Ghannam N N, Hammami M M, Bakheet S M, Khan B A
Department of Medicine (MBC-46), King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia.
Calcif Tissue Int. 1999 Jul;65(1):23-8. doi: 10.1007/s002239900652.
Bone mineral density (BMD) measurements of the anterio-posterior lumbar spine and the proximal femur using dual-energy x-ray absorptiometry, as well as relevant clinical and biochemical parameters, were determined in 321 healthy Saudi females in order to establish reference values and to study the effects of physical and lifestyle factors on BMD. Mean +/- SD of age, body mass index (BMI), number of pregnancies, and total duration of lactation were 35.4 +/- 11.3 years, 26.5 +/- 5.2 kg/m2, 3.1 +/- 3.1, and 23.7 +/- 42.4 months, respectively. Mean +/- SD of serum calcium, 25-hydroxyvitamin D (25OHD), and PTH levels were 2.37 +/- 0.09 mmol/liter, 24.5 +/- 17.2 nmol/liter, and 52.0 +/- 30.8 pg/ml, respectively. Peak BMD values were observed around age 35 years at the spine and earlier at the femur. Compared with USA females, Saudi females had lower weight-matched Z scores at the spine (-0.126 +/- 1. 078, P = 0.04), femoral neck (-0.234 +/- 0.846, P < 0.0001), and Ward's triangle (-0.269 +/- 1.015, P < 0.0001). Further, the prevalence of osteopenia and osteoporosis in subjects >/=31 years old were 18-41% and 0-7%, respectively, depending on the site examined. Severe hypovitaminosis D (25OHD level </=20 nmol/liter) was present in 52% of the subjects. However, there was no correlation between 25OHD level and BMD at any site. Parathyroid hormone (PTH) levels correlated significantly with 25OHD levels (r = -0.28, P < 0.0001) and with weight-matched BMD Z scores at the spine (r = -0.17, P = 0.005), femoral neck (r = -0.16, P = 0.007), and Ward's triangle (r = -0.2, P = 0.0008), suggesting that the distribution of 25OHD levels in the cohort is below the threshold needed for maintaining normal BMD. On the other hand, number of pregnancies and total duration of lactation correlated with weight-matched BMD Z scores at the spine (r = -0.17, P = 0.003; r = -0.1, P = 0.08, respectively). We conclude that BMD in healthy Saudi females is significantly lower than in their USA counterparts. This may be due in part to increased number of pregnancies and longer duration of lactation together with prevalent vitamin D deficiency. http://link.springer-ny.com/link/service/journals/00223/bibs /65n1p23. html
为了建立参考值并研究身体和生活方式因素对骨密度（BMD）的影响，我们对321名健康的沙特女性进行了双能X线吸收法测量腰椎前后位和股骨近端的骨密度，以及相关的临床和生化参数。年龄、体重指数（BMI）、怀孕次数和哺乳总时长的平均值±标准差分别为35.4±11.3岁、26.5±5.2kg/m²、3.1±3.1次和23.7±42.4个月。血清钙、25-羟基维生素D（25OHD）和甲状旁腺激素（PTH）水平的平均值±标准差分别为2.37±0.09mmol/升、24.5±17.2nmol/升和52.0±30.8pg/ml。脊柱的骨密度峰值在35岁左右出现，而股骨的骨密度峰值出现得更早。与美国女性相比，沙特女性在脊柱（-0.126±1.078，P = 0.04）、股骨颈（-0.234±0.846，P < 0.0001）和沃德三角区（-0.269±1.015，P < 0.0001）的体重匹配Z评分较低。此外，根据检查部位的不同，31岁及以上受试者中骨质减少和骨质疏松的患病率分别为18 - 41%和0 - 7%。52%的受试者存在严重维生素D缺乏症（25OHD水平≤20nmol/升）。然而，25OHD水平与任何部位的骨密度之间均无相关性。甲状旁腺激素（PTH）水平与25OHD水平显著相关（r = -0.28，P < 0.0001），与脊柱（r = -0.17，P = 0.005）、股骨颈（r = -0.16，P = 0.007）和沃德三角区（r = -0.2，P = 0.0008）的体重匹配骨密度Z评分也显著相关，这表明该队列中25OHD水平的分布低于维持正常骨密度所需的阈值。另一方面，怀孕次数和哺乳总时长与脊柱的体重匹配骨密度Z评分相关（分别为r = -0.17，P = 0.003；r = -0.1，P = 0.08）。我们得出结论，健康沙特女性的骨密度显著低于美国女性。这可能部分归因于怀孕次数增加、哺乳时间延长以及普遍存在的维生素D缺乏。http://link.springer-ny.com/link/service/journals/00223/bibs / 65n1p23.html
