an accurate measurement of bone mineral density for patients at risk of osteoporotic fractures. This review describes the development of μCT, its ability to analyze bone, and how it can be used alongside other clinical and laboratory techniques. μCT offers a non-destructive alternative for imaging mineralized tissues with no required preparation and can also be utilized with living specimen to track skeletal development.

The changes of preoperative bone mineral density of patients with nonfunctional pituitary adenoma

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.

佛山市成年居民骨密度CT定量研究

目的:研究佛山地区成年人椎体骨密度(BMD)与性别、年龄的关系,探讨本地区不同年龄段BMD均值及各年龄段骨质疏松症(OP)的发病率。方法:对佛山市中医院2021年10月至2023年3月的1 065例(男性648例,女性417例)健康成年人体检者使用定量CT(QCT)行椎体BMD检测,按年龄段进行分组;采用t检验和方差分析对不同性别、不同年龄段BMD值进行检验,采用χ2检验和相关分析对不同性别、不同年龄段的OP发病率进行分析。结果:20~29岁、30~39岁、40~49岁及60~69岁、70~79岁不同性别间的BMD差异均有统计学意义,女性BMD在青中年时期高于男性。在40~49岁、50~59岁、60~69岁、70~79岁男性组及30~39、40~49岁、50~59岁、60~69岁女性组中,同性别不同年龄段间的BMD值差异有统计学意义,且随年龄的增长呈下降趋势;同性别不同年龄段的OP发病率差异均有统计学意义,年龄与OP发病率呈正相关关系(r男=0.517,r女=0.636)。结论:佛山市健康成年人QCT测量的椎体BMD与性别、年龄相关,在20~29岁达到峰值,随年龄的增长而下降;从40~49岁开始,OP发病率在男性和女性中随着年龄的增长而增加。

放射性核素对双能X射线骨密度仪检测骨密度的影响研究

目的:研究核医学检查和治疗中常用放射性核素对双能X射线骨密度仪(DXA)检测骨密度(BMD)的影响。方法:对DXA设备专用质量保证(QA)模块和脊椎模体均进行常规扫描,在QA模块旁及脊椎模体的水槽中分别加入常用放射性核素锝99m(^(99)Tc^(m))-亚甲基二膦酸盐(^(99)Tc^(m)-MDP)、氟18(^(18)F)-氟代脱氧葡萄糖(^(18)F-FDG)和碘[^(131)I]化钠(Na^(131)I)后扫描,对检测所得高、中、低BMD值、身体成分百分含量值、第1、2、3、4节腰椎(L_(1)、L_(2)、L_(3)、L_(4))及4节腰椎平均(L_(1)~L_(4))BMD值、T值进行对比分析。结果:在QA模块旁分别放置^(99)Tc^(m)-MDP、^(18)F-FDG、Na^(131)I后的扫描与QA模块的常规扫描所得高、中、低BMD值及身体成分百分含量值相比,差异均无统计学意义(F_(BMD值)=1.621、0.259、0.099,F_(身体成分百分含量值)=0.367、0.151、0.635;P>0.05);向脊椎模体的水槽中分别注入放射性核素^(99)Tc^(m)-MDP、^(18)F-FDG、Na^(131)I后的扫描和脊椎模体的常规扫描所得L_(1)、L_(2)、L_(3)、L_(4)及L_(1)~L_(4)的BMD值及T值相比,差异均无统计学意义(F_(BMD值)=0.435、0.529、0.507、0.489、0.516,F_(T值)=0.634、1.585、0.961、0.777、0.801;P>0.05)。结论:核医学检查和治疗中常用放射性核素^(99)Tc^(m)-MDP、^(18)F-FDG、Na^(131)I对DXA检测BMD无影响。

老年髋部骨折术后早期负重锻炼影响骨质疏松进展的研究

目的探讨早期负重锻炼对老年髋部骨折术后骨质疏松进展的影响。方法纳入本院接受手术治疗的63例老年髋部骨折患者,根据开始负重锻炼时间设立观察组与对照组,分析术后患者健侧髋关节骨密度的变化。观察组在术后1周内开始定量的辅助下单腿站立训练及负重行走锻炼,对照组在术后3周后方开始定量的辅助下单腿站立训练及负重行走锻炼。分别检测并比较两组术前、术后6周、12周、24周的健侧髋关节骨密度值。结果术后两组病例均出现了健侧髋部骨密度减低,与对照组相比,观察组各时间段骨密度下降幅度更小。观察组术后第12周时健侧髋关节骨密度达到最低值,较术前平均下降0.8%;对照组在术后第24周时骨密度最低,较术前平均下降3.14%。将两组健侧髋部骨密度进行比较,其中股骨颈部在术后6周、12周、24周两组比较差异有统计学意义(P<0.05),转子间和髋总和在术后12周、24周的两组比较差异有统计学意义(P<0.05),Ward’s三角在术后第24周两组比较差异有统计学意义(P<0.05)。组内配对检验发现观察组术后第24周骨密度与术前比较差异无统计学意义(P>0.05)。结论早期负重锻炼能延缓对侧髋部骨密度的降低,延缓骨质疏松的进展,有利于二次骨折的预防。

中老年男性骨质疏松(OP)危险分层与定量超声骨密度(QUS-BMD)及双能X线骨密度(DXA-BMD)的相关性

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。

DEXA测量松质骨BMD与其生物力学相关性

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。

绝经前期妇女血清PINP、ICTP和25-OH-VitD_3水平的变化及其与BMD的相关性分析

目的:观察绝经前期妇女血清PINP、ICTP和25-OH-VitD3水平的变化,分析其与骨密度(BMD)的相关性。方法:采用双能X线吸收法(DEXA)对67例绝经前期健康女性进行第(1～4)腰椎(L1-4)、左、右髋部(股骨近段+股骨颈)的BMD测定,并根据BMD测定结果分为BMD正常组和BMD降低组。用放射免疫分析(RIA)测定血清Ⅰ型前胶原氨基端前肽(PINP)、Ⅰ型胶原交联羧基末端肽(ICTP)和25-羟维生素D3(25-OH-VitD3),分析与各部位BMD的相关性。结果:①19例出现BMD降低(28.4%),两组间腰椎及左、右髋部BMD差异显著(P<0.01);②BMD减低组的PINP和ICTP[分别为(56.9±18.2)μg/L和(3.78±0.83)μg/L]高于BMD正常组[分别为(43.8±15.1)μg/L和(3.45±0.98)μg/L],其中PINP差异显著(P<0.05),25-OH-VitD3水平两组间无显著性差异[分别为(25.6±7.8)ng/ml和(27.4±9.2)ng/ml,P>0.05];③PINP与L1-4、左股骨近段、左股骨颈的BMD呈正相关(r=0.274～0.402,P<0.05),ICTP及25-OH-VitD3与BMD无明显相关性(r=-0.226～0.083,P>0.05),PINP与25-OH-VitD3呈一定程度的正相关(r=0.395,P<0.05)。结论:绝经前期妇女有骨转换增高趋势,BMD检查联合骨转换标志物测定有利于识别绝经前期高风险发生骨质疏松的妇女,以指导OP预防性治疗。

The Effect of the Paleo Diet on People Suffering from Osteoporosis (Review Paper)

Osteoporosis is a disease that decreases bone mass and increases bone porosity, weakening bones. The Paleo diet is an eating plan that imitates the dietary patterns of the Stone Age. It excludes grains, dairy, and processed foods and emphasizes feeding on lean meats, fruits, vegetables, and nuts. Consumption of the Paleo diet has many positive sides, such as high protein intake and weight loss. Still, excluding dairy products risks calcium and vitamin D deficiencies, which are crucial for bone health. Statistics and simulations that have explored the relationship between the Paleo diet and bone health (especially for people suffering from low bone density) show mixed outcomes on bone health.). While the consumer does get lots of benefits from fruit and vegetable intake in a large sum due to them containing nutrients like magnesium, potassium, and vitamin K (which are also necessary for bone health), the lack of dairy products (gives the maximum amount of calcium and vitamin D) raises concerns about maintaining adequate bone mineral density (BMD). More information on this topic shows the negative impact of this diet on people suffering from osteoporosis due to a lack of nutrient intake that nourishes the bone. Although the Paleo diet can enhance overall health through nutrient-dense foods and reduced processed intake, it can’t be said the same for people suffering from osteoporosis.

青少年强直性脊柱炎早期年龄、身高、体重与L_(1-4)BMC、L_(1-4)BMD相关性初步分析

目的 研究青少年强直性脊柱炎 (Ankylosingspondylitis,AS)早期年龄、身高、体重与腰椎L1 -4骨矿含量 (L1 -4BMC)、腰椎L1 -4骨密度 (L1 -4BMD)的相关性。方法 选择男性青少年AS早期病例 31例。应用DPX -IQ双能X线骨密度仪 (DEXA)检测L1 -4BMC和L1 -4BMD ,分析年龄、身高、体重与L1 -4BMC、L1 -4BMD的关系。结果年龄、身高、体重、L1 -4BMC、L1 -4BMD的测定值分别为 (1 7 5 6± 2 0 1 )岁、 (1 6 8 5 2± 8 5 9)cm、 (5 6 1 3±1 2 72 )kg、 (5 2 1 6± 1 2 1 7)g、 (0 971 1± 0 1 392 ) g/cm2 。L1 -4BMC与身高、体重和年龄呈正相关 (R =0 786 ,Radj2 =0 5 75 ,P <0 0 0 0 1 ) ,其中身高和体重是主要相关因素 (R =0 74 7,Radj2 =0 5 2 6 ,P <0 0 0 0 1 )。年龄、身高和体重因素中仅体重因素进入L1 -4BMD回归方程 (R =0 6 5 7,Radj2 =0 4 1 2 ,P <0 0 0 0 1 )。结论 身高和体重与L1 -4BMC相关 ,体重与L1 -4BMD相关。

高原男性骨质疏松症患者血清叶酸水平变化与股骨颈骨密度的相关性

目的 探讨高原骨质疏松症患者血清叶酸水平与股骨颈骨密度(BMD)的相关性。方法 随机选取2023年6~8月间于兴海县人民医院行健康体检的60例老年男性作为研究对象,应用双能X线骨密度仪(DXA)测定受试者股骨颈BMD,按1994年WHO标准将其分为骨量正常的对照组(n=29)和骨质疏松组(n=31);采集两组受试者空腹静脉血检测叶酸浓度;同时测量全髋及腰椎BMD,并采用Spearman等级相关性分析叶酸与股骨颈、全髋、腰椎BMD的相关性。结果 两组受试者的年龄、身高、体质量、体质量指数比较差异均无统计学意义(P>0.05);骨质疏松组患者的血清叶酸浓度为(46.88±4.02) nmol/L,明显低于对照组的(54.01±4.79) nmol/L,差异有统计学意义(P<0.05);骨质疏松组患者的股骨颈、全髋和腰椎的BMD分别为(0.922 9±0.1813) g/cm^(2)、(1.065±0.054 03) g/cm^(2)、(1.255±0.061 58) g/cm^(2),明显低于对照组的(1.026±0.098 39) g/cm^(2)、(1.112±0.065 27) g/cm^(2),(1.315±0.075 81) g/cm^(2),差异均有统计学意义(P<0.05);经Spearman等级相关性分析结果显示,血清叶酸浓度与股骨颈、全髋和腰椎BMD均呈正相关(r=0.644 5、0.650 6、0.574 2,P<0.001)。结论 叶酸浓度降低与高原骨质疏松症密切相关,高原骨质疏松症患者血叶酸水平的缺乏可能是骨质疏松发生的一个重要风险因素,为高原骨质疏松性骨折的治疗及预防提供了新的理论指导和实验依据。

探讨腰椎BMC和BMD指标评价儿童骨体重负荷的优次

目的 探讨学龄前儿童骨负荷体重对腰椎 BMC、BMD的影响 ,并比较两指标的优次。方法 应用双能 X线吸收测定仪测量成都地区 132例 3～ 7岁儿童腰椎2～ 4正位的骨量。结果 儿童体重、BMC、BMD随增龄而增加 ,男女儿童按体重配对 ,体重与 BMC的相关好于与 BMD的相关 ;体重标准化 BMC随增龄而增大 ,体重标准化 BMD随增龄反而减小 ,BMC更符合骨力学强度特性。结论 BMC指标判断骨强度优于 BMD。

Optimization of Physical Activity as a Countermeasure of Bone Loss: A 5-Year Study of Bikram Yoga Practice in Females

Over the last decade, the number of people diagnosed with osteoporosis has increased dramatically due to many factors. While it has been asserted that one variable associated with preserving bone health is participation in high-impact exercises, those same exercises are also well documented to damage the hip and knee joints. Therefore, the goal of the present study was to evaluate the potential benefits of a highly regimented, low impact weight-bearing exercise, Bikram Yoga. Specifically, the bone mineral content was measured using DEXA analysis of the proximal femur and lumbar spine of nine female Bikram Yoga instructors between the ages of 30 and 59, who not only participated in a minimum of 3 classes (4.5 hours) a week, but also actively taught Bikram Yoga classes. These same participants, who remained active as instructors and practitioners, were rescanned five years later. The results of the study, which focused on the percent change in individual bone mineral density over the five-year period were as follows: the premenopausal subjects showed a mean increase in BMD of 6.6% at the femoral neck, 2.0% for the total hip, and 1.0% for the total lumbar spine. In contrast, post-menopausal subjects revealed a mean decrease in bone mineral density (BMD) of ﹣6.0%, ﹣8.1%, and ﹣5.6% in the femoral neck, total hip, and total lumbar spine, respectively. Consequently, the results of this study suggest that performing Bikram Yoga may preserve, or even perhaps, increase bone mineral density in pre-menopausal women and hence, may be an effective countermeasure for preventing osteoporosis.

Bikram Yoga as a Countermeasure of Bone Loss in Women

The purpose of this pilot study was to observe whether Bikram Yoga training helps bone growth or arrest bone loss in women. In this study, the bone mineral density (BMD) was measured at the hip, spine and whole body for a group of 14 pre-menopausal women (11 Caucasians, 2 Asians and 1 African Ameri-can). These 14 women had participated in Bikram Yoga classes (26 yoga postures) at least 3 times a week for 3 or more years. DEXA scans were used to measure BMD at the lumbar spine, hip and the whole body. In addition, the Z-scores were calculated for each subject at these three locations. The study results indicate that the BMD at these body areas of this group of women is generally above the mean BMD expected for normal, healthy, women of comparable age and ethnicity. Overall, the study findings suggest that the intervention of Bikram Yoga training may be beneficial for skeletal health and could prevent bone loss.

类风湿关节炎血清肿瘤坏死因子α与骨密度的相关性及瓜蒌桂枝汤抗炎机制研究

【目的】分析类风湿关节炎(rheumatoid arthritis,RA)患者血清肿瘤坏死因子α(TNF-α)与骨密度(BMD)的相关性以及瓜蒌桂枝汤的抗炎机制。【方法】将2020年1月至2022年1月在贵州省人民医院就诊的76例风湿热痹型RA患者设为观察组,将同期在该院体检中心体检的76例健康体检者设为正常对照组,比较观察组与正常对照组以及不同分期RA患者血清TNF-α、BMD的差异,比较不同骨密度RA患者血清TNF-α的差异,Pearson分析TNF-α与BMD的相关性。同时,根据治疗方法的不同,将76例RA患者分为西医组和中西结合组,每组38例,西医组给予常规西药治疗,中西结合组在西医组基础上给予瓜蒌桂枝汤加味治疗,疗程为4周。观察2组RA患者治疗前后疼痛视觉模拟量表(VAS)评分、晨僵时间、血清炎症因子、BMD的变化情况,评价2组患者临床疗效,探讨瓜蒌桂枝汤在治疗RA中的抗炎机制。【结果】(1)观察组RA患者血清TNF-α水平高于正常对照组,BMD低于正常对照组,差异均有统计学意义(P<0.01);Ⅳ期RA患者血清TNF-α水平高于Ⅲ期和Ⅱ期患者,BMD低于Ⅲ期和Ⅱ期患者,差异均有统计学意义(P<0.05);骨质疏松组患者血清TNF-α水平高于骨密度低下组和骨密度正常组,差异均有统计学意义(P<0.05);Pearson分析结果显示:TNF-α与BMD呈负相关性(r=-0.401),差异有统计学意义(P<0.05)。(2)治疗4周后,中西结合组的总有效率为94.74%(36/38),西医组为68.42%(26/38),组间比较,中西结合组的临床疗效明显优于西医组,差异有统计学意义(P<0.01)。(3)治疗后,2组RA患者的VAS评分均较治疗前降低(P<0.05),晨僵时间均较治疗前缩短(P<0.05),且中西结合组治疗后的VAS评分低于西医组,晨僵时间短于西医组,差异均有统计学意义(P<0.01)。(4)治疗后,2组RA患者的血清TNF-α、C反应蛋白(CRP)、白细胞介素6(IL-6)水平均较治疗前降低(P<0.05),且中西结合组治疗后的血清TNF-α、CRP、IL-6水平均明显低于西医组,差异均有统计学意义(P<0.01)。【结论】RA患者血清TNF-α与骨密度呈负相关性,瓜蒌桂枝汤可有效缓解RA患者关节疼痛、僵硬等症状,抑制炎症因子释放,减轻炎症反应,对于预防骨密度降低和骨质疏松具有一定的积极意义。

Effect of depot medroxyprogesterone acetate(DMPA) on bone mineral density(BMD) and evaluating changes in BMD after discontinuation of DMPA in adolescent women

Objective To compare bone mineral density （BMD） between users of intramuscular depot medroxyprogesterone acetate （DMPA） and nonhormonal subjects and evaluated the changes in BMD after discontinuation of DMPA.Methods The study included 102 women aged 16-18 years using DMPA for 24 months and 97 same-age nonusers. BMD of the lumbar spine and femoral neck were measured using dual-energy X-ray absorptiometry. The mean BMD values were compared between DMPA users （DMPA group） and nonusers （control group） and the changes of BMD during 36 months after discontinuation of DMPA were observed.Results Mean BMD at the spine and femoral neck did not differ significantly between DMPA group and control group over 12 months, but the BMD values at both anatomical sites were significantly lower in DMPA group than in control group after 24 months treatment. After DMPA discontinuation, the mean BMD values in DMPA users increased substantially. At 24 months after DMPA discontinuation, there were no significant differences between DMPA group and control group. But the values of the lumbar spine and femoral neck BMD in DMPA group were still 1.70% and 1.87%, respectively, below nonusers at 36 months after DMPA discontinuation.Conclusion The use of DMPA for short-term （ ≤12 months） had no significant effects on BMD at spine and femoral neck, but long-term exposure to DMPA had significant loss in BMD in adolescents. Bone loss occurring with DMPA use is reversible after DMPA discontinuation.

葛根异黄酮对去卵巢大鼠骨矿密度和骨强度的影响

目的 研究葛根总异黄酮 (TIP)对雌激素缺乏引起的骨质疏松症的防治作用。方法 10月龄 SD大鼠 ,手术切除双侧卵巢后 7d,每天 ig TIP10 0和 2 0 mg/kg,并设假手术组 (Sham)、模型对照组 (OVX)和尼尔雌醇阳性组(E3)。在给药 4和 7个月时 ,测定大鼠全身骨矿总量 (BMC)和骨矿密度 (BMD)及骨生物力学强度等。结果 (1)和OVX组相比 ,TIP大剂量组在给药 4个月时 BMC和 BMD分别提高 14.6 %和 12 .1% ,7个月时分别提高 6 .8%和14.2 % ;小剂量组 4个月时分别提高 7.8%和 6 .9% ,7个月时分别提高 8.6 %和 14.9%。 (2 ) TIP大、小剂量组股骨相对体积质量分别提高 3.8%和 3.4% ;胫骨相对体积质量分别提高 6 .8%和 6 .3% ;股骨 Ca盐密度均提高 15 %以上。 (3) TIP大、小剂量组股骨最大负荷分别提高 16 .1%和 9.1% ;结构强度分别提高 19.4%和 12 .5 %。 (4) TIP使大鼠子宫重量明显增加。结论 TIP对去卵巢引起的大鼠骨质疏松症具有明显的防治作用 ,这种作用可能和它的弱雌激素样活性有关。