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Objective To analyze the controlled risk factors of osteoporotic vertebral fractures, and determine the clinical value for the management of risk factors. Methods 626 cases of postmenopausal women were selected, age, height, weight and bone mineral density(BMD) of patients were collected.The Tetrax balance test system was used to assess the fall risks.Vertebral changes of patients were evaluated through X ray of thoracolumbar lateral. The clinical data were analyzed and compared between vertebral fracture group and non-vertebral fracture group. Spearman test was used to analyze the correlation between vertebral fracture and age, height, weight, body mass index(BMI), the risk of fall, body fat and BMD. Results 328 patients presented with osteoporotic vertebral fractures, while the other 298 cases did not suffer from osteoporotic vertebral fractures. There were 426 vertebral bodies involved. Comparing to non-vertebral fracture group, the vertebral fracture group showed higher age [(68.67±9.29)years vs.(63.04± 9.30)years], lower height[(151.10 ± 4.39)cm vs.(154.90 ± 5.86)cm], lower bone mineral density[lumbar spine BMD (0.85 ± 0.16)g/cm2 vs.(0.93 ± 0.17)g/cm2, hip spine BMD (0.72 ± 0.18)g/cm2 vs.(0.81 ± 0.13)g/cm2],higher body fat [(41.30 ± 5.20)％vs.(36.30 ± 5.90)％] and higher fall risk (41.38 ± 25.79 vs. 36.20 ± 26.22) ( P<0.001). While there were no statistical differences in weight and BMI between the two groups, age, height, BMI, body fat, fall risk, lumbar spine and hip BMD were significantly correlated with vertebral fracture (r=0.358,-0.323, 0.169, 0.186, 0.135,-0.398,-0.364, respectively, all P<0.001). Conclusions Decreased bone mineral density, increased age, abdomen fat content and increased fall risk, are the risk factors of osteoporotic vertebral fractures.
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ObjectiveTo investigate the effects of caleitriol,training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osleoporosis or osteopenia.Methods A total of 200 postmenopausal women with osteoporosis or osteopenia,whose balance test confirmed higher fall risk,were randondy assigned to group A or B.Those of group A received the following intervention:( 1 ) 0.25 μg calcitriol,QD; (2) general information on fall and osteoporosis; (3) balance training; (4) lower extremity muscle strength exercises.Those of group B were only treated with 0.25 μg calcitriol.All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D.Fall index,bone mineral density,serum levels of calcium and phosphorus,and adverse reactions were record.Results After 3 months' intervention,the fall index of both groups was significantly decreased ( group A:t =2.16,P＜0.05 ; group B:t =2.08,P＜0.05 ).After 6 months' intervention,the fall index of both groups went on decreasing,and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found.After 1-year intervention,the fall index of group A was further decreased in comparison with group B ( t =2.66,P＜0.05 ).No hypercalcemia occurred during the study period.Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months' intervention.Twelve months' active vitamin D intervention could either reduce the risk of fall or improve bone mineral density.Patient education,balance training and muscle exercise may be effective intervention to reduce fall risk.
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Objective To evaluate the effects of an intervention programme of health education and life style modification on postmenopausal osteoporosis women. Methods A total of 120 postmenopausal osteoporosis women were enrolled in this one-year randomized controlled follow-up study and assigned to the intervention group ( Group A, n = 60) or the control group ( Group B, n = 60). Both groups were treated with alendronate sodium. In Group A, education program was performed once a season in the form of face-to-face consultation or group session. In Group B, no additional intervention was used. The primary outcome was patients' compliance in follow-up. The secondary outcomes were change in bone mineral density (BMD).BMD was measured by dual-X-ray absorptiometry (DXA) on lumbar spine and hip at baseline and 12 months after the intervention. Results After one-year intervention,51 subjects in Group A and 38 in Group B completed the follow-up. Groups A showed better compliance. BMD on lumbar spine and hip was significantly increased in both groups when compared with baseline. The changes of BMD on lumbar (0.042+0.067 vs 0.026±0.070,P=0. O29) or Words region (0.029 +0. 129 vs 0.023±0. 143,P=0. 041 ) showed statistical significance between the two groups. Conclusion For alendronate sodium treatment, health management ensures the effectiveness of the therapy and improves the compliance of the patients.
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Objective To evaluate the effectiveness of comprehensive lifestyle modification in the primary health care system on status of pre-chronic diseases in a conventional healthcare program.Methods Two hundred and twenty-nine adult volunteers in 5 conventional healthcare centers were divided into 4 groups:group of prehypertension(n=67),group of prediabetes(n=38),group of abnormity serum cholesterol(n=71)and group of osteopenia(n=53).A muhicomponent behavioral intervention including education,physical activity,dietary practice,cease smoke,calcium supplement and exposure to sunlight was conducted for 12 months.The main outcome of each group was blood pressure,blood glucose,serum cholesterol and bone mineral density.Results Over 12 months,compared with the status before intervention,participants in each group were statistically significantly improved,the mean net reduction in systolic BP/diastolic BP was 9.4 mm Hg/6.6 mm Hg(1 mm Hg=0.133 kPa,t=5.93/8.29.P＜0.05)in group of prehypertension;the reductions of blood glucose,serum cholesterol were 0.9 mmol/L(t=3.69,P＜0.05)and 0.5 mmol/L(t=4.09,P＜0.05)in group of prediabetes and group of abnormity serum cholesterol,and the increase of bone mineral density on lumbar spine was 0.015 g/cm2(t=2.03,P＜0.05)in group of osteopenia,Conclusions For chronic disease prevention,ater one year the comprehensive lifestyle intervention produced beneficial changes in diet,physical activity,and biochemical parameters.This type of intervention is a feasible option to prevent chronic disease and should be implemented in the primary health care system.