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[绝经前后女性超声测量骨矿物质密度——与性激素及营养状况的关系]

[Bone mineral density by ultrasonic measurement in pre- and postmenopausal women--relationship with sex hormones and nutritional states].

作者信息

Shono N, Kugino K, Yoshida S, Nakayama M, Ueno H, Nishizumi M

机构信息

Department of Community Health Science, Saga Medical School, Japan.

出版信息

Nihon Eiseigaku Zasshi. 1997 Jan;51(4):755-62. doi: 10.1265/jjh.51.755.

Abstract

In this cross-sectional study we evaluated the relationships of the sex hormones, estradiol (E2), free testosterone (free T), dehydroepiandrosterone-sulfate (DHEA-S), sex hormone-binding globulin (SHBG) and nutritional status to bone density assessed by ultrasonic measurements. The subjects were 16 premenopausal (38-50 years) and 28 postmenopausal (47-86 years) women living in a rural area in Yamaguchi Prefecture in Japan. They were healthy and did not smoke or drink. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and the stiffness index (SI) were used as the indices to evaluate ultrasonic bone density (UBD) for the calcaneus. In premenopausal women, the concentration of free T was negatively associated with BUA. The DHEA-S concentration had a significant negative correlation with BUA after adjustments for age and body mass index (BMI). Daily intakes of fat, animal fat, animal protein, calcium (Ca) and vitamin B2 (Vit B2) were positively associated with UBD. In postmenopausal women, although DHEA-S positively correlated with SOS, BUA and SI, the significance disappeared after adjustments for age and BMI. The protein intake was positively associated with BUA. Multiple regression analysis for SOS, BUA and SI as dependent variables was performed. Independent variables were age, BMI, E2, free T, DHEA-S, SHBG and daily intakes of animal fat, animal protein, Vit B2 and Ca. In premenopausal women, the animal fat intake contributed significantly and positively to the variations of SOS and SI. The intake of Vit B2 had a significant positive correlation, and the level of DHEA-S had a significant negative correlation with BUA. In postmenopausal women, age and BMI contributed significantly to the variations of SOS, BUA and SI, while the nutritional variables and the sex hormones were not found to be significant. In conclusion, different factors predicting UBD were suggested for pre- and postmenopausal women. In premenopausal women, daily intakes of animal fat and Vit B2 might be effective to maintain higher bone density. Further investigations are still needed to clarify the relationship between DHEA-S and UBD.

摘要

在这项横断面研究中,我们评估了性激素(雌二醇(E2)、游离睾酮(游离T)、硫酸脱氢表雄酮(DHEA-S)、性激素结合球蛋白(SHBG))及营养状况与通过超声测量评估的骨密度之间的关系。研究对象为居住在日本山口县农村地区的16名绝经前(38 - 50岁)和28名绝经后(47 - 86岁)女性。她们身体健康,不吸烟、不饮酒。声速(SOS)、宽带超声衰减(BUA)和硬度指数(SI)被用作评估跟骨超声骨密度(UBD)的指标。在绝经前女性中,游离T浓度与BUA呈负相关。在校正年龄和体重指数(BMI)后,DHEA-S浓度与BUA呈显著负相关。脂肪、动物脂肪、动物蛋白、钙(Ca)和维生素B2(维生素B2)的每日摄入量与UBD呈正相关。在绝经后女性中,尽管DHEA-S与SOS、BUA和SI呈正相关,但在校正年龄和BMI后,这种相关性消失。蛋白质摄入量与BUA呈正相关。以SOS、BUA和SI为因变量进行了多元回归分析。自变量为年龄、BMI、E2、游离T、DHEA-S、SHBG以及动物脂肪、动物蛋白、维生素B2和钙的每日摄入量。在绝经前女性中,动物脂肪摄入量对SOS和SI的变化有显著的正向贡献。维生素B2的摄入量与BUA呈显著正相关,而DHEA-S水平与BUA呈显著负相关。在绝经后女性中,年龄和BMI对SOS、BUA和SI的变化有显著贡献,而营养变量和性激素未显示出显著影响。总之,绝经前和绝经后女性预测UBD的因素不同。在绝经前女性中,每日摄入动物脂肪和维生素B2可能对维持较高骨密度有效。仍需进一步研究以阐明DHEA-S与UBD之间的关系。

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