Tamura K, Akiyama T, Taguchi A, Fujikawa H, Saitoh H, Yanaihara T
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1996 Nov;48(11):1079-84.
The bone mineral density in reproductive aged and pregnant women was measured with an ultrasound bone densitometer (Achilles, Luner Co, USA). Both parameters of bone density on Os calsis, sound of speed (SOS) and broad ultrasound attenuation (BUA) were significantly correlated with bone mineral density in lumbar2-4 measured by dual energy X-ray absorptiometry (DXA) (p < 0.01) in reproductive aged women (mean age; 24.5 +/- 2.3, n = 30). The changes in bone density during pregnancy and at delivery were studied. In a cross-sectional study, no significant changes in SOS, BUA and stiffness were observed, but in a longitudinal study (n = 21), all of these parameters decreased as pregnancy advanced. The markers of bone turnover (serum Ca, alkaline phosphatase, procollagen type 1-C peptide, urinary Ca/Cr and deoxypyridinoline/Cr) did not change during pregnancy. Ten pregnant women with low bone density (less than-1.5 SD mean value) were found. There was no significant difference between the markers of bone turnover in pregnant women with low and normal bone density. The clinical usefulness of the screening of bone density of reproductive aged and pregnant women to detect osteopenia is suggested.
采用超声骨密度仪(美国Luner公司的跟腱骨密度仪)测量育龄期及孕妇的骨矿物质密度。在育龄期女性(平均年龄24.5±2.3岁,n = 30)中,跟骨的两个骨密度参数,即声速(SOS)和宽带超声衰减(BUA),与双能X线吸收法(DXA)测量的腰2-4椎体骨矿物质密度显著相关(p < 0.01)。研究了孕期及分娩时骨密度的变化。在一项横断面研究中,未观察到SOS、BUA和硬度有显著变化,但在一项纵向研究(n = 21)中,随着孕期进展,所有这些参数均下降。骨转换标志物(血清钙、碱性磷酸酶、1型前胶原C肽、尿钙/肌酐和脱氧吡啶啉/肌酐)在孕期未发生变化。发现10名骨密度低(低于平均值-1.5标准差)的孕妇。骨密度低和正常的孕妇之间,骨转换标志物无显著差异。提示对育龄期及孕妇进行骨密度筛查以检测骨质减少具有临床实用性。