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香港围绝经期和绝经后中国女性桡骨远端骨密度及骨量流失的基线情况:采用外周定量计算机断层扫描测量

Baseline BMD and bone loss at distal radius measured by peripheral quantitative computed tomography in peri- and postmenopausal Hong Kong Chinese women.

作者信息

Qin L, Au S K, Leung P C, Lau M C, Woo J, Choy W Y, Hung W Y, Dambacher M A, Leung K S

机构信息

Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong.

出版信息

Osteoporos Int. 2002 Dec;13(12):962-70. doi: 10.1007/s001980200134.

Abstract

The current study was designed to investigate the rate of bone loss in distal radius and its association with baseline volumetric bone mineral density (BMD) and years since menopause (YSM) in peri- and postmenopausal women using precise and multislice peripheral quantitative computed tomography (pQCT; Densiscan 2000). Two hundred and five healthy Hong Kong Chinese perimenopausal ( n = 26) and postmenopausal ( n = 179) women within 10 years of the onset of menopause were recruited. Anthropometric parameters and menstrual status were also measured. The linear regression model derived from the baseline volumetric BMD revealed a significant and slightly better correlation with YSM than age, with a YSM-related annual decline of 2.56%, 1.82% and 0.65% in trabecular BMD (tBMD), integral BMD (iBMD) and cortical BMD (cBMD), respectively. Follow-up measurements after a time interval of 12 months showed that the rate of bone loss was higher than the annual decline in BMD calculated from the baseline BMD, with decreases of 2.89%, 2.16% 0.91% in tBMD, iBMD and cBMD, respectively. Baseline BMD was associated with age or YSM ( r ranges from -0.283 to -0.502; p<0.001 in all cases), but no relationship was found between annual rate of bone loss and age or YSM. The rate of bone loss did not correlate with baseline volumetric BMD values or YSM after dividing the subjects into fast bone losers (with annual tBMD loss > or =3%), normal bone losers (with annual tBMD loss > or = 1% but <3%) or slow bone losers (with annual tBMD loss <1%). The rate of bone loss was greater in both trabecular and cortical bone of postmenopausal women within the first 3 menopausal years but was only significant in the iBMD as compared with perimenopausal and postmenopausal women over 7 years after onset of menopause. The percentage distribution of slow and fast bone losers was not found to be associated with YSM. As a total of only 4 fracture cases were documented, the study could not provide conclusive information on whether perimenopausal and early postmenopausal baseline volumetric BMD or rate of bone loss determines the development of osteoporosis or fracture occurrence.

摘要

本研究旨在使用精确的多层外周定量计算机断层扫描(pQCT;Densiscan 2000),调查围绝经期和绝经后女性桡骨远端的骨质流失率及其与基线体积骨密度(BMD)和绝经年限(YSM)的关系。招募了205名健康的香港中国围绝经期(n = 26)和绝经后(n = 179)女性,她们均在绝经开始后10年内。还测量了人体测量参数和月经状况。从基线体积骨密度得出的线性回归模型显示,与年龄相比,YSM与之有显著且稍强的相关性,小梁骨密度(tBMD)、整体骨密度(iBMD)和皮质骨密度(cBMD)与YSM相关的年下降率分别为2.56%、1.82%和0.65%。在12个月的时间间隔后的随访测量显示,骨质流失率高于根据基线骨密度计算的骨密度年下降率,tBMD、iBMD和cBMD的下降率分别为2.89%、2.16%和0.91%。基线骨密度与年龄或YSM相关(r范围为-0.283至-0.502;所有情况下p<0.001),但未发现骨质流失年率与年龄或YSM之间存在关联。将受试者分为快速骨质流失者(年tBMD流失≥3%)、正常骨质流失者(年tBMD流失≥1%但<3%)或缓慢骨质流失者(年tBMD流失<1%)后,骨质流失率与基线体积骨密度值或YSM无关。绝经后女性在绝经后的前3年内,小梁骨和皮质骨的骨质流失率均较高,但与围绝经期和绝经后7年以上的女性相比,仅iBMD有显著差异。未发现缓慢和快速骨质流失者的百分比分布与YSM有关。由于总共仅记录了4例骨折病例,该研究无法提供关于围绝经期和绝经后早期基线体积骨密度或骨质流失率是否决定骨质疏松症的发展或骨折发生的确切信息。

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