绝经后骨质疏松症的流行病学调查

绝经后骨质疏松症的流行病学调查邢淑敏绝经后骨质疏松症（ＰＭＯ）流行病学调查涉及内容较广，包括研究其在不同群体妇女中的发病情况及对健康的危害，分析有关发病的危险因素，提出预防措施，以将其危害减到最低的程度．ＰＭＯ的诊断标准尚未取得统一，国际采用的最新标...

Association of CA Repeat Polymorphism in Estrogen Receptor β Gene with Postmenopausal Osteoporosis in Chinese

Postmenopausal osteoporosis （PMO） is considered a polygenic disease. The estrogen receptor β （ESR2） gene is a candidate mediating the genetic influence on bone mass and the risk of osteoporosis. The aim of this study is to investigate the association of a cytosine-adenine （CA） repeat polymorphism in the fifth intron of the ESR2 gene with PMO in Chinese Han population. The CA repeat polymorphism was genotyped in a case-control study, involving 78 femoral neck PMO patients vs. 122 controls and 108 lumbar spine （L2-4） PMO patients vs. 92 controls. The （CA）n〈22 and （CA）n≥22 alleles were designated short （S） and long （L）, respectively. ESR2 genotype was categorically defined as SS （2 S alleles）, SL （having the mixed S and L alleles）, and LL （2 L alleles）. At both the femoral neck and the L2-4 region, LL genotype and L allele frequencies of the PMO group were significantly higher than those of the control group （P〈0.01）. The subjects with the SL, the LL, and the combined SL and LL genotype had a significant increased risk of PMO when compared with those with the SS genotype （P〈0.05）. After adjustments for age, years since menopause, menopausal age, and body mass index, logistic regression analysis showed that the subjects with the combined SL and LL genotype had increased risk of PMO when compared with those with the SS genotype both at the femoral neck （adjusted OR 4.923, 95% CI 1.986-12.203 , P=0.001） and the L2-4 （adjusted OR 2.267, 95% CI 1.121-4.598, P=0.023）. This extensive association study has identified the ESR2 CA repeat polymorphism to be independently associated with PMO at the femoral neck and the L2-4 in Chinese Han population. The data also suggested that the presence of the L allele may dominantly increase the risk of PMO at the two regions.

The Effect of Acupuncture on Bone Mineral Density in Postmenopausal Women

According to the TCM theory that the kidney is in charge of the bone, the authors carried out a study on the effect of acupuncture on bone mineral density in 40 postmenopausal women with osteoporosis treated by the method of reinforcing the kidney to strengthen the bone, with satisfactory therapeutic results reported as follows.……

EFFECT OF ACUPUNCTURE ON SERUM INTERLUKIN-6 IN WOMEN WITH POSTMENOPAUSAL OSTEOPOROSIS

: To observe the effect of acupuncture on serum interlukin-6 (IL-6) level in women with post-menopausal osteoporosis. Methods: 59 cases of postmenopausal osteoporosis women were randomly divided into acupunctue group(n=32) and calcium D group(n = 27). In acupuncture group, Zusanli (ST 36), Sanyinjiao (SP 6), Shenshu (BL 23) and Pishu (BL 20) were punctured, 3 times every week, continuously for 6 months. In control group, patients were ordered to take Calcium D, one pill (containing 1500 mg calcium carbonate and VitD3) every morning, continuously for 6 months. Serum IL-6 was detected using radioimmunoassay. Results: After six months' treatment, the result showed that in acupuncture group serum IL-6 calcium level lowered while in control group serum IL-6 content increased. Statistical analysis indicates that there are no significant differences between two groups or between pre-treatment and post-treatment in every single group( P > 0.05). Conclusion: Although no statistical difference was found between two groups, acupuncture could decrease secretion of IL-6 in postmenopausal osteoporosis women to a certain degree, refrain the activity of osteoclast and improve the quality of bone.

Role of Sclerostin in the Bone Loss of Postmenopausal Chinese Women with Type 2 Diabetes

Objective To evaluate the role of sclerostin in bone loss of postmenopausal Chinese women with type 2 diabetes me｜litus. Methods The postmenopausal patients suffering from type 2 diabetes mellitus and age, body mass index, and duration of menopause matched healthy controls were enrolled into this cross-sectional study according to criteria of inclusion and exclusion.

Osteoporosis in celiac disease and in endocrine and reproductive disorders

As the increase in lifespan brings to light diseases that were previously not clinically detectable,osteoporosis has become an issue of worldwide significance. The disease is marked by a loss of bone mass; the bones become less dense,fragile and more prone to fracturing. Because it is regulated by endocrine and environmental factors,osteoporosis presents a multifactorial etiopathogenesis,with the genetic component accounting for 70% of an individual variation in bone mass density (BMD),the principal determinant,with age,of fracture risk. Pathological conditions such as celiac disease (CD) exacerbate the process of bone loss,so that the occurrence of osteoporosis in celiac subjects is of particular note: indeed,the screening of osteoporosis patients for this disease is advisable,since it may be the only sign of undiagnosed CD. An increase in interleukin IL-1β,of the IL-1 system,in the relatives of celiac patients confirms the genetic predisposition to osteoporosis and its presence is evidence of an association between the two conditions. The direct effect on the bones of CD is secondary to poor absorption of calcium and vitamin D. In women osteoporosis is indirectly associated with early menopause and amenorrhea,and it may follow prolonged breast-feeding and frequent pregnancies,while in men it is associated with hypogonadism and GH deficit. These endocrine and non-endocrine factors exert their effects on bones by modulating the RANK/RANK-L/OPG system. An appropriate lifestyle from adolescence onwards,together with early diagnosis of and treatment for CD and primary and secondary endocrine pathologies are important for the prevention of damage to the bones.

The Present State and Perspective in Treatment of Primary Osteoporosis by Acupuncture and Moxibustion

Primary osteoporosis, a commonly encountered metabolic bone disease in the postmenopausal women and the aged people, can be classified by modern medicine into postmenopausal osteoporosis (Type I) and senile osteoporosis (Type II). The disease seriously affects health and quality of life of the people as it often cause ostealgia, fracture and the secondary symptoms or diseases. Presently, the pharmacotherapy (including both Chinese herbal drugs and western drugs) remains the first among all other therapeutic methods which are mainly adopted in treatment of the disease at home and abroad. Studies related have been curried out quite early and systematically, and considerable progress has been made, but limit of the pharmacotherapy has also been found. Certain non-drug treatments (such as dietetic therapy, physical exercise, acupuncture and moxibustion, and qigong, especially acupuncture and moxibustion therapy, although with a late start, have been proved effective with satisfactory results. The following is a summary of all the contributions concerned.……

The Effect of Age and Markers of Obesity on Bone Density in Iraqi Postmenopausal Women

Osteoporosis is a disease characterized by a low bone mineral density and structural deterioration of bone tissue. Leptin is considered to play a role in the maintenance of energy balance and body weight. Weight and body mass index are associated with low bone mineral density with high serum leptin concentration in older women. The study is designed to elucidate the impact of age and BMI （Body Mass Index） on osteoporotic patients （Iraqi postmenopausal women） and the functional role of leptin in those patients. A total of 72 patients divided into three groups according to BMI and two groups according to age： BMD （bone mineral density）, T-score and serum leptin concentration increased as BMI increased, while with increased age, BMD and T-score deceased and serum leptin concentration increased. There is a significant difference of BMD and T-score in BMI （25-30） group and BMI （〉 30） group from that in BMI （〈 25） group. In conclusions： Both age and BMI have an impact on osteoporosis although age shows more impact on the severity of the disease than does BMI. Studying the direct impact of leptin on BMD may open the way in using new methods in treating and preventing the osteoporosis in patients with risk factors.

Relationships between endothelial nitric oxide synthase gene polymorphisms and osteoporosis in postmenopausal women

Objective： To investigate the relationships between endothelial nitric oxide synthases （eNOS） G894T and 27 bpvariable number tandem repeat （VNTR） gene polymorphisms and osteoporosis in the postmenopausal women of Chinese Han nationality. Methods： In the present study, 281 postmenopausal women from Xi＇an urban area in West China were recruited, and divided into osteoporosis, osteopenia, and normal groups according to the diagnostic criteria of osteoporosis proposed by World Health Organization （WHO）. The bone mineral density （BMD） values of lumbar vertebrae and left hips were determined by QDR-2000 dual energy X-ray absorptiometry. Blood samples were tested for plasma biochemical indicators including testosterone, estradiol, calcitonin, osteocalcin, and procollagen type I amino-terminal propeptide by enzyme-linked immunosorbent assay （ELISA）, tartrate-resistant acid phosphatase by spectrophotometric method, and the content of nitric oxide by Griess method. Genome DNA was extracted from whole blood, and G894T polymorphism of eNOS gene was analyzed by using polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） method and 27 bp-VNTR polymorphism of eNOS gene was genotyped by PCR method. Then the relationships between genotypes and biochemical indicators, genotypes and osteoporosis, and haplotypes and osteoporosis were analyzed. Results： The average BMD values of the femoral neck, ward＇s triangle and lumbar vertebrae 1-4 （LI-L4） in the subjects with T/T genotype in eNOS G894T locus were significantly higher than those in the subjects with G/T and G/G genotypes （P〈0.05）. The average BMD of the femoral neck in the subjects with a/a genotype of eNOS 27 bp-VNTR locus was evidently higher than that in the subjects with b/b genotype （P〈0.05）. The plasma testosterone and osteocalcin concentrations in the subjects of eNOS G894T G/T genotype were evidently higher than those in the subjects of other genotypes （P〈0.05）; the plasma estradiol concentration in the subjects of eNOS 27 bp-VNTR a/a genotype was obviously higher than that in the subjects of b/b genotype （P〈0.01）. eNOS G/G homozygous frequencies in osteoporosis women, osteopenia women, and normal women were 85.37%, 76.38%, and 83.87%, respectively （P〉0.05）. 0% osteoporosis woman, 0.79% osteopenia women, and 3.23% normal women were eNOS a/a homozygous （P〈0.05）. The frequencies of eNOS 27 bp-VNTR a allele were 5.33% in the osteoporosis group, 10.24% in the osteopenia group, and 16.13% in the normal group （P〈0.05, odds ratio （OR）=0.29, 95% confidence interval （CI）=0.11-0.77）, suggesting that a/a genotype and a allele might have protective effects on osteoporosis. The haplotype analysis showed that G-b was 87.7% （214/244） in the osteoporosis group （P〈0.05, OR=2.48, 95% CI=1. 18-5.18）. G-a was 5.3% （13/244） in the osteoporosis group （P〈0.05, OR=0.29, 95% CI=0. 11-0.77）. G-b was a risk factor for osteoporosis, and G-a a protective factor. Conclusion： eNOS G894T G/T genotype influenced the plasma testosterone and osteocalcin concentrations, and T/T genotype influenced BMD. eNOS 27 bp-VNTR a/a genotype increased plasma estradiol concentration to have a protective effect on osteoporosis.

Effect of Acupuncture plus Small Dosage of Herba Epimedii on Improving the Life Quality of Climacteric Postmenopausal Women

Objective： To investigate the effects of acupuncture and combined acupuncture and medicine on the quality of life and the genital endocrine level in postmenopausal women. Methods： Forty-seven patients were randomly assigned to acupuncture and acupuncture plus medicine groups, 23 cases in the acupuncture group and 24 cases in the acupuncture plus medicine group. The observed course of treatment was 3 months. A Chinese concise SF 36 questionnaire was used to evaluate the quality of life in the different groups of patients before and after treatment. Meanwhile, radioimmunoassay was used to observe the differences in serum genital hormones： follicle stimulating hormone （FSH）, luteinizing hormone （LH） and estradiol （E2） contents between pretreatment and posttreatment in both groups. Results： After treatment, there was a significant difference in quality of life between the two groups and it was better in the acupuncture plus medicine group than in the acupuncture group（P〈 0.01）. E2 content increased more markedly in the acupuncture plus medicine group than in the acupuncture group（P〈 0.05）. There were no significant differences in FSH and LH contents between the two groups（P 〉 0. 05）. Conclusion. Both acupuncture and acupuncture plus medicine can improve the quality of life and increase obviously low E2 content in postmenopausal women. Acupuncture plus medicine raises the patients＇ quality of life and E2 content more markedly than acupuncture. It is suggested that both acupuncture and acupuncture plus medicine can improve the symptoms, signs, and physical and mental health, raise the quality of life and ameliorate genital-endocrine environment in postmenopausal women, but a combination of acupuncture and medicine has a better effect.

Clinical Observation on Combined Acupuncture and Medication for Osteoporosis in Postmenopausal Women

Objective： To observe the clinical effect of combined acupuncture and medication for osteoporosis in postmenopausal women. Methods： A total of 100 cases with postmenopausal osteoporosis were randomly allocated into a treatment group and a control group, 50 in each group. The cases in the treatment group were treated with electroacupuncture coupled with Calcitriol soft capsules, while the cases in the control group were treated with electroacupuncture alone. Results： There were significant differences in treatment effects between the treatment group and control group （P〈0.05）. Conclusion： Combined acupuncture and medication can obtain a marked effect for postmenopausal osteoporosis.

Therapeutic Efficacy Observation on Acupuncture for Postmenopausal Osteoporosis

Objective: To observe the clinical efficacy of acupuncture for post- menopausal osteoporosis (PMOP). Methods: A total of 64 PMOP cases were randomized into an observation group and a control group, 32 cases in each group. Acupuncture was employed in the observation group, versus oral Osteoform capsule in the control group. After 3-month treatment, the Bone Density (BD) and Estradiol (E 2 ) were measured respectively before and after treatment, followed by statistical analysis on clinical efficacies in the two groups. Results: The total effective rate of the observation group was 81.3%, showing a statistical difference compared with the control group (P<0.05). After treatment, the BD measurements in all body regions of the observation group were significantly elevated (P<0.05), showing a statistical difference compared with the control group (P<0.05). Also, the E 2 levels in both groups were significantly increased (P<0.01), showing no between-group statistical significance (P>0.05). Conclusion: Acupuncture has exact efficacy for PMOP and is therefore effective for the prevention and treatment of PMOP.