Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all pat...Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.展开更多
目的分析亚洲人骨质疏松(osteporsis,OP)自我筛查工具(osteoporosis self-assessment tool for Asian,OSTA)指数与骨密度(bone mineral density,BMD)的相关性,并探讨跟骨定量超声(quantitative ultrasound,QUS)测定BMD对中老年男性OP的...目的分析亚洲人骨质疏松(osteporsis,OP)自我筛查工具(osteoporosis self-assessment tool for Asian,OSTA)指数与骨密度(bone mineral density,BMD)的相关性,并探讨跟骨定量超声(quantitative ultrasound,QUS)测定BMD对中老年男性OP的诊断价值。方法对893例45岁以上男性研究对象行QUS-BMD检查,记录跟骨QUS-BMD及QUS-T值,测量身高、体重,计算OSTA指数,其中255例研究对象同时行双能X线(dual-energy Xray absorptionmetry,DXA)BMD测定,按OSTA分层标准将受试者分为OP高、中、低风险组。比较各组间跟骨QUS-BMD、QUS-T以及各部位DXA-BMD的差异,分析OSTA指数与髋部、腰椎DXA-BMD的相关性。根据WHO的OP诊断金标准(骨质疏松:T值≤-2.5,骨量减少:-2.5<T值<-1,骨量正常:T值≥-1)将受试者分为OP组、骨量减少组和骨量正常组,评价跟骨QUS-T值对OP的诊断价值。结果 DXA-BMD测定者中,OP者71例(27.8%),骨量减少者143例(56.1%),骨量正常者41例(16.1%)。OSTA分层高、中、低不同OP风险组中,股骨颈、全髋和全腰椎BMD逐渐升高,高危组明显低于中危组和低危组(P<0.05),而中、低危组间的差异无统计学意义(P>0.05)。OP风险高、中、低危3组中OP患病例数分别为37例(48.7%)、17例(17.5%)和17例(20.7%),高危组中OP患病例数显著高于中、低危组(P<0.05)。Spearman相关分析示OSTA指数与股骨颈、全髋及全腰椎BMD呈显著正相关(P<0.05),相应的相关系数分别为0.448、0.439和0.141。跟骨QUS-BMD和QUS-T值在不同OP风险组间的差异无统计学意义(P>0.05)。跟骨QUS-T值诊断OP的曲线下面积为0.753,最佳截断值为-1.3,相应的灵敏度和特异度分别为77.5%和61.4%。结论随着OSTA指数升高,OP风险降低,股骨颈、全髋及全腰椎的BMD升高,OSTA指数与各部位DXA-BMD成线性正相关。OSTA指数和跟骨QUST值对诊断中老年男性OP症筛查具有一定的价值。展开更多
目的通过骨密度(bone mineral density,BMD)比较、SF-36生存质量评分指标的变化来观察益气温经方(即强骨饮颗粒)治疗绝经后骨质疏松性髋部骨折的临床疗效。方法以2013年6月—2014年8月在浙江中医药大学附属第二医院骨科的绝经后骨质疏...目的通过骨密度(bone mineral density,BMD)比较、SF-36生存质量评分指标的变化来观察益气温经方(即强骨饮颗粒)治疗绝经后骨质疏松性髋部骨折的临床疗效。方法以2013年6月—2014年8月在浙江中医药大学附属第二医院骨科的绝经后骨质疏松性髋部骨折患者为研究对象,将符合入选标准的120例患者随机分为益气温经方组、基础用药组和仙灵骨葆组,每组40例。基础用药组每日服用钙尔奇D3片和阿法骨化醇胶囊;仙灵骨葆组在基础用药组的基础上,加仙灵骨葆胶囊;益气温经方组在基础用药组的基础上,加益气温经方。经6个月治疗后,观察各组BMD和SF-36生存质量评分。结果治疗6个月后,益气温经方组和仙灵骨葆组经治疗后BMD均有提高(P<0.05),优于基础用药组(P<0.05);益气温经方组BMD的平均增加量(2.21%)高于仙灵骨葆组(1.95%),差异无统计学意义;与基础用药组相比,2组平均变化率比较有明显差异(P<0.05)。各组治疗后各维度生存质量评分均有上升,各维度组内治疗前后比较,差异有统计学意义(P<0.05);益气温经方组在生理功能、生理职能、活力、社会功能方面优于基础用药组(P<0.05);在躯体疼痛、总体健康、情感职能、精神健康方面,与各组间差异无统计学意义。结论益气温经方防治绝经后骨质疏松性髋部骨折可有效提高患者的生存质量,提升其腰椎的BMD。展开更多
文摘Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.
文摘目的通过骨密度(bone mineral density,BMD)比较、SF-36生存质量评分指标的变化来观察益气温经方(即强骨饮颗粒)治疗绝经后骨质疏松性髋部骨折的临床疗效。方法以2013年6月—2014年8月在浙江中医药大学附属第二医院骨科的绝经后骨质疏松性髋部骨折患者为研究对象,将符合入选标准的120例患者随机分为益气温经方组、基础用药组和仙灵骨葆组,每组40例。基础用药组每日服用钙尔奇D3片和阿法骨化醇胶囊;仙灵骨葆组在基础用药组的基础上,加仙灵骨葆胶囊;益气温经方组在基础用药组的基础上,加益气温经方。经6个月治疗后,观察各组BMD和SF-36生存质量评分。结果治疗6个月后,益气温经方组和仙灵骨葆组经治疗后BMD均有提高(P<0.05),优于基础用药组(P<0.05);益气温经方组BMD的平均增加量(2.21%)高于仙灵骨葆组(1.95%),差异无统计学意义;与基础用药组相比,2组平均变化率比较有明显差异(P<0.05)。各组治疗后各维度生存质量评分均有上升,各维度组内治疗前后比较,差异有统计学意义(P<0.05);益气温经方组在生理功能、生理职能、活力、社会功能方面优于基础用药组(P<0.05);在躯体疼痛、总体健康、情感职能、精神健康方面,与各组间差异无统计学意义。结论益气温经方防治绝经后骨质疏松性髋部骨折可有效提高患者的生存质量,提升其腰椎的BMD。
