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This is a commentary on a recent meta-analysis regarding to the associations between calcium and vitamin D supplementation on fracture incidence.Calcium and vitamin D supplementation is the simplest and the least expensive way among the available preventive strategies for osteoporosis management.The regional feature and rule of individualized medication should be considered.
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Objective To observe influence of basic osteoporosis intervention on the 25-hydroxy vitamin D[25(OH)D] levels,low limb muscle strength and its balance function among Chinese elderly people.Methods Cross sectional study and statistics analysis were performed among total 1026 elderly (≥65years) patients from 16 hospitals throughout China.Daily taking amount of dairy products,calcium,vitamin D supplement,sunlight and physical exercise were recorded.Serum 25 (OH) D level was measured.Limb muscle strength and balance tests were performed.Results Daily intake of dairy products was insufficient in more than 42.0％ (430 cases) participating patients.The average sunlight time of participating patients was (1.2 ± 0.8) h per day.The average physical exercise time was (1.2 ± 0.7) h per day.37.7 ％ (387 cases) participating patients took supplemental calcium and vitamin D.36.8％ (278 cases)participating patients took supplemental calcium.The 25 (OH) D level was less than 50 nmol/L in 77.2％ (792 cases) participating patients,while 50～75 nmol/Lin 16.7％(171 cases).48.7％ (474/973),64.6％(624/966)and 63.6％ (614/966) patients were in high fall risk according to the timed up and go test(TUG),chair rising test(CRT) and tandem gait test(TGT),which showed that the levels of 25 (OH) D deficiency were positively correlated with the elderly fall risk.Conclusions Daily intake of dairy products,sunlight,calcium and ordinary vitamin D supplement are insufficient among Chinese elderly people.Decreases of muscle strength and balance function among elderly people are related to 25 (OH) D levels.Exercise,not Vitamin D supplement,can reduce fall risk through improving muscle strength and balance function in elderly people.
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correlation with cross-sectional area and negative correlation with bucking ratio. The effect of fat mass on hip geometric parameters at the three regions was inconsistent. (3) Fat mass and percentage of body fat ( Fat%) showed negative correlation with cross-sectional area and average cortical thickness and positive correlation with bucking ratio in young group. However, the negative contribution produced by fat mass and Fat% to hip geometric structure became weaker gradually in middle-aged and older groups. ( 4 ) Limb lean mass yielded the largest positive contribution to cross-sectional area and average cortical thickness at all three regions in young group. However, the contribution produced by trunk lean mass became the largest positive contribution to cross-sectional area and average cortical thickness in older group. Conclusions Among all the body composition parameters, hip BMD has showed the most marked correlation with hip geometric structure. Lean mass is ranked the second in the correlation. The impacts of fat mass and lean mass on hip geometry are changing with aging and their different tissue distributions.
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Objective To investigate bone health conditions in 1637 aged women. Methods From May 2004 to October 2008, Bone mineral density (BMD) of 1637 women at age of more than 60 years old were measured by Hologic DephiA dual energy X-ray absorptiometry (DXEA) in Huadong hospital affiliated to Fudan University. All data were compared and analyzed among each group which will be divided by every ten years. Those women were divided into groups on 10 years range. BMD of lumbar vertebral and hip bone,fracture incidence and bone turnover marker were compared and analyzed. Results (1) BMD: at age of 3=90, 80 - 89, 70 - 79, 60 - 69, BMD of the lumbar vertebral 2 - 4(L2-4) values were (0. 96 ± 0. 18),(0. 90 ± 0. 20) , (0. 81 ± 0. 16) , (0. 83 ± 0. 14) g/cm2 , respectively. There were significantly increased BMD of lumbar of women at the age of 80 - 89 and ≥90 year-old compared with those of 60 - 69 year-old (P<0. 05). At age of ≥90,80 -89,70-79,60 -69 BMD of femur neck, Total, Torch, Ward's trianger were(0. 60 ±0. 11) , (0. 65 ±0. 11) ,(0. 47 ±0. 09) ,(0. 37 ±0. 09) g/cm2; at age of 80 -89 BMD of FN,Total, Torch, Ward's trianger were(0. 57 ±0. 10) , (0. 68 ±0. 13) , (0. 48 ±0. 11) , (0. 35 ±0. 10) g/cm2;at age of 70-79 BMD of FN, Total, Torch, Ward's trianger were (0.57±0. 10) ,(0. 69 ±0. 12), (0.49± 0. 10) , (0. 36 ± 0. 11) g/cm2; at age of 60 - 69 BMD of FN, Total, Torch, Ward's trianger were (0. 63 ± 0. 10) , (0. 76 ±0. 12) , (0. 54 ±0. 10), (0. 45 ±0. 15) g/cm2; There were significantly decreased in BMD of hip at the age of 70 - 79, 80 - 89,≥90 year-old compared with those of 60 - 69 year-old (P < 0. 05).(2) Fracture incidence: one time fracture incidence at age of 60 - 69,70 - 79,80 - 89, ≥ 90 were 34. 8 % (242/695) ,45. 0% (296/658) ,51. 3% (137/267) ,5/17. There were increasing trend of fracture in aged women. (3) Bone turnover marker of bone Gla protein (BGP) N-mid(N-midBGP) in serum and C-terminal telopeptide of type Ⅰ collagen/Cr (CTX/Cr) in urine values were (17 ±5) μg/L, (106 ±56) μg/mmol at age of more than 90 years ,(17 ±7) (μg/L,(128 ±99)μg/mmol at age of 80-89 years,(21 ± 14) μg/L,(182 ± 173)μg/mmol at age of 70-79 years, (25±13)μg/L, (190 ± 168)μg/mmol at age of 60 - 69 years. There were significant decreased trends of N-midBGP at age of 70 -79,80 -89 compared with that of 60-year (P < 0. 05). There were significant decreased trends of CTX/Cr 80 - 89 compared with that of 60-year (P < 0. 05). Conclusions There were significant decreased bone metabolism in aged women. The risk of hip fracture is significantly increased in aged women. Diagnosis of osteoporosis based on BMD of hip in aged women is more reliable.
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BACKGROUND: Incidence rate of cervical osteoarthritis in the middleaged and elderly is high. Some researches on risk factor causing cervical osteoarthritis have been performed abroad, but most of the factors are being discussed.OBJECTIVE: To investigate the occurring cervical osteoarthritis risk factors in the middle-aged and elderly from different regions of China and provide evidences for prevention and intervention of cervical osteoarthritis in community.DESIGN: Cross-sectional study.SETTING: Beijing Hospital, Ministry of Health, together with Second Hospital of Xi'an Jiantong University, Institute of Integrated Traditional and Western Medicine of Hebei Medical University, Shanghai Huadong Hospital, Nanfang Hospital, Second Affiliated Hospital of Harbin Medical University, West China Hospital of Sichuan University.PARTICIPANTS: The investigation was conducted from July to August2005. On the basis of stratified multi-stage cluster sampling method, 6 218formal registered permanent residents of over 40 years old from Xi'an,Shijiazhuang, Shanghai, Guangzhou, Harbin and Chengdu were enrolled.They all agreed to join the investigation voluntarily. There were 2 916males of 40-94 years and 3 302 females of 40-86 years.METHODS: Questionnaire investigation of epidemiology of cervical osteoarthritis was performed in the testees, and radiograph was used in the persons with clinical symptom. The basic sample unit was neighborhood committee (city) and village committee (countryside). Sampling method:Taking each city as a whole, composed of two levels, namely city and countryside, in the first phase the persons were extracted from district (county),in the second phase from sub-district (countryside), in the third phase from neighborhood committee (village eommittee). Diagnosis standard of cervical osteoarthritis was positive clinical symptom and 2 grade or above of radiograph Kellgren & Lawrence grading. The content of questionnaire contained 6 aspects: general condition, history of present illness, history of past illness, physical check-up, radiographs and disease diagnosis, totally94 questions and 141 variation indexes. Influential factors of prevalence rate of cervical osteoarthritis were analyzed using multifactor non-conditional Logistic regression analysis. Odds ratio (OR) was used for expressing index of strength of relationship between disease and exposures. If OR ＞ 1,it was indicated that there was positive correlation between disease occurrence and exposures. If OR ＜ 1, it was suggested that there was negative correlation between disease occurrence and exposures.MAIN OUTCOME MEASURES: Prevalence rate of cervical osteoarthritis in each city and OR.RESULTS: Totally 6 218 investigational subjects were included in the result analysis, without drop out. ①Total prevalence rate of cervical osteoarthritis in population of 40 years or above from 6 domestic cities was23.6%. There was significnat difference of prevalence rate in each city (P＜0.01). ②Result of Logistic regression analysis: Age (OR=1.010-1.058),defecation with squat ting pot (OR =1.024-1.997) and history of hypertension (OR =1.815-3.078) were common risk factor in most areas. In northern area the common risk factor compos ed of daily stair climbing or grade climbing (OR =1.018-1.020), while drinking colored wine (OR=3.451, Xi'an), history of osteoarthri tis of father (OR =2.491, Xi'an), history of diabetes (OR =5.013, Shijiazhuang), history of osteoarthritis of mother (OR =2.045, Shanghai), smoking (OR =6.857, Guangzhou), age of starting drinking (OR =3.044, Guangzhou) and full-time athletic sports (OR=9.020, Harbin), etc. emerged in different areas.CONCLUSION: The onset of cervical osteoarthritis has the same risk factor in 6 domestic areas, and main risk factor in different areas has certain differences, which can provide reference data for the prevention and cure of cervical osteoarthritis for the future and reduce waster of medical resources.
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<p><b>OBJECTIVE</b>To investigate the relationships between the polymorphisms of estrogen receptor (ER) gene, bone mineral density (BMD) and bone biochemical markers in Chinese postmenopausal women.</p><p><b>METHODS</b>BMD of lumbar spine and femoral neck were measured using dual-energy X-ray absorptiometry (DEXA) in 186 Chinese postmenopausal women. The PvuII and XbaI polymorphisms of the ER gene were detected using polymerase chain reaction (PCR). Bone biochemical markers, serum alkaline phosphatase, osteocalcin and pyridinoline were measured by ELISA.</p><p><b>RESULTS</b>The femoral neck (FN) BMD (Z score) was higher in pp compared to Pp (-0.01 +/- 0.12 vs. -0.35 +/- 0.09, P < 0.05) while lumbar spine BMD (Z score) was higher in XX type compared to Xx and xx genotypes (0.01 +/- 0.45 vs -1.53 +/- 0.17, -1.29 +/- 0.10, < 0.001 and 0.001, respectively). Women without Px haplotype (n = 79) had a higher BMD Z-score for the lumbar spine (-1.03 +/- 0.14 vs -1.45 +/- 0.11, P < 0.05) and femoral neck (-0.01 +/- 0.11 vs -0.31 +/- 0.09, P < 0.05) than those who had it (n = 107).</p><p><b>CONCLUSIONS</b>The present study suggested that the pp and XX genotypes of ER gene might play a certain role in maintaining FN and lumbar spine BMD. ER genotypes without Px haplotype might be favorable to bone mass, while those with it might exert some harmful effect on bone mineral density.</p>
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Aged , Female , Humans , Middle Aged , Bone Density , Genotype , Polymorphism, Genetic , Postmenopause , Metabolism , Receptors, Estrogen , Genetics , Regression AnalysisABSTRACT
<p><b>OBJECTIVE</b>To understand the distribution of prevalence rate of osteoporosis in the middle - aged and elderly in parts of China.</p><p><b>METHODS</b>Bone mineral density (BMD) was measured and questionnaires were taken for 5593 people aged above 40 years in five administrative areas in China selected by the stratified - multi - steps - cluster sampling method.</p><p><b>RESULTS</b>The total prevalence rate of osteoporosis was 16.1%. The prevalence rate among males was 11.5% and among females was 19.9% (P < 0.01). There were also osteoporosis prevalence differences among cities, age groups, gender groups and areas.</p><p><b>CONCLUSION</b>The prevention and treatment of osteoporosis are very important for females but also should not be ignored in males.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Age Factors , Bone Density , China , Epidemiology , Geography , Osteoporosis , Diagnosis , Epidemiology , Prevalence , Rural Health , Sex Factors , Urban HealthABSTRACT
Vitamin D receptor (VDR) genotypes and bone mineral density (BMD) of 611 subjects in Shanghai were investigated. The results indicated that the frequency of Bb genotype in male is higher than that in female (26.9% vs 12.7%, P
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Objective To investigate the distribution of prevalence of primary osteoporosis (POP) in the middle aged and the elderly in parts of China. Methods Bone mineral density (BMD) was measured and questionnaire was surveyed from 5 602 people aged above 40 years old in five administrative areas in China, by the stratified multi steps cluster sampling method. Results The total prevalence of POP in these population was 12.4％ according to the most significant parts of the accumulation lose rate. Among them, the prevalence was 8.5％ in male and 15.7％ in female(P
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Objective To evaluate usefulness of high-resolution MRI in quantitative analysis of femoral micro-structure.Methods This study included 110 cases which were divided into 4 groups according to the results of DXA.High-resolution MRI of left hip joint wasperformed on a 1.5T super-conductive MR scanner.3 ROIs were selected on the largest oblique-coronal images of femur to gain thebinary images derived from software processing and 30 parameters were analyzed.Results The parameters to be of statistical significance were 77% and 67%,respectively.Full points of structural parameters with significant difference were 6,4~6 points were 60% and 2~3 points were 40%.Trabecula connective parameters such as trabecula area,mean framework length and mean trabecula perimeter had positive correlation with bone density,r=0.547～0.722,0.58～0.654 and 0.573～0.688,P
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Objective To evaluate the relationship between osteoporosis(OP) and the age of menarche and menopause,parity and lactation and bone mineral density(BMD).Methods BMD was measured in 1472 postmenopausal women by Norland XR-36 dual energy Xray absorptiometry(DXA) from May 1999 to April 2003 in our hospital.All data of BMD were compared and statistically analyzed between women with different age of menarche and menopause,parity and lactation period.The diagnostic criteria of osteoporosis was defined by a loss of BMD greater than 2.5 standard deviations below average peak BMD of young adult women.Results In all 1472 subjects,the incidence of osteoporsis is 58.5%(861/1472).There was significant increase in osteoporosis of lumbar spine in women with the age of menarche≥17(119 out of 336 cases were with osteoporosis in lumbar)compared with women with age of menarche≤13(75 out of 276 cases were with osteoporosis in lumbar).In women with menarche age of 11-13,14-16,17-19,lumbar vertebral(L_(2-4)) BMD values were(0.83?0.16),(0.82?0.16),(0.80?0.14) g/cm~2,respectively.There was significant increase in BMD of lumbar in the menarche age group of 11-13 compared with the age group of 17-19 in women within menopause 1-10 years(P
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Objective To investigate the relationship between the polymorphisms of collagen type Ⅰ alpha 1 (COLIA1) gene and bone mineral density of postmenopausal women in Shanghai. Methods The polymorphisms of Sp1 binding site in COLIA1 gene were observed in 205 postmenopausal women by PCR, digested with MscⅠ restriction endonuclease and separated by 12% polyacrylamide gel electrophoresis. The capital letter S represents for the absence of the restriction endonuclease site, while the small letter s for the presence of the restriction endonuclease site. Bone mineral density at lumbar spine and femoral neck, etc. were measured by DEXA. Results Neither Ss nor ss genotypes of COLIA1 gene was found in our sample, all were SS genotype. Conclusion The contribution of Sp1 site variation of COLIA1 gene to bone mass might have a strong ethnic difference. The restriction fragment length polymorphisms of COLIA1 gene do not show relationship with the bone mass of postmenopausal women in Shanghai. The significance of this genetic marker of osteoporosis needs to be further explored in larger samples and in different areas.