Radial bone mineral density in pre- and perimenopausal women: a prospective study of rates and risk factors for loss.
Radial bone mineral density in pre- and perimenopausal women: a prospective study of rates and risk factors for loss.
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绝经前和围绝经期妇女的桡骨骨矿物质密度：丢失率和危险因素的前瞻性研究。
DOI：
10.1002/jbmr.5650070609
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Jannausch,M
中科院分区：
文献类型：
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作者：
Sowers,MR;Clark,MK;Hollis,B;Wallace,RB;Jannausch,M
1984年，采用单光子吸收法对来自一个农村社区的217名年龄在22-54岁之间的白色女性的桡骨骨密度（BMD）进行了评估。在手腕到手肘距离的三分之一处测量BMD，该部位主要代表皮质骨组织。这些妇女中的大多数（181; 83%）在5年后复查。总体平均5年桡骨BMD损失为-5.6%。随访时保持阳性雌激素状态的女性（n= 108）的平均丢失率为-4.5%，随访时雌激素状态为阴性的女性（n= 73）的平均丢失率为-7.4%。基线桡骨BMD测量对随访BMD值具有高度预测性（r= 0.80）。雌激素水平阳性和基线BMD值较高的女性BMD变化也较小。较高的基线骨密度并不能预测雌激素阴性妇女的变化量。骨转换标志物骨钙素和骨特异性碱性磷酸酶与雌激素阴性但不阳性女性的BMD变化显著相关。在基线和随访BMD测量中没有确定性证据表明存在“峰值年龄”。根据骨密度变化率，骨矿物质含量的“峰值”出现在25岁之前。与BMD水平降低显著相关的因素是绝经期未进行雌激素替代、未经产、吸烟和首次怀孕年龄。与更多骨质流失相关的因素是绝经期没有雌激素替代，吸烟，口服避孕药使用时间较短，年龄较大。克托莱指数、肌肉面积、流产次数、曾经母乳喂养或钙摄入量与BMD水平或其5年丢失率无关。在调整年龄或雌激素状态后，体力活动和饮酒与BMD水平或变化无关。
Radial bone mineral density (BMD) of 217 white women aged 22–54 years from a single rural community was evaluated in 1984 using single‐photon absorptiometry. BMD was measured at a site one‐third the distance from the wrist to the elbow, a site that represents predominantly cortical bone tissue. Most of these women (181; 83%) were reexamined 5 years later. The overall average 5 year radial BMD loss was ‐5.6%. The average rate of loss was ‐4.5% for women retaining positive estrogen status at follow‐up (n= 108) and ‐7.4% for women who were in negative estrogen status at follow‐up (n= 73). Baseline radial BMD measures were highly predictive of the follow‐up BMD values (r= 0.80). Women with positive estrogen status and greater baseline BMD also had less BMD change. Greater baseline BMD did not predict the amount of change in women with negative estrogen status. The bone turnover markers osteocalcin and bone‐specific alkaline phosphatase were significantly associated with BMD change in women with negative, but not positive estrogen status. There was no conclusive evidence of a “peak age” in the baseline and follow‐up BMD measures. Based on rates of BMD change, “peak” bone mineral content appears to occur before age 25 years. Factors significantly associated with lower levels of BMD were menopause without estrogen replacement, nulliparity, smoking, and age at first pregnancy. Factors associated with more bone loss were menopause without estrogen replacement, smoking, shorter duration of oral contraceptive use, and older age. Quetelet index, muscle area, number of lost pregnancies, ever breast‐feeding, or calcium intake were not associated with BMD level or its 5 year rate of loss. Physical activity and alcohol intake were not associated with BMD level or change after data were adjusted for age or estrogen status.