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老年男性桡骨骨密度的纵向变化

Longitudinal changes in radial bone density in older men.

作者信息

Overton T R, Basu T K

机构信息

Department of Biomedical Engineering, University of Alberta, Edmonton, Canada.

出版信息

Eur J Clin Nutr. 1999 Mar;53(3):211-5. doi: 10.1038/sj.ejcn.1600703.

Abstract

OBJECTIVE

To examine changes in radial bone density and biochemical status, with particular reference to calcium, over 18 months in a group of older men.

SUBJECTS

Thirty-six healthy men (aged 66 76 y) were recruited to the study during July and August, 1993. These men were free-living residents of Edmonton who were recruited through local organizations for the retired and semi-retired. Data for the younger group of men (age 29-60 y) were taken from a previous study conducted in our laboratory.

DESIGN

using special-purpose computed tomography (gammaCT), trabecular (TBD), cortical (CBD) and integral (IBD) bone densities (gm/cm3) were measured in the ultra-distal radius at 6-month intervals over 18 months. At baseline, and at each subsequent study visit, serum was obtained from each subject for determinations of calcium, phosphate, 25-hydroxyvitamin D, alkaline phosphatase, and immunoreactive parathyroid hormone. A 24-h urine sample was also obtained at each study visit for determination of urinary calcium, phosphate and creatinine.

RESULTS

In repeated measures analysis of variance of the data for the older men serum 25-hydroxyvitamin D was significantly decreased (P<0.001) over time, while TBD was increased (+0.60% per year, P<0.01). Longitudinal rates of change for TBD, CBD and IBD were: -0.94%, 0.92% and 0.74% per year respectively when bone density data at baseline for the older men and the historical data for younger men were combined. However, separate analyses of the data for the younger and the older men indicated no significant age-related changes in bone density for men aged 29-60 y, or for men aged 66-76 y. However, differences in TBD, CBD and IBD between the younger and older groups of men were significant (P < 0.001).

CONCLUSIONS

In a group (n = 36) of older men (mean age 71.7 y) studied longitudinally over 18 months, bone density in the distal radius did not decrease over time. Mean bone density in this group of men was, however, significantly (P < 0.001) lower than in a group of younger men (n = 17, mean age 46.7 y). Regression analysis using cross-sectional bone density data at baseline for the older male group, and historical data for the younger male group, indicates that bone loss occurs with increasing age at a rate of about 1% per year averaged over ages 29-76 y. Bone density variables were not correlated with either height or weight, or with any biochemical or hormonal variable measured in this study.

摘要

目的

研究一组老年男性在18个月内桡骨骨密度及生化指标的变化,尤其关注钙的变化情况。

对象

1993年7月和8月招募了36名健康男性(年龄66 - 76岁)参与本研究。这些男性是埃德蒙顿的自由居住者,通过当地退休和半退休人员组织招募而来。较年轻男性组(年龄29 - 60岁)的数据取自我们实验室之前进行的一项研究。

设计

使用专用计算机断层扫描(γCT),在18个月内每隔6个月测量一次桡骨超远端的小梁骨密度(TBD)、皮质骨密度(CBD)和整体骨密度(IBD)(克/立方厘米)。在基线时以及随后的每次研究访视时,采集每位受试者的血清,用于测定钙、磷、25 - 羟基维生素D、碱性磷酸酶和免疫反应性甲状旁腺激素。每次研究访视时还采集24小时尿液样本,用于测定尿钙、磷和肌酐。

结果

在对老年男性数据进行的重复测量方差分析中,血清25 - 羟基维生素D随时间显著降低(P < 0.001),而小梁骨密度增加(每年增加0.60%,P < 0.01)。当将老年男性的基线骨密度数据与年轻男性的历史数据合并时,小梁骨密度、皮质骨密度和整体骨密度的纵向变化率分别为每年 - 0.94%、0.92%和0.74%。然而,对年轻男性和老年男性的数据分别进行分析表明,29 - 60岁男性或66 - 76岁男性的骨密度没有明显的年龄相关变化。但是,年轻男性组和老年男性组之间的小梁骨密度、皮质骨密度和整体骨密度差异显著(P < 0.001)。

结论

在一组(n = 36)平均年龄71.7岁的老年男性中进行了为期18个月的纵向研究,桡骨远端骨密度并未随时间下降。然而,该组男性的平均骨密度显著低于一组较年轻男性(n = 17,平均年龄46.7岁)(P < 0.001)。使用老年男性组基线时的横断面骨密度数据和年轻男性组的历史数据进行回归分析表明,在29 - 76岁年龄段,骨量流失随年龄增长的速率约为每年1%。骨密度变量与身高、体重以及本研究中测量的任何生化或激素变量均无相关性。

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