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.

Objective The effect of dietary restriction, intense exercise end menstrual dysfunction on bone mineral density remains controversial. The aim of this study was to assess the skeletal health status and relationship between bone mineral density end nutrient intake, menstrual status, estrogen level and other factos in Chinese adolescent dancers. Methods Sixty dancers and 77 healthy controls underwent measurements of bone density, body composition, and estrogen level. Nutrient intake, menstrual status and physical activity were assessed with questionnaires. The correlation between these factors were analyzed. Results The dancers under study had a significantly lean body mass index (18.3±1.4 kg/m2 vs. 21.7±3.1 kg/m2), lower percentage of body fat (0.25±0.05 vs. 0.34±0.04) end later age at menarche (14.0±0.9 y vs.13.0±1.3 y), and the estrogen level, daily calorie and fat intake in them were also lower than in the controls. All the dancers undertook intensive physical activity every day and up to 69% of them suffered from irregular menarche. Yet they had relatively high BMD and BMC of the total body and legs than the controls after adjusting for BMI end age. Site-specific BMD was positively correlated to BMI, body composition and training hours per week and negatively correlated to the age at menarche and menstrual frequency. Coneluslons The relatively high BMD and BMC of the dancers at the total body end legs were probably caused by high levels of weight-bearing physical activity. To ameliorate disordered eating, especially low energy intake might be helpful to prevent the Triad and to improve the bone health in adolescent dancers.

植物雌激素染料大素对去卵巢大鼠的骨代谢的影响

Objective Genistein,as a phytoestrogen,is a type of soybean-derived isoflavone that possesses structural similarity to become estrogen. The purpose of this study was to elucidate whether the administration of genistein, extracted from a Chinese herbal medicine Huaijiao ( Sophora japonica-Leguminosae) ,is capable of preventing rapid bone loss occurring in rats after surgical ovariectomy and improving the symptom caused by this. Methods Sixty rats were randomly divided into six groups, including control (sham-operated), ovariectomized model ( OVX) , E2-treated (E2) group that were subcutaneously injected with E2 at a dosage of 1.5 mg/kg once a week,and genistein-treated (Gen) groups at the dosage of 4. 5 rag/kg,9. 0 mg/kg and 18 mg/kg respectively. The treatment was administrated 8 days later after the operation. Samples were taken from every group randomly at 12 weeks after the treatment. Parameters,such as body weight,serum biochemical criterion,bone mineral density(BMD) and biomechanics, were evaluated. Results The results indicated that genistein could restrain body weight, increase the levels of serum Ca,Mg,P,calcitonin(CT) and decrease the levels of bone gla protein ( BGP) and alkaline phosphatase (ALP) significantly. Compared with OVX group, genistein at the dosage of 4. 5 mg/kg and 9 mg/kg enhanced the BMD of femur, tibias and L2-4. Genistein could also meliorate biomechanical indexes of rats (P<0. 05 or P<0. 01). Conclusions In comparison with the anti-osteoporosis effect of E2,the genistein extracted from Huaijiao has the same beneficial effect on anti-osteoporosis and has little side effect.

骨密度在老年髋部骨折预测中的应用

骨质疏松及其并发症是临床医生广为关注的难题.它能影响老年人的生存质量,甚至导致死亡.老年髋部骨折绝大多数是由骨质疏松引起,它是骨质疏松并发症中给老年患者带来痛苦大、治疗和预防难度大的疾病.面对发病率越来越高的老年髋部骨折,如何有效、积极地预防和治疗,需要我们更全面地掌握骨质疏松性骨折的发生和发展的规律,明确骨密度测定的重要性及骨折和骨质疏松的相关性.通过骨密度测定确定骨质疏松及骨折的危险人群,从而采取有效的保护措施,减少骨折的发生.

体脂量是绝经后女性股骨近端骨强度的决定因素

Objective To clarify the determinative role of lean mass (LM) and fat mass (FM) on geometric indices of the hip bone strength in healthy postmenopausal women.Methods A cross-sectional study was performed.One hundred and one healthy postmenopausal women, ageing from 48.8 to 82.6 years old, were involved.Bone mineral density (BMD) of the femoral neck (FN_BMD), the total hip (TH_BMD), and the proximal femur was detected using dual energy X-ray absorptiometry.Total FM and total LM were derived from the whole body scan.Multivariate linear regression models were used to assess the relationship. Results In univariate analysis, there was a significant negative correlation between advanced age, years since menopause and FN_BMD, TH_BMD, and the hip geometric parameters (CT, CSA, SM, and SI) (P<0.05 for all).Height, body weight, FM and LM had a positive relationship with bone data.In multiple liner regression analysis, both LM and FM were significant predictors of the hip BMD and hip structural geometric properties after controlling of age, height, years since menopause.However, when both LM and FM were included in the multivariate regression model after controlling for confounders above, the relationships between LM and bone data disappeared.Only FM was an independent predictor for bone mass and hip strength (P <0.001 for all). Variation explained by FM for FN_BMD, TH_BMD, and hip strength parameters (CT, CSA, SM, and SI) was 19.9%, 16.1%, 31.3%, 30.3%, 34.0%, and 24.4%, respectively.Conclusion These data suggest that FM, rather than LM, is independently associated with measures of the proximal femur strength in healthy postmenopausal women.

仙灵骨葆胶囊治疗骨质疏松症的疗效及其对骨代谢及骨转换指标的影响分析

目的：分析仙灵骨葆胶囊治疗骨质疏松症的疗效及其对骨代谢及骨转换指标的影响。方法将160例原发性骨质疏松症（ POP）患者分为观察组80例和对照组80例。对照组患者行钙尔奇D联合唑来膦酸盐治疗，观察组患者行仙灵骨葆胶囊治疗。于2组患者治疗前、治疗3疗程后及6个疗程后，测量患者的腰椎正位（L2－4）和右股骨颈的骨密度（BMD），并检测患者的骨代谢指标包括血钙（Ca）、磷（P）、碱性磷酸酶（ALP）及骨转换指标包括骨钙素（OC）和I型胶原交联 C－末端肽（CTX－1）。同时，分析BMD与OC、CTX－1的相关性。结果治疗后，2组患者的BMD较治疗前均增加（P均＜0．05），但治疗6个疗程后，观察组患者BMD的增加幅度大于对照组（P＜0．05）。治疗后，2组患者的OC均较治疗前上升（P均＜0．05）、CTX－1均较治疗前下降（P均＜0．05）；但治疗6个疗程后，观察组患者OC、CTX－1的改善幅度均大于对照组（P均＜0．05）。 BMD与OC呈正相关性（r＝0．352，P＝0．21），与CTX－1呈负相关性（r＝－0．453，P＝0．017）。结论仙灵骨葆胶囊治疗骨质疏松症的疗效显著，能有效增加患者的骨密度，改善骨代谢及骨转换状态，控制骨量减少；且OC、CTX－1与患者BMD密切相关，可作为评价POP疗效的有效指标。

转化生长因子β1与骨生化指标和骨密度的关系

背景:转化生长因子β1 是一种重要的调节骨构塑的细胞因子,其是否能作为反应骨转换的敏感因子尚不清楚.目的:探讨转化生长因子β1 与骨形成、骨吸收指标,以及腰椎正位骨密度间的关系.方法:实验共纳入来自长沙的健康妇女663 名,年龄20～80 岁.采用ELISA 法测定空腹血清转化生长因子β1、骨特异性碱性磷酸酶和Ⅰ型胶原羧基末端肽的水平,同时应用双能X 射线骨密度仪测定腰椎正位的骨密度.并分析转化生长因子β1 与其他各指标的相关性.结果与结论:检测结果显示30～39 岁,40～49 岁年龄段妇女的血清转化生长因子β1 水平高,转化生长因子β1 水平与年龄呈负相关,与体质量指数无相关.校正体质量指数后发现,转化生长因子β1 与骨特异性碱性磷酸酶和Ⅰ型胶原羧基末端肽负相关,校正体质量指数和年龄后血清转化生长因子β1 水平与腰椎正位骨密度正相关.说明转化生长因子β1 能动态地反映骨转换情况.

中国部分地区中老年人群骨质蔬松症流行病学研究

Objectives To understand the normal references of standardized bone mineral density (sBMD) in general population in China and investigate the distribution of prevalence rate and risk factories of osteoporosis in the middle-aged and elderly population in China. Methods Using the three manufactures of Dual Energy X- ray Absorptiometry (DEXA) equipment, Bone mineral density (BMD) was measured among 3521 general population aged above 20 years old in five area of China by the random sampling method ; Questionnaires and BMD were surveyed from 5593 people aged above 40 years old in five administrative areas in China, by the stratified-multi-steps-cluster sampling method; 216 variables were analyzed by the non-conditional logistic regression. Results We found out the standardized normal references of BMD and peak bone values in lumbar spine and proximal femur by sex and age; The total prevalence rate of osteoporosis in the population aged over 60 years old was 22.6% . Of them, the prevalence rate of male was 15.0% and that of female was 28.6% (P< 0.01); We screened 47 risk factors that influence the osteoporosis including the age , the chronic disease in respiration, the stomach trouble and the age of stop smoking which are common risk factors in male and female. Conclusions The prevalence rate of osteoporosis in females was higher than that of female and increased with age. The prevention and treatment of osteoporosis are very important to the female but should not be ignored in male; There are common influencing factors and there are some certain variances of the risk factors and exposed level in male and female in China.

乌鲁木齐地区妇女维生素D受体基因与骨密度关系研究

维生素D受体(VDR)基因与骨密度(BMD)的关系各家报道不一.本研究对乌鲁木齐地区维吾尔、哈萨克、蒙古三个民族绝经后妇女进行VDR基因多态性研究,同时测定BMD,探讨骨质疏松与遗传的关系.

绝经后女性骨密度与中心脉压关系的探讨

骨质疏校症是一种全身性的骨骼疾病,随着年龄的增大而日渐严重,特别在约经后女性人群中,这种骨代谢异常表现得尤为显著.

甲状旁腺激素基因多态性对广东地区老年人骨密度的影响

目的:探讨甲状旁腺素(PTH)基因多态性与中国广东地区部分老年人群骨密度的相关性.方法:随机筛选广东老年人549例,年龄65～87岁,平均(71.03±7.37)岁,采用双能X线吸收测定其腰椎侧位、股骨颈、粗隆间、大转子、ward's三角等部位的骨密度值.用聚合酶链反应及限制性片段长度多态性技术检测外周血白细胞基因组PTH基因型.结果:549例受试对象中,PTH基因BB型382例,69.6%;Bb型148例,27.0%;和bb型19例,3.4%.无论是整个受试群体,还是根据性别将其分为男性及女性群体,其等位基因及基因型分布均符合Hardy-Wenbeng平衡定律.分析基因型与骨密度的关系显示,不同的基因型之间的骨密度均无统计学意义变化(P>0.05).结论:PTH基因多态性与广东地区汉族老年人群骨密度关系不密切,不能作为筛查和预示骨质疏松症的遗传易感位点.

定量CT骨密度测量研究进展及其临床应用

定量CT(quantitative CT,QCT)是1982年由美国加州大学旧金山分校(UCSF)放射科的 Genant 等利用临床CT机进行骨密度测量的一种方法[1]。同时期的双能X 线吸收骨密度测量法(dual-energy X-ray absorptiometry,DXA)因其辐射剂量低、操作方便和市场优势等因素成为了临床骨密度测量的主要技术。近年来,随着多排螺旋 CT 和3 D QCT 技术的不断发展,QCT又重新开始受到人们的关注,越来越多地被应用到各种研究中。QCT 在国内也已经开展了相关的研究,但临床应用还没有普及。现就其技术特点和发展趋势综述如下。

Although insulin-like growth factor-I (IGF-I) and estrogen signaling pathways have been shown to be involved in mediating the bone anabolic response to mechanical loading, it is not known whether these two signaling pathways crosstalk with each other in producing a skeletal response to mechanical loading. To test this, at 5 weeks of age, partial ovariectomy (pOVX) or a sham operation was performed on heterozygous IGF-I conditional knockout (H IGF-I KO) and control mice generated using a Cre-loxP approach. At 10 weeks of age, a 10 N axial load was applied on the right tibia of these mice for a period of 2 weeks and the left tibia was used as an internal non-non-loaded control. At the cortical site, partial estrogen loss reduced total volumetric bone mineral density (BMD) by 5%in control pOVX mice (P50.05, one-way ANOVA), but not in the H IGF-I KO pOVX mice. At the trabecular site, bone volume/total volume (BV/TV) was reduced by 5%-6%in both control pOVX (P,0.05) and H IGF-I KO pOVX (P50.05) mice. Two weeks of mechanical loading caused a 7%-8%and an 11%-13%(P,0.05 vs. non-loaded bones) increase in cortical BMD and cortical thickness (Ct.Th), respectively, in the control sham, control pOVX and H IGF-I KO sham groups. By contrast, the magnitude of cortical BMD (4%, P50.13) and Ct.Th (6%, P,0.05) responses were reduced by 50%in the H IGF-I KO pOVX mice compared to the other three groups. The interaction between genotype and estrogen deficiency on the mechanical loading-induced cortical bone response was significant (P,0.05) by two-way ANOVA. Two weeks of axial loading caused similar increases in trabecular BV/TV (13%-17%) and thickness (17%-23%) in all four groups of mice. In conclusion, partial loss of both estrogen and IGF-I significantly reduced cortical but not the trabecular bone response to mechanical loading, providing in vivo evidence of the above crosstalk in mediating the bone response to loading.

Osteoporotic fractures are a major public health problem worldwide, but incidence varies greatly across racial groups and geographic regions. Recent work suggests that the incidence of osteoporotic fracture is rising among Asian populations. Studies comparing areal bone mineral density and fracture across races generally indicate lower bone mineral density in Asian individuals including the Chinese, but this does not reflect their relatively low risk of non-vertebral fractures. In contrast, the Chinese have relatively high vertebral fracture rates similar to that of Caucasians. The paradoxically low risk for some types of fractures among the Chinese despite their low areal bone mineral density has been elucidated in part by recent advances in skeletal imaging. New techniques for assessing bone quality non-invasively demonstrate that the Chinese compensate for smaller bone size by differences in hip geometry and microstructural skeletal organization. Studies evaluating factors influencing racial differences in bone remodeling, as well as bone acquisition and loss, may further elucidate racial variation in bone microstructure. Advances in understanding the microstructure of the Chinese skeleton have not only helped to explain the epidemiology of fracture in the Chinese, but may also provide insight into the epidemiology of fracture in other races as well.

Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women.