定量CT分析结直肠癌患者治疗前后身体组分的变化及其危险因素

目的 探讨结直肠癌(CRC)患者治疗前后身体组分的变化及其危险因素。方法 回顾性分析2018年1月至2021年12月在医院收治的221例经过根治性手术和术后静脉化疗的CRC患者，其中男性124例，女性97例，对其治疗前后全腹CT扫描图像进行分析。使用定量CT(QCT)分别测量治疗前后腰椎骨密度(BMD)、腹部皮下脂肪面积(SFA)、腹部内脏脂肪面积(VFA)、椎后肌群肌肉面积(MA),并计算出腹部总脂肪面积(TFA)。结果 治疗后SFA高于治疗前，腰椎BMD、椎后肌群MA低于治疗前(P<0.05),治疗后TFA、VFA较治疗前差异无统计学意义(P>0.05)。≥60岁患者治疗后VFA及腰椎BMD低于治疗前(P<0.05)。<60岁患者治疗前后各身体组分差异无统计学意义(P>0.05)。男性患者治疗后TFA及SFA高于治疗前，腰椎BMD及椎后肌群MA低于治疗前(P<0.05)。女性患者治疗后TFA及VFA低于治疗前(P<0.05)。男性、开腹及结肠癌是腰椎BMD下降的独立危险因素(P<0.05)。男性、直肠癌、治疗前低腰椎BMD、T分期大是...     

青年女性腰椎骨密度与体脂分布的相关性

目的研究女性骨密度峰值阶段腰椎骨密度与体脂分布的相关性,探讨青年女性瘦身与老年骨质疏松症发生的关系。方法纳入一组25～35岁的女性志愿者,采集每位志愿者的一般信息(身高、体重、腰围、臀围),计算体质量指数(body mass index,BMI)和腰臀比(waist-hip ratio,WHR)。依据BMI将其分为两组,瘦型(BMI21.4)和胖型(BMI≥21.4)。利用Midways pro定量CT(QCT)分析系统,测量脐水平腹内脂肪面积(visceral fat area,VFA)、腹壁脂肪面积(subcutaneous fat area,SFA)、腰椎2～4的骨密度(bone mineral density,BMD),计算腹脂比(VF/SF)及腰椎平均BMD(vBMD)。两组间体脂参数、vBMD的差异比较采用独立样本t检验,vBMD与体脂参数的相关性采用Pearson相关性检验。结果纳入共计95名志愿者,其中瘦型43名,胖型52名。两组间VFA、SFA比较差异具有统计学意义,P值分别为0.01、0.003;两组间腰臀比、VF/SF、vBMD比较差异没有统计学意义;青年女性腰椎vBMD与VF/SF呈显著性相关(r=0.381,P=0.034)。结论女性腰椎峰值骨密度与BMI、腰围、臀围、VFA、SFA不具有相关性,与腹脂比(VF/SF)显著相关。青年女性科学瘦身不会降低机体骨密度储备。     

定量CT测量的腹部脂肪分布与血脂和血糖的关系

目的探讨腹部内脏脂肪面积（VFA )和皮下脂肪面积（SFA )与血脂、血糖代谢水平的关系。方法2010年于我院行腰椎定量CT( QCT )检查患者277名,年龄范围14耀90岁,中位年龄63岁。使用匝悦栽脂肪测量软件测量脐水平层面VFA和SFA;同时获得患者静脉血总胆固醇（TC )、甘油三酯 (栽郧）、高密度脂蛋白胆固醇（HDL-C)、低密度脂蛋白胆固醇（LDL-C )及空腹血糖（FBG )实验室检查 结果。为了使正常组和异常组年龄匹配,取年龄40岁及以上病例（246例）,根据TC、TG、HDL-C、LDL-C,FBG结果的正常、异常,将VFA和SFA数据分组进行独立样本非参数检验。计算全部病例 (277例）正常、异常组VFA和SFA值的95%.可信区间,并做VFA和SFA与各项实验室指标的相关性 分析。结果 TC、TG、HDL-C、LDL-C正常、异常组间VFA值均有显著性差异（孕<0.05 );TG正常、异 常组间SFA值有显著性意义（孕<0.05 )。VFA与TG、TC、FBG的相关性（则越0. 247 ,0. 326 ,0. 190 )大 于SFA(则越0.210,0. 151,0. 111 )。结论血脂代谢正常、异常人群腹部脂肪面积不同,异常人群大于 正常人群。VFA与血糖、血脂的相关性更大,其中TG为最明显相关因素。根据血糖、血脂异常组脂 肪面积的95%.可信区间可知,本组研究中,高血脂患者的VFA大于140.3 cm2,SFA大于187.2糟皂2 ;高血糖患者的VFA大于140.5 cm2。腹脂面积临界值的确定还有待做更大样本的测量。     

骨硬化蛋白水平与绝经后妇女体脂含量及骨密度的相关性研究

目的 探讨绝经后妇女血清骨硬化蛋白水平与体脂含量及骨密度(bone mineral density, BMD)之间的相关性。方法 对230名年龄在50~75岁之间健康的绝经后妇女进行横断面研究。通过双能X射线吸收仪测量受试者全身、腰椎、左侧股骨BMD及全身脂肪和肌肉含量。通过定量夹心酶联免疫吸附法测量受试者血清骨硬化蛋白水平。结果 与非骨质疏松症的女性相比,骨质疏松女性血清硬化蛋白水平显著降低(P <0.05)。血清骨硬化蛋白水平与体重和脂肪量呈正相关(P <0.05)。即使在校正年龄、绝经年龄、身高和体重之后,骨硬化蛋白水平与全身及各个部位的BMD均呈正相关(P <0.05)。多元线性逐步回归分析显示,与年龄、绝经年龄、脂肪量和肌肉量相比,血清骨硬化蛋白水平是全身和腰椎BMD最重要的决定因素(P <0.05)。年龄与血清硬化蛋白对髋部BMD的影响相似。结论 在绝经后妇女中,骨质疏松症患者的血清硬化蛋白水平低于非骨质疏松症患者。血清硬化蛋白与全身、腰椎、髋部的BMD和体脂含量呈正相关。     

端粒及内脏脂肪对2型糖尿病患者骨密度的影响

目的 探讨端粒长度与内脏脂肪面积（visceral adipose area，VFA）在2型糖尿病（type 2 diabetes mellitus，T2DM）合并骨质疏松症（osteoporosis，OP）发病中的影响作用。方法 收集2020年6月至2021年8月我院内分泌科（为国家标准化代谢性疾病管理中心）T2DM患者160例，将T2DM患者根据骨密度（bone mineral density，BMD）中T值分为OP组、骨量减少组、骨量正常组。利用qPCR法测定外周血白细胞端粒长度。记录所有参与者的一般临床资料，检测血糖、血脂、25羟基维生素D[25(OH)D]、性激素等指标，应用双能X线测定BMD（包括股骨颈、全髋关节、腰椎），应用生物电阻抗法测定VFA，应用SPSS 24.0统计学软件进行数据分析。结果 ①OP组、骨量减少组、骨量正常组中外周血端粒长度依次增加，OP组VFA大于骨量减少组和骨量正常组。②各部位BMD与VFA负相关，与端粒长度正相关。③端粒长度是各部位BMD的独立影响因素，VFA是股骨颈、全髋关节BMD的独立影响因素。结论 T2DM患者低BMD与较大的VFA、较短的端粒长度有关。     

脂肪因子Omentin-1、脂联素与中老年女性骨密度相关性研究

目的观察脂肪因子Omentin-1、脂联素与中老年女性骨密度之间的相关性。方法选取2017年3月至2018年4月在佛山市中医院就诊的338名女性,按照绝经状态分为围绝经期/绝经期组(n=194)和绝经后组(n=124)。将参研人员年龄、体质量指数(bone mass index,BMI)、腰围、吸烟状况、身体活动、脂联素、Omentin-1和激素进行多变量调整(ANCOVA),用于研究其脂肪因子和骨密度(bone mineral density,BMD)之间的潜在关系。结果与绝经后女性的腰椎BMD [(0. 69±0. 08)g/cm~2]相比,围绝经期女性的腰椎BMD[(0. 89±0. 09) g/cm~2]更高;在围绝经期/绝经期组女性中,脂联素和Omentin-1均与腰椎BMD无显著相关性(P0. 05);在绝经后组女性中,脂联素与腰椎BMD无相关性(P 0. 05);而在绝经后组女性中,Omentin-1与腰椎BMD呈显著负相关(P0. 05)。结论绝经后女性的Omentin-1与腰椎BMD呈负相关。     

腰肌指数、腰椎椎体骨髓脂肪分数与骨密度关系及对骨质疏松的诊断效能

目的 探讨腰肌指数(psoas muscle index, PMI)、腰椎椎体骨髓脂肪分数(fat fraction, FF)与骨密度(bone mineral density, BMD)间的关系及对骨质疏松(osteoporosis, OP)的诊断效能。方法 选取四川省骨科医院2018年3月至2021年5月BMD筛查的200例检查者作为研究对象，根据BMD分为骨量正常组(T值≥-1.0,n=105)、骨量减少组(-2.5相似文献   

成人无功能性垂体腺瘤患者术后垂体功能减退对骨密度和身体成分的影响

目的横断面调查成人无功能性垂体腺瘤(non-functional pituitary adenoma,NFPA)术后垂体功能减退患者骨密度(bone mineral density,BMD)及身体成分的改变,进一步分析BMD与身体成分的关系。方法收集2018年11月至2020年1月就诊于中南大学湘雅医院的成人NFPA术后垂体功能减退患者43例,并收集年龄、性别比、体质量指数(body mass index,BMI)匹配的健康对照组56例,测量所有研究对象BMI、腰围、腰臀比,采用双能X线骨密度仪(DEXA)评估腰椎及髋关节的BMD并分析骨骼肌质量及体脂含量。结果(1)垂体功能减退组腰椎L_1~4、股骨颈的BMD及Z值,全身总和骨矿含量均显著低于对照组(P<0.05)。(2)在男性,垂体功能减退患者的腰臀比、腰围身高比、躯干及全身脂肪百分比、脂肪指数显著高于对照组;在女性,垂体功能减退患者的腰围、腰臀比、躯干及全身脂肪百分比、A/G比率、躯干脂肪比/腿部脂肪比均显著高于对照组(P<0.05)。(3)Pearson相关性分析显示,四肢骨骼肌质量(ASM)、骨骼肌质量指数(SMI)与男性患者各部位的BMD呈显著正相关,躯干及全身脂肪百分比与女性患者髋部BMD呈显著负相关(P<0.05)。多元线性回归分析示,SMI是男性患者腰椎L_1~4 BMD、股骨颈BMD、全髋关节BMD、全身骨矿含量的独立保护因素(P<0.05)。结论(1)成人无功能性垂体腺瘤术后发生垂体功能减退的患者出现骨密度减低及腹部脂肪沉积的风险增加。(2)骨骼肌质量及体脂对骨密度有重要影响,SMI是男性垂体功能减退患者腰椎与髋部骨密度、全身骨矿含量的独立保护因素。     

血脂测定在绝经后2型糖尿病妇女骨质疏松中的临床意义

目的探讨血脂检测在绝经后2型糖尿病(type 2 diabetes mellitus,T2DM)妇女骨质疏松(osteoporosis,OP)中的临床意义。方法选取2012年1月至2016年6月我院内分泌科收治的绝经后T2DM患者210例,并选取同期体检的60名无糖代谢异常的绝经后女性作为对照组。检测所有研究对象的血糖、血脂及相关生化指标,采用双能X线骨密度仪检测其腰椎1~4及左股骨颈的骨密度(bone mineral density,BMD)。结果 (1)T2DM组的糖尿病病程、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖、糖化血红蛋白(glycosylated hemoglobin,Hb A1c)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)高于对照组,而高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及左股骨颈BMD低于对照组(P0.05)。T2DM组中骨量减少及OP组血清磷与BMD正常组相比显著降低,而LDL-C显著增高;OP组与骨量减少组相比LDL-C亦增高(P0.05)。(2)T2DM组Pearson相关分析显示,FBG、血清磷、血尿酸均与腰椎1~4BMD、左股骨颈BMD呈正相关,而碱性磷酸酶、LDL-C均与腰椎1~4 BMD、左股骨颈BMD呈负相关;TC与腰椎1~4 BMD呈负相关,Hb A1c、甘油三酯与左股骨颈BMD呈正相关。(3)多因素Logistic分析显示,LDL-C是绝经后T2DM女性BMD降低的独立危险因素(β=1.522,P=0.000)。(4)ROC曲线结果显示,LDL-C为2.09 mmol/L时预测绝经后T2DM女性BMD降低的敏感性为87.9%、特异性为64.3%,曲线下面积为0.69。结论血清LDL-C水平与绝经后T2DM女性BMD降低密切相关,对临床上早期发现OP并采取有效措施具有指导意义。     

mDIXON-Quant技术评估中老年女性骨质量的临床研究

目的 探讨中老年女性腰椎骨髓脂肪分数(fat fraction,FF)和T2?值与骨密度(bone mineral density,BMD)的关联性及mDIXON-Quant技术对骨量下降的诊断效能.方法 招募中老年女性健康志愿者共126名,采用双能X线吸收测量仪(dual-energy X-ray absorptio...     

Altered abdominal fat distribution and its association with the serum lipid profile in non-diabetic haemodialysis patients.

BACKGROUND: Disturbances of lipid and carbohydrate metabolism may be associated with the distribution of abdominal adiposity. However, little is known about the alteration of abdominal adiposity and its association with the serum lipid profile in haemodialysis patients. METHODS: We evaluated the distribution of abdominal adiposity by using computed tomography and examined its relationship with the serum lipid profile in 92 non-diabetic haemodialysis patients and 80 control subjects with normal renal function. Since the mean body mass index (BMI) and total body fat mass were significantly lower in the haemodialysis patients than in the control subjects, the subcutaneous abdominal fat area and the visceral fat area were standardized by body mass index and compared between the haemodialysis patients and the control subjects. RESULTS: Mean subcutaneous fat area/body mass index (SFA/BMI) was significantly lower, and mean visceral fat area/body mass index (VFA/BMI) was significantly higher in the haemodialysis patients (SFA/BMI, 2.40+/-0.12; VFA/BMI, 2.28+/-0.15) than in the control subjects (SFA/BMI, 3.75+/-0.21, P<0.01; VFA/BMI, 1.65+/-0.15, P<0.01). Consequently, visceral fat area/ subcutaneous fat area ratio was significantly higher in the haemodialysis patients (1.05+/-0.07) than in the control subjects (0.46+/-0.04, P<0.01). A scattered plot of visceral fat area relative to BMI revealed that visceral fat area was higher in the haemodialysis patients than in the control subjects at any BMI level. A simple regression analysis showed that BMI, total body fat mass, subcutaneous fat area and visceral fat area were all associated with serum triglycerides and the atherogenic index, (total cholesterol-HDL cholesterol)/HDL cholesterol. Furthermore, a multiple regression analysis indicated that the visceral fat area was the best predictor for either the atherogenic index or triglycerides among these fat components. CONCLUSIONS: These data indicate that haemodialysis patients exhibited a visceral fat accumulation irrespective of BMI, and this shift of abdominal adiposity might be associated with disturbance of the serum lipid profile in non-diabetic haemodialysis patients.     

葛根素对绝经后骨质疏松大鼠骨代谢、骨密度及骨生物力学的影响

目的研究葛根素对绝经后骨质疏松大鼠骨代谢、骨密度及骨生物力学的影响,探讨中医药防治绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)的作用机制。方法48只大鼠随机分为正常组、去卵巢组、骨化三醇组和葛根素组,12只/组,构建绝经后骨质疏松大鼠动物模型并给予不同药物干预8周,正常组和去卵巢组:5 mL/kg 0.9%NaCl,ih,qd;葛根素组:葛根素35 mg/kg,ih,qd;骨化三醇组:骨化三醇0.25μg,po,qd,连续给药6周。检测各组大鼠血清骨代谢指标、骨组织(BMD、BMC)和骨生物力学指标,SP法检测各组骨组织ER表达,HE观察骨组织形态学变化。结果去卵巢组大鼠血清骨代谢指标、腰椎和股骨BMD和BMC、股骨骨生物力学指标较正常组显著降低(P<0.05),骨化三醇组和葛根素组上述指标较去卵巢组均显著增高(P<0.05),葛根素组上述指标较骨化三醇组均增高(P<0.05)。去卵巢组大鼠骨组织ER蛋白表达较正常组显著降低(P<0.05),骨化三醇组和葛根素组ER蛋白表达较去卵巢组均显著增高(P<0.05),葛根素组ER蛋白表达较骨化三醇组均增高(P<0.05)。去卵巢组骨皮质明显变薄,骨小梁稀疏纤细或断裂,排列紊乱,髓腔明显扩大,造血细胞明显减少。葛根素组骨皮质结构较完整,骨小梁数目增多,致密均匀粗壮,连接成网状,髓腔变小,造血细胞增多。结论葛根素通过提高绝经后骨质疏松大鼠雌激素水平,调节骨代谢,提高骨量和骨密度,改善骨生物力学性能和骨形态学结构,起到抗PMOP的疗效和骨保护作用。     

辛伐他汀联合阿仑膦酸钠对去卵巢骨质疏松大鼠骨代谢的影响

目的探讨辛伐他汀联合阿仑膦酸钠干预对去卵巢大鼠骨质疏松骨代谢的影响。方法 60只雌性SD大鼠随机平均分为5组:假手术组、去势组、辛伐他汀组、阿仑膦酸钠组、联合药物组,首先构建去卵巢大鼠骨质疏松性模型。分别检测骨代谢相关生化指标、氧化应激生化指标和骨组织骨密度(bone mineral density,BMD),HE染色观察骨组织形态学。结果去势组大鼠血清Ca、P、SOD、CAT和骨组织BMD均较假手术组显著降低(P0.05),辛伐他汀组、阿仑膦酸钠组、联合药物组上述指标均较去势组升高,以联合用药组升高最显著(P0.05)。去势组大鼠血清ALP、BGP、PICP、TRAP、GLA、ICIP和MDA较假手术组均显著增高(P0.05),辛伐他汀组、阿仑膦酸钠组、联合药物组上述指标较去势组均降低,以联合用药组降低最显著(P0.05)。去势组股骨骨小梁明显稀疏,连接不完整,大量纤维组织,髓腔内大量空泡状脂肪细胞。联合药物组骨小梁数目明显增多,结构较完整,粗细均匀致密,连接成网状。结论辛伐他汀联合阿仑膦酸钠通过调节去卵巢大鼠骨代谢,抗氧化应激,增加骨密度,改善骨组织结构,发挥抗骨质疏松作用。     

Effects of isoflavone and exercise on BMD and fat mass in postmenopausal Japanese women: a 1-year randomized placebo-controlled trial.

The combined intervention of isoflavone intake and walking exercise over 1 year in postmenopausal Japanese women exhibited a trend for a greater effect on prevention of bone loss at the total hip and Ward's triangle regions. INTRODUCTION: The additive effects of isoflavones and exercise on bone and lipid metabolism have been shown in estrogen-deficient animals. In this study, we determined the effects of isoflavone intake, walking exercise, and their interaction on bone, fat mass, and lipid metabolism over 1 year in postmenopausal Japanese women. MATERIALS AND METHODS: A total of 136 postmenopausal women at <5 years after the onset of menopause were randomly assigned to four groups: (1) placebo, (2) walking (45 minutes/day, 3 days/week) with placebo, (3) isoflavone intake (75 mg of isoflavone conjugates/day), and (4) combination of isoflavone plus walking. BMD, fat mass, serum lipid, and serum and urinary isoflavone concentrations were assessed. RESULTS: A significant main effect of isoflavone on the reduction in trunk fat mass was obtained at 12 months. Significant main effects of walking on the reduction in fat mass in the whole body and the trunk were observed at 3, 6, and 12 months and that in the legs and arms at 6 and 12 months. Serum high-density lipoprotein (HDL)-cholesterol concentration significantly increased by 12 months after the walking and the combined intervention. After 12 months, a significant main effect of isoflavone on BMD was observed only at Ward's triangle. Walking prevented bone loss at the total hip and the Ward's triangle to significant degrees. The effect of the combined intervention on BMD at total hip and Ward's triangle regions was greater than that of either alone. No significant interaction was observed between isoflavone and walking in any measurements recorded during the study. CONCLUSIONS: Our study suggest that combined intervention of 75 mg/day of isoflavone intake and walking exercise 3 times/week for 1 year showed a trend for a greater effect on BMD at total hip and Ward's triangle regions than either alone. Intervention with isoflavone in postmenopausal Japanese women showed a modest effect on BMD compared with those in Westerners. Further studies over longer treatment duration that include assessment of BMD at various regions are necessary to ascertain the clinical significance of the combined intervention of isoflavone plus walking in postmenopausal women.     

Bone marrow fat content in relation to bone remodeling and serum chemistry in intact and ovariectomized dogs

Summary It was previously shown that 11 months after ovariectomy the volume fraction of trabecular bone in the spine and 11th rib medullary canal of Beagle dogs (6 control, 9 ovariectomized) was significantly reduced. In this paper it is shown that these changes are accompanied by increased marrow fat volume in the 11th rib (59.0±9.5% vs. 44.3 ±10.0%). Conversely, the volume fraction of functional (hematopoietic) cells in the marrow was reduced by ovariectomy. Additionally, variations in marrow fat volume were tested for correlation with 22 other variables pertinent to bone physiology. Marrow fat volume was significantly positively correlated with serum osteocalcin, rib trabecular bone porosity, rib cross-sectional area, and gains in body weight. It was negatively correlated with serum estrogen concentrations and the extent of rib trabecular surfaces labeled with tetracycline.     

Ovariectomy and trabecular bone remodeling in the dog

Summary The early effects of ovariectomy (OX) on serum biochemistry and trabecular bone remodeling in the dog were investigated. Adult beagle dams were ovariectomized (n=8) or sham-ovariectomized (n=6) and followed for 6 months. All dogs received an iliac crest biopsy at the time of surgery to establish baseline remodeling data. A second contralateral biopsy was obtained at sacrifice. Serum osteocalcin became significantly elevated approximately 8 weeks following OX and remained elevated for the duration of the study. Histomorphometric analysis of serial transilial specimens showed that, at 6 months, OX had significantly increased the rate of bone remodeling in the ilium. Six months following OX in the dog, changes in serum biochemistry and trabecular bone remodeling in the ilium are consistent with those seen in postmenopausal women suffering from “high remodeling osteoporosis”.     

双侧卵巢切除山羊不同时间段骨形态计量学与骨密度的变化

采用骨病理形态学、骨计量学与骨密度测定法,动态观察了山羊假手术组（Ｓｈａｍ）和双侧卵巢切除组（ＯＶＸ）术前、术后３月、６月、１２月和１８月各不同时间段髂骨骨病理形态学、骨小梁体积百分比（Ｖｖ％）,骨小梁宽度和腰椎（Ｌ２－Ｌ４）骨密度的变化。结果显示：Ｓｈａｍ组术后各时间段髂骨骨病理形态学、骨小梁体积百分比和骨小当宽度无明显变化（Ｐ〉０．０５）。Ｌ２￣Ｌ４骨密度呈缓慢上升趋势,至术后１８月比术前增高     

磁共振水-脂分离成像对使用糖皮质激素类风湿患者骨量评价的研究

目的通过利用磁共振水-脂分离成像技术对使用糖皮质激素的类风湿患者椎体脂肪含量的测定,来评估不同年龄段类风湿患者随着激素应用时间的延长,椎体脂肪含量的变化,从而间接评估椎体骨质量。方法纳入40例类风湿患者为研究对象,按年龄分为30~40岁组20例、40~50岁组20例,不同年龄组在治疗前DXA行骨密度值(BMD值)与MR所测腰椎脂肪分数(FF)进行相关性分析;并对不同年龄组治疗前、激素治疗3个月后及6个月后腰椎椎体脂肪分数进行比较;骨髓脂肪FF计算公式:FF=[Mfat/(Mfat+Mwater)]*100%,式中Mwater、Mfat分别指水像及脂像ROI总像素信号强度值。结果不同年龄组类风湿患者治疗前BMD均值组间比较差异有统计学意义(P=0.007);所有患者椎体BMD值与FF值呈显著相关性;用药3个月后脂肪分数上升的程度明显高于用药6个月组,且40~50岁年龄组脂肪分数增加的程度要高于30~40岁年龄组。结论长期使用激素治疗的类风湿患者椎体内脂肪分数明显增加;发病年龄较大及用药时间长的患者腰椎脂肪分数呈逐渐上升趋势,提示使用激素治疗的类风湿患者椎体脂肪含量增加,椎体骨量下降,易发生骨质疏松性骨折。     

Effects of estrogen deficiency on the growth of tissue into porous titanium implants

The effect of systemic deficiency of estrogen on the growth of tissue into porous titanium-fiber implants was studied in ovariectomized Beagle dogs. Five dogs were ovariectomized and five dogs had a sham operation. After waiting four months to allow the levels of circulating estrogen to decline, a titanium-alloy implant that contained four surface pads of titanium-alloy mesh was implanted in the proximal part of the humerus of each dog bilaterally. Two months later, the implants were harvested and subjected to a mechanical push-out test and quantitative histological study. The push-out strength of the implants from the ovariectomized dogs was 31 per cent less than in the control animals. Ovariectomy caused no difference in the amount of ingrowth of bone but resulted in a significant increase in the amount of fibrous connective tissue within the porous pads. The presence of this fibrous tissue appeared to have an important effect on bone-implant fixation: in the control dogs, strength correlated positively with ingrowth of bone and negatively with ingrowth of fibrous tissue, whereas in the ovariectomized dogs, strength correlated positively with ingrowth of fibrous tissue and not at all with ingrowth of bone.