维生素D、维生素B12和同型半胱氨酸水平与绝经后女性骨密度的相关性研究

目的探索绝经后非骨质疏松症和骨质疏松症女性患者高半胱氨酸、维生素D、维生素B_(12)和骨密度(bone mineral density,BMD)之间的关系。方法选取2017年8～12月在我院就诊的138名女性作为研究对象,根据骨密度将绝经后女性分为骨质疏松组(n=58)和非骨质疏松组(n=80)。记录两组患者的体质量指数(body mass index,BMI)、年龄、腰围等一般资料,检测腰椎L_(1～4)前后位、左侧股骨近端的BMD,测定血清同型半胱氨酸、维生素B_(12)、维生素D、碱性磷酸酶、钙、磷水平。分析两组患者不同指标的差异以及高半胱氨酸、维生素D、维生素B_(12)和BMD之间的相关性。结果两组患者的年龄、BMI、腰围、同型半胱氨酸、维生素D、维生素B_(12)、腰椎L_(1～4)和左股骨颈骨密度比较差异有统计学意义(P均0.05);Rho相关性和回归分析表明,同型半胱氨酸与维生素D和B_(12)在绝经后非骨质疏松症和同型半胱氨酸与维生素B_(12)在绝经后骨质疏松症女性中呈显著负相关。结论高水平同型半胱氨酸可以通过绝经后非骨质疏松症患者维生素D水平和绝经后骨质疏松症女性维生素B_(12)水平预测。     

维生素E联合雷洛昔芬对绝经后女性骨质疏松症影响的临床观察

目的初步探索维生素E联合雷洛昔芬治疗绝经后女性骨质疏松症的安全性及有效性。方法将120名绝经后妇女随机分为治疗组和对照组,治疗组使用维生素E联合雷洛昔芬干预,对照组单纯予以雷洛昔芬干预。在试验前及试验干预12个月后分别检测两组受试者的腰椎及髋部骨密度、血清骨代谢指标、细胞因子水平及研究期间的药物不良反应和骨折发生率。结果干预12个月后两组患者腰椎(L1～4)及左侧股骨颈的骨密度明显增加,而治疗组的骨密度水平显著高于对照组(P0.05);干预12个月后治疗组血清BGP、ALP、IL-6、TNF-α、IL-10及TGF-β1的水平均明显改变,而治疗组上述指标的改变均较对照组更为明显,差异有统计学意义(P0.05);治疗组骨折发生率明显下降,和对照组比较,差异有明显统计学意义(P0.05),而药物不良反应的差异无统计学意义(P0.05)。结论维生素E联合雷洛昔芬能有效保护绝经后妇女髋部及腰椎骨密度,改善骨代谢及炎症因子水平,降低骨折发病率,具有较好的安全性。     

骨代谢标志物实验室检测在绝经后骨质疏松症治疗中的意义

目的:探讨骨代谢标志物实验室检测在绝经后骨质疏松症治疗中的意义。方法:选取56例绝经后骨质疏松症患者,给予阿伦膦酸钠,每次70 mg,每周1次,口服。1个疗程为6个月。治疗前后对骨转换标志物甲状旁腺素、骨钙素、I型胶原C端肽、骨性碱性磷酸酶和25羟维生素D3进行检测,分析骨转换标志物的变化。结果:骨钙素和I型胶原C端肽治疗前后比较,差异有统计学意义(P0.05);甲状旁腺素、骨性碱性磷酸酶、25羟维生素D3、血清钙及血清磷治疗前后比较,差异无统计学意义(P0.05)。结论:骨转换标志物骨钙素和I型胶原C端肽可作为判断绝经后骨质疏松症治疗改善的实验室检测指标。     

白藜芦醇对绝经后骨质疏松女性骨代谢和氧化代谢产物水平的影响

目的 探讨白藜芦醇对绝经后骨质疏松症妇女骨代谢和氧化代谢产物水平的影响。方法 选取 2015年11月至 2017年11月在成都市第二人民医院就诊的84例绝经后骨质疏松症患者作为研究对象,随机分为治疗组和对照组。治疗组的患者每天服用白藜芦醇,对照组的患者给予安慰剂片。3个月后,测量各组患者的血清骨代谢标志物[I型前胶原氨基端前肽(PINP)、骨钙素(BGP)、骨碱性磷酸酶(BALP)、I 型胶原 C 末端肽特殊序列(β-CTX)]和氧化代谢产物[蛋白羰基(PCO)、高级氧化蛋白产物(AOPP)、总抗氧化能力(TAC)、Akatsu(MDA)]水平的改变。结果 服用白藜芦醇治疗后,治疗组血清PINP 、BGP 、BALP 、β-CTX 、PCO、AOPP和MDA水平较治疗前显著降低(P＜0.05),治疗后两组之间的差异具有统计学意义(P＜0.05);治疗组血清TAC水平较治疗前显著升高(P＜0.05),治疗后两组之间的差异具有统计学意义(P＜0.05)。然而,对照组治疗前后的PINP 、BGP 、BALP 、β-CTX 、PCO、TAC、AOPP和MDA指标,其差异并没有统计学意义(P＞0.05)。结论 白藜芦醇可以降低绝经后骨质疏松症女性体内氧化应激和高骨转化速度。     

雷洛昔芬对绝经后妇女同型半胱氨酸及血脂的影响

目的观察雷洛昔芬(RLX)对绝经后妇女同型半胱氨酸及血脂的影响。方法采用随机、双盲、安慰剂对照研究,对62例绝经后妇女分为试验组(n=32)和安慰剂组(n=30),分别给予RLX 60 mg/d及安慰剂,共12个月。结果RLX组用药6个月前后同型半胱氨酸无明显变化,用药12个月时明显降低,与安慰剂组比较有显著性差异(P<0.05);RLX组用药12个月总胆固醇、低密度脂蛋白胆固醇显著降低(P<0.01),高密度脂蛋白胆固醇和甘油三酯则无明显变化。结论RLX可降低绝经后妇女同型半胱氨酸水平,降低血清总胆固醇、低密度脂蛋白胆固醇水平。     

骨代谢标志物在宁波地区绝经后女性骨质疏松症患者中的临床应用

目的 研究骨代谢标志物在宁波地区绝经后中老年女性骨质疏松症患者诊疗中的作用。方法 随机选择绝经后的中老年女性受试者264例,年龄均大于50岁,根据骨密度结果将264例检测对象根据骨密度大小分为骨量正常组82例,骨量减少组90例,骨质疏松组92例,同时采用电化学发光免疫分析方法测定受检对象血清中β-CTX、PINP、25-OHD3水平,并进行对比分析。结果 骨质疏松组：β-CTX水平与正常对照组、骨量减少组比较差异有统计学意义（P <0.05) ;PINP、25-OHD3水平在3组间差异无统计学意义（P>0.05)。结论骨质疏松症患者血清骨代谢标志物水平与骨质疏松存在密切的相关性;β- CTX是骨质疏松症诊断和疗效评估的理想指标;PINP、25-OHD3是骨质疏松症诊断和治疗的参考指标。     

青娥丸对绝经后骨质疏松症患者骨密度、骨代谢指标和骨硬化蛋白的影响

目的观察青娥丸(QEW)对绝经后骨质疏松症患者骨密度、骨代谢指标和骨硬化蛋白的影响。方法 2016年1月至6月期间,我院收治的120例门诊和住院PMOP患者随机分为QEW组(给予钙片和青娥丸),ALF组(给予钙片和阿法骨化醇)和对照组(给予钙片)(每组n=40),随访期为1年。测量基线和治疗1年后血清骨硬化蛋白、25羟维生素D和骨转换标志物(β-CTX,N-MID和T-PINP)的水平。结果 QEW组和ALF组治疗后1年血清骨硬化素水平显著高于对照组(P0. 05),但QEW组和ALF组比较差异无统计学意义(P0. 05)。治疗后1年QEW组和ALF组血清β-CTX,N-MID和T-PINP水平均降低,而两组间差异无统计学意义(P0. 05)。但QEW组和ALF组血清β-CTX,N-MID和T-PINP水平显著低于对照组(P0. 05)。结论 QEW调节绝经后骨质疏松症患者骨代谢的机制可能与QEW增加硬化蛋白表达的作用有关。     

杜仲壮骨胶囊联合雷洛昔芬治疗绝经后骨质疏松症临床研究

目的探索杜仲壮骨胶囊联合雷洛昔芬治疗绝经后骨质疏松症临床疗效。方法 158例绝经后骨质疏松症患者随机分为治疗组(n=79)和对照组(n=79)。对照组给予雷洛昔芬治疗,治疗组给予杜仲壮骨胶囊联合雷洛昔芬治疗,为期治疗12个月。检测治疗前后两组患者股骨颈、腰椎及髋部的骨密度,同时测定血清骨代谢指标:骨碱性磷酸酶(BALP)、I型原胶原N-端前肽(PINP)和血清I型胶原交联C-末端肽(S-CTX)、碱性磷酸酶(ALP)、骨钙素(BGP)的水平,记录两组治疗总有效率和药物不良反应。结果治疗组的治疗总有效率为93.67%,而对照组的为78.48%,两组比较差异有统计学意义(P0.05)。治疗12个月,两组股骨颈、髋部及腰椎密度都有不同程度的升高,其中治疗组骨密度变化更明显,和对照组比较差异有明显的统计学意义(P0.05);同时各组血清S-CTX、PINP和ALP水平均降低,BALP和BGP水平均升高,而治疗组改变更明显,两组比较差异有明显的统计学意义(P0.05)。两组患者药物不良反应比较差异有明显的统计学意义(P0.05)。结论杜仲壮骨胶囊联合雷洛昔芬治疗绝经后骨质疏松症,安全有效,较雷洛昔芬单独治疗效果更佳。     

绝经后妇女血维生素B12、叶酸水平与骨密度相关性的初步研究

目的探讨绝经后妇女血维生素B12、叶酸水平与骨密度的相关性。方法应用双能X线骨密度仪测定受试者腰椎及股骨骨密度,按1994年WHO标准将其分为3组,即骨质疏松组、骨量减少组及骨量正常组;采取空腹静脉血进行维生素B12、叶酸的集中检测;并分别进行维生素B12、叶酸与不同部位骨密度的相关性分析。结果①骨质疏松组的血维生素B12的水平(512.55±209.85)pg/ml,低于骨量减少组(551.29±237.71)pg/ml和骨量正常组(565.71±189.03)pg/ml。②骨质疏松组的血叶酸的水平(11.27±6.04)pg/ml,低于骨量减少组(13.18±6.14)pg/ml和骨量正常组(11.9±3.73)pg/ml。③绝经后妇女血维生素B12的水平与全髋BMD呈正相关(r=0.25,P<0.01),与股骨颈BMD呈正相关(r=0.212,P<0.05),与股骨干BMD呈正相关(r=0.257,P<0.01),与股骨大转子BMD呈正相关(r=0.239,P<0.05);血维生素B12的水平与L1~L4BMD无相关性(r=0.141,P>0.05)。④绝经后妇女血叶酸的水平与全髋BMD、股骨颈BMD、股骨干BMD、股骨大转子BMD和L1~L4BMD均无相关(r分别为0.005,0.021,0.017,-0.021和0.078,P>0.05)。结论绝经后妇女血维生素B12的水平的缺乏可能是骨质疏松发生的一个重要风险因素,叶酸的缺乏并非骨质疏松发生的风险因素。     

骨疏宁片联合阿托伐他汀对2型糖尿病合并绝经后骨质疏松症患者骨密度及骨代谢的影响

目的研究骨疏宁片联合阿托伐他汀对2型糖尿病合并绝经后骨质疏松症患者骨密度及骨代谢的影响。方法 124例2型糖尿病合并骨质疏松症妇女随机分为治疗组和对照组,治疗组进行骨疏宁片联合阿托伐他汀治疗,对照组单纯予以阿托伐他汀治疗。治疗前及治疗后12个月分别检测两组受试者腰椎1~4和左侧股骨颈骨密度、VAS疼痛评分以及骨代谢指标。结果治疗前,各组受试者骨密度、VAS疼痛评分以及骨代谢指标比较无统计学意义(P0.05)。治疗6个月及12个月,两组患者VAS评分不同程度降低,其中以治疗组骨痛的治疗效果要明显优于对照组(P0.05)。治疗12个月两组L1~4椎体、股骨颈的BMD明显升高(P0.05),而治疗组明显高于对照组(P0.05)。治疗12个月,两组血清I型胶原N端前肽(type 1 collagen N terminal peptide,P1NP)的水平明显升高,而I型胶原羧基末端肽(type I collagen carboxy-terminal peptide,CTX)水平明显下降,和对照组比较,治疗组血清P1NP及CTX水平改变更为明显(P0.05)。结论骨疏宁片联合阿托伐他汀可以显著提高2型糖尿病合并骨质疏松症女性骨密度及降低VAS评分,且能改善2型糖尿病合并绝经后骨质疏松症患者骨代谢异常,值得临床推广。     

Protective effect of folic acid on cyclosporine-induced bone loss in rats

Hyperhomocysteinemia is seen in patients with decreased bone mineral density. Cyclosporine can cause alveolar bone loss and osteopenia. It is also associated with elevated serum homocysteine levels. We aimed to investigate the effect of cyclosporine on serum homocysteine level, bone volume, and bone density, and determine whether folic acid had a protective effect against bone loss. In an experimental study, 40 male Sprague-Dawley rats were randomly assigned to five groups and received dietary supplementation for 6 weeks with olive oil (Group A), cyclosporine (Group B), folic acid (Group C), and cyclosporine plus folic acid (Group D), or no supplementation (Group F, control). Serum homocysteine, calcium, alkaline phosphatase, total bone volume, periodontal ligament volume, and volume density of bone were compared between groups. Mean serum homocysteine level (10.84 ± 0.93 μmol/l) was significantly higher in group B (cyclosporine supplementation) compared with the other groups (P = 0.001). Mean total mandibular volume was 46.3 ± 13.6 mm(3) in rats treated with cyclosporine, 80.4 ± 15.70 mm(3) in rats treated with folic acid (P = 0.004), and 73.9 ± 21.3 mm(3) in rats treated with cyclosporine plus folic acid (P = 0.028). In our experimental model, cyclosporine increased serum homocysteine levels and decreased bone volume and density. Folic acid may have a preventive role against bone loss in rats treated with cyclosporine.     

持续运动锻炼对绝经后女性骨密度影响的追踪研究

目的比较不同运动锻炼参与程度的绝经后女性骨密度差异及在12个月间的变化。方法对82名符合条件的社区绝经后女性骨密度进行12个月追踪。研究对象分为锻炼量达标组(n=42)和不达标组(n=40),不达标组进一步分为不锻炼和偶尔锻炼亚组。采用定量超声(QUS)法采集跟骨骨密度T值、Z值、超声传导声速(SOS)、超声宽带衰减(BUA),统计各组骨质疏松不同发生风险等级的人数比,测量时间点为基线、6个月和12个月。结果达标组骨密度各指标水平和骨质疏松高度风险人数比(16.7%)在12个月间基本维持稳定(P0.05);不达标组T值(F=11.877,P=0.000)、Z值(F=7.459,P=0.002)、BUA值(F=4.207,P=0.026)在12个月间均出现显著下降,骨质疏松高度风险人数比由20.0%上升至30.0%。达标组与不达标组T值变化具有明显的组间效应(F=4.268,P=0.042)和时间效应(F=6.378,P=0.004)。偶尔锻炼亚组骨密度各指标水平在12个月间下降幅度低于不锻炼亚组。结论不同运动锻炼参与水平可不同程度地维持绝经后女性骨密度水平或延缓其增龄性流失。持续规律的运动锻炼对绝经后女性骨密度水平具有积极的改善作用。     

坤泰胶囊辅助治疗对绝经后骨质疏松症妇女骨密度、骨代谢和激素水平的影响

目的探讨坤泰胶囊辅助治疗对绝经后骨质疏松症患者骨密度、激素水平和骨代谢的影响。方法 150例绝经后骨质疏松症患者被随机分为治疗组、联合治疗组和对照组,每组50例。治疗组给予雷洛昔芬,联合治疗组给予雷洛昔芬加坤泰胶囊治疗,治疗12个月。检测治疗后两组患者髋部及腰椎的骨密度(bone mineral density,BMD)改变,同时测定血清雌二醇(estradiol,E2)、黄体生成素(luteinizing hormone,LH)、促卵泡剌激素(follicle stimulating hormone,FSH)、骨钙素(OC)和I型胶原交联C-末端肽(CTX-1)的水平,并记录治疗期间出现的药物不良反应。结果对照组的腰椎和髋部BMD在1年后较基线时有不同程度降低,比较差异有统计学意义(P0. 05);治疗1年后,治疗组和联合治疗组髋部及腰椎BMD都有不同程度的升高,且组间比较差异有明显的统计学意义(P0. 05);同时治疗组和联合治疗组血清CTX-1水平均降低,OC水平均升高,两组比较有明显的统计学意义(P0. 05);各组血清FSH和LH水平均降低,E2水平升高,两组比较有明显的统计学意义(P0. 05)。两组患者治疗时均未发现明显药物不良反应。结论坤泰胶囊辅助治疗有助于降低骨转换率,改善性激素水平,改善绝经后女性骨质疏松患者髋部及腰部的骨密度。     

Pharmacological Dose of Vitamin B12 Is as Effective as Low-Dose Folinic Acid in Correcting Hyperhomocysteinemia of Hemodialysis Patients

Various regimens of folic acid-based and vitamin B12 (Vit B12) supplementations have been tried for lowering plasma homocysteine (Hcy) levels in uremic patients. However, the therapeutic potency of low-dose folic acid and Vit B12 alone is not properly understood. In this study, seventy-five patients on chronic hemodialysis (HD) therapy were randomized into three groups. The FNA group received intravenous (IV) supplementation with folinic acid 3 mg weekly; the Vit B12 group received IV supplementation with vitamin B12 1 mg weekly; and the combination group received IV supplementation with both agents weekly. Blood levels of Hcy, folic acid, and Vit B12 were measured monthly for three months. After three months of treatment, plasma levels of Hcy decreased significantly in all three groups when compared with their baselines (all p < 0.05). The final Hcy level was significantly lower in the combination group (11.5 ± 2.3 μmol/L) when compared with that of the FNA group (15.9 ± 5.6 μmol/L, p < 0.05) but not with the Vit B12 group (15.9 ± 11.6 μmol/L), although their baseline levels were similar. The percentage decreases of tHcy at the end of the treatment in the FNA group, Vit B12 group, and combination group were 16.4%, 29.3%, and 38.9% respectively. Our study showed that IV pharmacologic dose of Vit B12 alone is as effective as low-dose folic acid in correcting hyperhomocysteinemia in chronic HD patients, and combining both drugs in low doses may have added effects.     

Relation of folates, vitamin B12 and homocysteine to vertebral bone mineral density change in postmenopausal women. A five-year longitudinal evaluation

Elevation of homocysteine is associated with an increased risk for bone fractures. Whether the risk is due to homocysteine or to the reduced levels of cofactors necessary for its metabolisation, such as folates or vitamin B12, is not completely clear. In this study we wanted to determine whether in postmenopausal women, levels of folates, homocysteine or vitamin B12 are predictive of the rate of vertebral bone mineral density (BMD) change. The study was conducted at the centre for the menopause of our university hospital. Between September 2001 and March 2002, 161 healthy postmenopausal women volunteered for a cross-sectional evaluation of BMD and levels of serum folates, homocysteine and vitamin B12. Women were recalled for a second evaluation of vertebral BMD after about 5 years. Women having used anti-resorptive therapies for more than 1 year were excluded. The analysis was possible in 117 postmenopausal women. The annual rate of vertebral BMD change was independently related to levels of folates (coefficient of regression (CR): 2.040; 95%CI: 0.483, 3.596; p=0.011), and initial BMD values (CR: -0.060; 95%CI: -0.117, -0.003; p=0.040). No significant relation was found between the change of vertebral BMD and homocysteine or vitamin B12. BMD values at the first (r=0.225; p=0.016) and the second (r=0.206; p=0.027) evaluation were related to levels of folates, but not of homocysteine or of vitamin B12. These data suggest an important role for folates deficiency in the vertebral BMD decline of postmenopausal women.     

Effect of walking exercise on bone metabolism in postmenopausal women with osteopenia/osteoporosis

The purpose of this prospective study was to determine whether moderate walking exercise in postmenopausal women with osteopenia/osteoporosis would affect bone metabolism. Fifty postmenopausal women, aged 49–75 years, with osteopenia/osteoporosis were recruited: 32 women entered the exercise program (the exercise group) and 18 served as controls (the control group). The exercise consisted of daily outdoor walking, the intensity of which was 50% of maximum oxygen consumption, with a duration of at least 1h with more than 8000 steps, at a frequency of 4 days a week, over a 12-month period. Lumbar (L2–L4) bone mineral density (BMD) was measured at the baseline and every 6 months with dual-energy X-ray absorptiometry (DXA) in both groups. Serum bone-specific alkaline phosphatase (BAP) and urinary cross-linked N-terminal telopeptides of type I collagen (NTX) levels were measured at baseline and at months 1, 3, 6, 9, and 12 by EIA and ELISA, respectively, in the exercise group, and urinary NTX level was measured at the baseline and every 6 months in the control group. There were no significant differences in baseline characteristics including age, height, body weight, bone mass index, years since menopause, lumbar BMD, and urinary NTX level between the two groups. Although no significant changes were observed in lumbar BMD and the urinary NTX level in the control group, lumbar BMD in the exercise group was increased as compared with the control group, but was sustained from the baseline. In the exercise group, the urinary NTX level rapidly responded to walking exercise from month 3, and this reduction was sustained until month 12, followed by reduction in the serum BAP level. A moderately negative correlation was found between the percent change in the urinary NTX level at month 3 and that in lumbar BMD at month 12 in the exercise group. This study clearly demonstrates that the mechanism for the positive response of lumbar BMD to moderate walking exercise in postmenopausal women with osteopenia/osteoporosis appears to be the suppression of bone turnover, and that an early change in the urinary NTX level may be useful to predict the long-term response of increasing lumbar BMD to exercise, although its efficacy for lumbar BMD may be quite modest.     

阿法骨化醇增加伊班膦酸钠治疗绝经后骨质疏松症的疗效

目的探索阿法骨化醇(alfacalcidol,ALF)在伊班膦酸钠(ibandronate,IBN)治疗绝经后骨质疏松症期间的作用。方法选取2015年7月至2017年6月在我院就诊的56例绝经后骨质疏松症患者作为研究对象,随机分为IBN组和IBN/ALF组;IBN组给予IBN治疗,IBN/ALF给予IBN联合ALF,治疗为期12个月。观察治疗前后两组女性骨密度及骨代谢指标的改变。结果与治疗前相比,3个月后两组骨转换指标均显著降低(P0.05)。IBN/ALF组血清1型前胶原氨基末端前肽(N-propeptide of type 1 collagen,P1NP)、抗酒石酸酸性磷酸酶-5b(tartrate-resistant acid phosphatase-5b,TRACP-5b)和尿I型胶原N末端交联(urinary type I collagen crosslinked amino terminal peptide,NTX)水平明显低于IBN组(P0.05)。IBN/ALF组6个月和IBN组12个月时腰椎(L_(1～4))骨密度(bone mineral density,BMD)均显著增加(P0.05)。12个月时IBN/ALF组(4.7%)的L-BMD显著高于IBN组(2.9%)。IBN/ALF组的全髋(H)-BMD从6个月开始显著增加,而IBN组的H-BMD改善不明显。IBN/ALF组(4.3%)的H-BMD在12个月时显著高于IBN组(2.7%)。结论 ALF有助于IBN治疗绝经后骨质疏松症的疗效。     

骨愈灵胶囊对绝经后骨质疏松症的疗效及骨代谢指标的影响

目的观察骨愈灵胶囊对绝经后骨质疏松症的疗效及骨代谢指标的影响。方法 148例绝经后骨质疏松症患者纳入本研究并随机分为治疗组和对照组。治疗组患者给予骨愈灵胶囊治疗,对照组患者给予雷洛昔芬治疗,两组患者治疗期限为12个月。检测治疗前和治疗12个月后2组患者腰椎正位(L_(1-4))、左股骨颈的骨密度、血清血钙、血磷、骨碱性磷酸酶(BALP)和抗酒石酸酸性磷酸酶-5b(TRAP-5b)水平变化情况以及治疗有效率和不良反应。结果治疗12个月后,两组患者腰椎正位(L_(1-4))、左股骨颈的骨密度患者均明显高于对照组,差异均有统计学意义(P0. 05);治疗12个月后,两组患者血清BALP水平较治疗前明显降低(P0. 05),血清TRAP-5b均较治疗前明显升高(P0. 05);而治疗组较对照组改善更为明显(P0. 05)。治疗组的患者治疗有效率优于对照组(P0. 05),而不良反应差异无统计学意义(P0. 05)。结论骨愈灵胶囊对绝经后骨质疏松症患者骨密度和骨代谢影响显著。     

Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women

Genetic hyperhomocysteinemia is associated with skeletal abnormalities and osteoporosis. We tested whether levels of homocysteine and critical co-enzymes of homocysteine metabolism, such as vitamin B₁₂ and folate, are related to lumbar spine bone mineral density (BMD) measured by DEXA in 161 postmenopausal women. Folate but not homocysteine or vitamin B₁₂, was lower in osteoporotic than normal women (7.2 ± 0.9 ng/L vs 11.4 ± 0.7 ng/L, P < 0.003). Folate, but not homocysteine or vitamin B₁₂, was independently related to BMD (r = 0.254, P < 0.011). BMD progressively increased from the lowest to the highest folate quartile (1.025 ± 0.03 g/cm² vs 1.15 ± 0.03 g/cm², P < 0.01) even when covaried for weight, which was the only other variable related to BMD. The present data suggest a major association between folate and bone mineralization.