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1.
SUMMARY

Background: Although postmenopausal African–American women are at lower risk for osteoporosis-related fractures compared with white women, fractures in African–American women are associated with significantly higher morbidity and mortality. Therefore, early diagnosis and treatment of osteoporosis in this population is just as important as it is for other ethnic groups and worthy of the attention of physicians and healthcare organizations.

Objective: The purpose of this study was to evaluate risk factors for osteoporosis in postmenopausal African–American women.

Design: This was a retrospective, case-control study in 201 postmenopausal African–American women at a community-based osteoporosis center. Spine and hip bone mineral density measurements were obtained by dual-energy x-ray absorptiometry. Patient and family medical history, past and present pharmaceutical use, and dietary and exercise habits were collected using a patient self-administered questionnaire.

Results: Using the manufacturer's African–American referent database, 56 women had osteoporosis, 99 had osteopenia, and 46 had normal bone mineral density. Risk factors more common in the osteoporotic group compared with the normal group included sedentary lifestyle (P < 0.03), family history of osteoporosis (P < 0.03), low body mass index (P < 0.05), and history of bilateral oophorectomy (P < 0.03). Polyarthritis was more prevalent in the normal versus the osteoporotic group (P < 0.001). In addition, premenopausal use of oral contraceptives (P < 0.005) and postmenopausal use of estrogen therapy (P < 0.05) were more common in the normal compared with the osteoporotic group.

Conclusions: Many risk factors for osteoporosis in African–American women are similar to those in white women and can aid in the selection of patients in need of bone density testing.  相似文献   

2.
Risedronate sodium is an N-containing bisphosphonate that has been approved for the prevention and treatment of osteoporosis in postmenopausal women. An increase in the rate of bone remodelling is a regular feature of oestrogen withdrawal during the menopausal transition, but excessive remodelling leads to bone fragility. Risedronate and similar compounds reduce the rate of bone remodelling by suppressing the action of osteoclasts. The antifracture efficacy of risedronate is impressive. In large clinical trials of postmenopausal women with osteoporosis-related fracture(s) at entry, the risk of incident vertebral and non-vertebral fractures was reduced by approximately 40%. In older women at risk for hip fracture, incident hip fractures were also reduced by approximately 40%. Antifracture efficacy develops within the first 6 months, and treatment has been followed for as long as 5 years without deleterious effects on bone. We await reports of experience with risedronate in 'real-world' cases of greater complexity (i.e., in patients with co-morbidities and medications that would have excluded them from published clinical trials).  相似文献   

3.
Risedronate sodium is an N-containing bisphosphonate that has been approved for the prevention and treatment of osteoporosis in postmenopausal women. An increase in the rate of bone remodelling is a regular feature of oestrogen withdrawal during the menopausal transition, but excessive remodelling leads to bone fragility. Risedronate and similar compounds reduce the rate of bone remodelling by suppressing the action of osteoclasts. The antifracture efficacy of risedronate is impressive. In large clinical trials of postmenopausal women with osteoporosis-related fracture(s) at entry, the risk of incident vertebral and non-vertebral fractures was reduced by ~ 40%. In older women at risk for hip fracture, incident hip fractures were also reduced by ~ 40%. Antifracture efficacy develops within the first 6months, and treatment has been followed for as long as 5 years without deleterious effects on bone. We await reports of experience with risedronate in ‘real-world’ cases of greater complexity (i.e., in patients with co-morbidities and medications that would have excluded them from published clinical trials).  相似文献   

4.
We investigated the correlation of bone mineral density (BMD) with risk factors and laboratory parameters (e.g., markers of bone turnover, biochemical indicators, and hormonal factors) in males without secondary osteoporosis. A total of 105 males were divided into two groups: Group 1 (n: 52) <60 years, and Group 2 (n:53) ≥ 60 years. The subjects were evaluated for risk factors (European Vertebral Osteoporosis Study (EVOS) and BMD) and for biochemical (i.e., blood calcium, blood phosphorus, urinary calcium/phosphorus, creatinine clearance, osteocalcin, and deoxypyridinoline) and hormonal markers (follicle-stimulating hormone [FSH], luteinizing hormone [LH], free testosterone [fT], and parathyroid [PTH]) of bone mineral metabolism. In Group 1, no significant relationship was observed between risk factors for both lumbar and femoral neck BMDs and risk factors and laboratory parameters (p>0.05). On the other hand, we observed in Group 2 a significant positive correlation between lumbar BMD and BMI, BMI at 25 years of age, and fT; in the same group, a negative correlation between lumbar BMD and deoxypyridinoline (p<0.05) was seen. We saw a significant positive correlation between femoral neck BMD and BMI, BMI at 25 years of age, and daily activities of life in Group 2. In addition, we saw a negative correlation between femoral neck BMD and height difference, fT, LH, and deoxypyridinoline in Group 2 (p<0.05). Risk factors for male osteoporosis were multifactorial: demographic and clinical data (difference of height, BMI, physical activity) together with biochemical and hormonal data (deoxypyridinoline, fT, LH) were significant, and most of the risk factors analyzed were related to bone loss in the proximal femur.  相似文献   

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6.
利塞膦酸钠防治绝经后骨质疏松症   总被引:4,自引:0,他引:4  
目的 评价利塞膦酸钠对绝经后骨质疏松症的防治。方法 212例绝经后骨量减少及骨质疏松妇女,随机分成试验组105例和对照组107例。试验组患者每天服用利塞膦酸钠5mg+元素钙500mg+维生素D200IU;对照组每天服用安慰剂+元素钙500mg+维生素D200IU。治疗时间1年。观察内容:骨痛、尿N肽端交联Ⅰ型胶原(NTX/Cr)、血清骨钙素(BGP)、骨密度(BMD)、不良反应及椎体和椎体外新骨折。结果与用药前比较,试验组骨痛症状均有不同程度改善,骨代谢指标(NTx/Cr、BGP)均明显下降(P〈0.05),腰椎和髋部骨量均有显著上升(P〈O.05),L2-4骨密度上升6.667%,股骨颈骨密度上升3.412%,大转子骨密度上升4.131%;对照组无明显变化。各组均未见明显不良反应。结论 利塞膦酸钠能有效地防治绝经后骨质疏松症。  相似文献   

7.
Teriparatide (Forsteo - Eli Lilly) is the first parathyroid hormone derivative to be licensed for the treatment of women with postmenopausal osteoporosis. It is described as a "bone-formation agent", in contrast to established treatments, such as bisphosphonates, raloxifene, calcitriol and calcitonin, which reduce bone resorption. Here we consider whether teriparatide offers any worthwhile advantages over these other options.  相似文献   

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10.
目的评价依普黄酮对防治女性绝经后骨质疏松的疗效。方法对46例绝经后骨质疏松患者服用依普黄酮,治疗2个月后,对治疗前后患者的骨痛进行评价,测定血生化指标碱性磷脂酶(ALP)、钙(Ca)、磷(P)和晨尿羟脯安酸(Hop/Cr)的比值。结果与治疗前相比,使用依普黄酮治疗后,患者疼痛状态明显缓解(P〈0.01或P〈0.05).而且腰椎、股骨颈、大转子和髋部的BMD分别增长了4.5%、5.1%、4.8%和3.9%(P〈0.01或P〈0.05);ALP、磷和晨尿羟脯安酸水平均显著下降,而总钙含量明显的升高(P〈0.01或P〈0.05)。结论依普黄酮能够促进骨的形成,对预防女性绝经后骨质疏松有较好的疗效。  相似文献   

11.
The therapy of osteoporosis has made enormous strides in the last decade. There is now a range of interventions, each with its pros and cons. Calcium and vitamin D supplementation remain the foundation and have few safety issues. Bisphosphonates are widely used, though gastrointestinal tolerance is a problem with some oral preparations. Intravenous administration may circumvent this, although this introduces the smaller problem of acute phase reactions. The side effect profile of hormone replacement therapy (HRT) is still being delineated after 40 years of use, with substantial new information expected in the next few years. This will clarify its place in the medical management of the menopause. Raloxifene appears to have a superior safety profile to HRT, though its efficacy on bone may be less. While none of these options is suitable for everyone, the range of available therapies does mean that most patients can find an intervention that is effective and acceptable.  相似文献   

12.
13.
The therapy of osteoporosis has made enormous strides in the last decade. There is now a range of interventions, each with its pros and cons. Calcium and vitamin D supplementation remain the foundation and have few safety issues. Bisphosphonates are widely used, though gastrointestinal tolerance is a problem with some oral preparations. Intravenous administration may circumvent this, although this introduces the smaller problem of acute phase reactions. The side effect profile of hormone replacement therapy (HRT) is still being delineated after 40 years of use, with substantial new information expected in the next few years. This will clarify its place in the medical management of the menopause. Raloxifene appears to have a superior safety profile to HRT, though its efficacy on bone may be less. While none of these options is suitable for everyone, the range of available therapies does mean that most patients can find an intervention that is effective and acceptable.  相似文献   

14.
15.
Abstract

Background:

Due to the chronic nature of osteoporosis and the risk of invasive breast cancer, raloxifene 60?mg/day (raloxifene) is intended to be used for long-term treatment (treatment >3 years).  相似文献   

16.
17.
Reid IR 《Drugs & aging》1999,15(5):349-363
Optimising lifestyle and diet are important in the management of osteoporosis, however, they cannot completely prevent postmenopausal bone loss. Calcium supplementation significantly retards but does not completely arrest bone loss, but several small controlled studies suggest that it reduces fracture incidence. Thiazide diuretics slow bone loss similarly but their effects on fracture incidence remain to be determined. Hormone replacement therapy (HRT) increases or maintains bone density, prevents height loss and prevents vertebral fractures. There is observational evidence that HRT decreases cardiovascular disease and increases the risks of thromboembolic disease and breast cancer. The selective estrogen receptor modulator (SERM) raloxifene also slows postmenopausal bone loss although it is less effective that HRT. It also increases the risk of thromboembolic disease but is associated with a significantly reduced risk of breast cancer. The bisphosphonates are of comparable efficacy to HRT in the prevention of bone loss and have been shown to halve the risk of fractures of the vertebrae, forearm and hip. The maintenance of normal vitamin D (colecalciferol) status is important, particularly in the elderly. HRT, the bisphosphonates and raloxifene are all suitable for use in the prevention of postmenopausal bone loss, but the former 2 are to be preferred in the treatment of established disease. The most comprehensive long term safety data are available for HRT. Clinical trials are underway at present with more potent bisphosphonates which may make possible longer dose intervals and alternative routes of administration. There is a need for an effective bone anabolic factor but those which have been trialled to date have not proceeded because of significant adverse effects.  相似文献   

18.
目的探讨唑来磷酸和普伐他汀对绝经后妇女骨质疏松的治疗作用。方法前瞻性研究我院92例绝经后骨质疏松女性患者,随机分成唑来磷酸+普伐他汀组(A组)、唑来磷酸组(B组)和普伐他汀组(C组),分别按照各自的方案治疗并检测各组治疗前后骨密度值、骨钙素含量。结果各组患者治疗前后骨密度值、骨钙素含量的差异有统计学意义(P〈0.05),A组患者治疗后骨密度值、骨钙素含量均较B、C组高,差异有统计学意义(P〈0.05),但B、C两组患者治疗后骨密度值、骨钙素含量差异无统计学意义(P〉0.05)。结论联合使用唑来磷酸和普伐他汀对骨质疏松有更好的治疗作用。  相似文献   

19.
目的观察玻璃酸钠联合唑来膦酸治疗绝经后妇女骨关节炎伴骨质疏松症的疗效。方法将98例确诊为骨关节炎伴骨质疏松症的患者随机平均分为2组,A组为对照组,关节腔内注射玻璃酸钠2.5 mL,每周1次,5周1个疗程;B组为试验组,除了使用玻璃酸钠外,加用唑来膦酸(密固达)治疗,对患者进行膝关节功能评分、VAS、BMD,结果进行统计分析。结果膝关节功能评分2组间差异无统计学意义(P〉0.05),膝关节疼痛缓解B组优于A组(P〈0.05),骨密度检测A组治疗前后无明显变化,B组较治疗前明显增加(P〈0.05)。结论采用膝关节腔内注射玻璃酸钠加唑来膦酸治疗绝经后妇女骨关节炎伴骨质疏松症患者,效果良好。  相似文献   

20.
蔡飞龙 《海峡药学》2010,22(5):102-104
目的观察阿仑膦酸钠对绝经后妇女骨质疏松症的治疗作用。方法口服阿仑膦酸钠,70 mg每周1次,连用1年,分别在6个月和12个月观察骨密度、U-Ca、U-Cr和U-Ca/U-Cr。结果治疗后6个月和12个月,腰椎L2-4、股骨颈、大转子和全髋骨密度较治疗前都有显著提高(P〈0.05),治疗12个月后与治疗6个月后比较差异也有统计学意义(P〈0.05);治疗6个月后和治疗12个月后U-Ca和U-Ca/U-Cr较治疗前都有显著降低(P〈0.05),且治疗12个月后U-Ca和U-Ca/U-Cr与治疗6个月后比较差异也有统计学意义(P〈0.05);而U-Cr治疗前后差异则无统计学意义(P〉0.05)。结论阿仑膦酸钠对绝经后妇女骨质疏松症有很好的治疗作用。  相似文献   

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