第7～9胸椎CT值对国人成年女性骨密度评估价值的研究

目的探讨胸椎CT值在国人成年女性骨密度(BMD)值评估中的应用价值。方法回顾性研究。纳入2020年3月—2021年7月南京中医药大学附属中西医结合医院成年女性体检者287名, 年龄21～84(55.8±13.6)岁。287名被试者均行胸部CT扫描, 以标准算法重建图像, 采用定量CT(QCT)测量软件分别测量T7～9椎体的BMD值, 计算平均BMD值;在影像存储和传输系统中测量T7～9椎体的CT值, 计算平均CT值。观察胸椎CT值与BMD值之间的相关性。将胸椎BMD值转换为腰椎BMD值, 根据腰椎BMD值诊断被试者骨质状态, 绘制受试者操作特征(ROC)曲线, 分析依据胸椎平均CT值诊断骨质疏松(BMD<80 mg/cm3)和骨质正常(BMD>120 mg/cm3)的灵敏度、特异度和最佳阈值。结果 T7～T9椎体的BMD和T7～9椎体平均BMD分别为(125.17±47.42)、(121.84±48.33)、(123.93±49.24)和(123.67±47.73)mg/cm3, T7～T9椎体的CT值和T7～9椎体平均CT值分别为(157.48±56.97)、(154.9...     

健康国人颈椎和腰椎体积骨密度的定量CT研究

目的 探讨国人健康成人颈椎和腰椎体积骨密度值(vBMD)分布情况。方法 采用横断面研究方法。2014年12月—2016年1月北京积水潭医院招募770名健康志愿者,其中男329名,女441名,年龄21～59岁。志愿者按年龄分为4组:A组(21～30岁)142人,B组(31～40岁)262人,C组(41～50岁)263人,D组(51～60岁)103人。采用日本TOSHIBA 128排CT机对志愿者行颈椎和腰椎定量CT扫描,并使用Mindways骨密度测量软件测量C₂～C₇、L₂～L₄椎体的vBMD值。采用单因素方差分析分别比较颈、腰椎中vBMD在不同性别、年龄组、节段的分布情况,男性、女性颈腰椎间各椎体vBMD的相关性采用Pearson相关分析。结果 男性志愿者C₂～C₇和L₂～L₄椎体vBMD分别为(288.40±60.63)、(275.71±56.33)、(283.91±59.62)、(278.95±53.76)、(253.38±49.99)、(217.94±44.96)和(151.64±31.74)、(145.22±31.77)、(147.16±35.81)mg/cm³,女性志愿者分别为(329.24±74.34)、(313.88±67.86)、(328.54±73.40)、(323.22±72.53)、(286.44±66.36)、(251.53±58.63)和(168.50±37.10)、(160.78±37.00)、(162.81±37.10)mg/cm³。无论男性还是女性,颈椎及腰椎的体积骨密度值均随着年龄增长而逐渐下降,差异均有统计学意义(P值均＜0.05)。男性志愿者同一年龄组内比较:C₂～C₇不同椎体的vBMD均呈下降趋势,差异均有统计学意义(P值均＜0.05);而L₂～L₄不同椎体的vBMD差异均无统计学意义(P值均＞0.05)。女性志愿者同一年龄组内比较:C₂～C₇不同椎体的vBMD均呈下降趋势,差异均有统计学意义(P值均＜0.05);D组L₂～L₄各椎体的vBMD均呈下降趋势,差异有统计学意义(P＜0.05),其他年龄组vBMD差异均无统计学意义(P值均＞0.05)。无论是男性或女性志愿者,在任何年龄组,颈椎vBMD均＞200 mg/cm³,腰椎vBMD值均＜200 mg/cm³,颈椎vBMD值均高于腰椎(P值均＜0.01)。男性、女性颈腰椎不同椎体间vBMD值均具有显著的相关性(r_男性=0.509～0.968, r_女性=0.658～0.976, P值均＜0.01);男性中,r_颈椎间=0.667～0.928,r_腰椎间=0.850～0.968,r_{颈椎与腰椎间}=0.509～0.675;女性中,r_颈椎间=0.754～0.933,r_腰椎间=0.956～0.973,r_{颈椎与腰椎间}=0.658～0.752;颈椎间或腰椎间vBMD相关系数均高于颈腰椎之间相关系数。结论 颈椎和腰椎vBMD在不同性别、年龄、节段分布存在差异,但各椎体vBMD均存在中-强相关性。本研究结果可为临床监测骨质疏松、评估骨折风险提供参考数据。     

大连地区汉族成年女性腰椎骨密度定量CT测量分析

目的:探索大连地区健康成年女性骨密度及其峰值随年龄变化规律,为女性骨质疏松症的防治提供科学依据,同时为建立中国北方成人女性的正常骨密度值数据库积累数据.方法:采用定量CT技术测量分析大连500例汉族健康女性腰椎各椎体骨密度.腰椎骨密度随年龄的变化用三次回归模型拟合来描述.结果:大连地区女性成人腰椎骨密度平均值(156.4±12 09)mg/ml,平均峰值(167.16±4.90)mg/ml,出现在20～29岁年龄段.40～49岁腰椎骨量丢失有统计学意义,与前组比较平均骨量丢失10.38%; 30～39岁、50～59岁与前组比较,平均骨量丢失2.98%、 4.10%.第5腰椎在4个年龄组里,骨量丢失改变有统计学意义.大连地区20～59岁汉族女性骨密度正常参考值范围为(164.07±30.23)mg/ml.结论:大连地区汉族成人女性从40岁起进入绝经过渡期,腰椎骨量丢失明显.     

大连汉族成年男性腰椎骨密度CT定量研究

目的探索健康成年男性骨密度及其峰值变化规律,为骨质疏松症的防治提供科学依据,同时为建立中国北方成人的正常骨密度值数据库积累数据。方法采用定量CT技术和骨密度专用分析软件测量分析腰椎L1-L5椎体骨密度。结果大连地区成人腰椎骨密度平均值(197.27±23.71)mg/ml、峰值(212.60±7.08)mg/ml,诊断骨质疏松症的正常参考值(212.60±59.26)mg/ml;平均峰值出现在24-32岁,之后骨密度随年龄逐渐缓慢下降,48-50岁骨量丢失显著;其中L4椎体在20-59岁的各年龄段的骨量变化均有显著性差异,比其他腰椎更具有年龄敏感性。结论大连地区汉族男性成人应从48岁关注预防骨质疏松症。     

成年国人冠状动脉管径的CT解剖学研究

目的 探讨冠状动脉管径随年龄变化的规律以及冠脉管径与其分布类型的关系. 方法 将临床及影像学检查无冠状动脉疾患的患者104人,行多层螺旋CT(MSCT)冠状动脉检查,并按照年龄及冠脉分布类型进行分组.冠状动脉的分段采用美国心脏协会15分段法.用MSCT测量右冠近段、中段及远段,左主干,前降支近段、中段及远段,回旋支近段及远段的起始部短轴化直径. 结果 MSCT检查结果 显示,右冠、前降支近、中、远段管径以及回旋支近段、远端管径两两相比均有显著性差异.冠状动脉各段管径在青年组至老年组中依次增大,老年组左主十管径较青、中年组有显著性差异,其余冠脉段管径在各年龄组问均兀显著性差异.左主干的管径以左优势型组中最大,与其他两型的左主干管径相比均有显著性差异,后两者左主干管径无显著性差异.前降支各段管径以左优势型组中最大,各段管径在3组间无显著性差异.回旋支各段管径以左优势型组最大,右优势型组最小,其中左优势型组的同旋支近段管径与其他两型相比有显著性差异,而后两者间无显著性差异;回旋支远段管径在3组间均有极显著性差异.右冠各段管径以有优势型组中最大,左优势型组最小,其中右优势型组的右冠近段管径与其他两型相比有显著件差异,而后两者间无显著性差异;右冠中、远段管径在3组间均有显著性差异. 结论 MSCT能多角度、多体位地显示冠状动脉.冠脉各段管径随年龄增加而增大,且管径与其分布类型相适应,活体冠状动脉各段管径的测量对冠状动脉病变的诊断具有一定的临床价值.     

胎儿标本胸12椎体水平椎管发育的CT影像研究

目的 CT影像测量胎儿标本胸12椎体(T₁₂)水平正常椎管的形态、大小,并分析其随胎龄增长的发育趋势。方法 利用64排螺旋CT对30例23～40孕周脊柱发育正常的胎儿标本进行扫描,并以T₁₂椎体中份水平为中心进行3D重建,在T₁₂椎体中份水平横断面图像上观察T₁₂椎管的正常形态,使用Image J软件测量椎管的前后径、左右径和面积,计算出各胎龄所测径线的平均值,并对所测数据和胎龄作回归分析,分析其随胎龄增长的发育趋势。结果 T₁₂水平椎管可以清晰显示,呈类圆形,并随胎龄逐渐增大,其前后径、左右径及面积均随胎龄呈线性增长,线性回归方程分别为:＾Y_{椎管前后径}(mm)=0.126+0.26×X_胎龄(周),R²=0.857, P<0.01 ;＾Y_{椎管左右径}(mm)=-0.411+0.274×X_胎龄(周),R²=0.822,P<0.01;＾Y_椎管面积(mm²)=-52.09+3.43×X_胎龄(周),R²=0.911,P<0.01。结论 CT可清晰显示胎儿T₁₂椎体水平椎管形态;T₁₂水平椎管各径线的大小与胎龄有良好的相关性,可以用来评估胎儿脊柱发育。     

西北地区国人正常髌股关节CT影像解剖学研究

目的 探讨西北地区国人正常髌股关节CT影像相关解剖学测量数据在不同性别间差异,为人工膝关节假体设计提供参考。方法 收集2017年5月—8月西安交通大学第二附属医院招募的78名志愿者156侧正常膝关节CT影像资料进行横断面研究。采用美国GE Revolution CT机,对78名志愿者自髂棘至足底进行CT扫描及三维重建,测量两侧髌骨厚度、髌骨关节面厚度、髌骨宽度、髌骨外侧关节面宽度、髌骨纵向长度、髌骨关节面长度、股骨左右径、股骨前后径、前股骨偏心距、滑车沟角。采用独立样本t检验分析不同性别间各观测指标的差异;应用线性回归模型控制年龄、身高、体质量偏倚,再次分析不同性别间各测量指标的差异,并对所有观测指标进行Pearson相关分析。结果 78名志愿者,不同性别间年龄、身高、体质量、BMI比较,差异均有统计学意义(t=6.270、17.602、11.366、4.377,P值均＜0.01)。在控制年龄、身高、体质量偏倚前,男性髌骨厚度、髌骨关节面厚度、髌骨宽度、髌骨外侧关节面宽度、髌骨纵向长度、髌骨关节面长度、股骨左右径、股骨前后径、前股骨偏心距分别为(22.39±1.53)mm、(11.75±0.94)mm、(47.04±2.81)mm、(27.18±2.16)mm、(45.18±2.74)mm、(30.60±2.28)mm、(86.31±3.94)mm、(66.76±3.26)mm、(6.37±1.38)mm,均明显大于女性的(19.75±1.29)mm、(10.91±0.95)mm、(40.47±2.30)mm、(23.37±1.61)mm、(38.74±2.51)mm、(26.76±1.70)mm、(74.28±3.00)mm、(60.07±2.89)mm、(5.63±1.36)mm,差异均有统计学意义(t=11.692、5.582、16.024、12.518、15.303、11.969、21.545、13.581、3.381,P值均＜0.01);控制偏倚后,髌骨关节面厚度和前股骨偏心距男性、女性之间差异均无统计学意义(P值均＞0.05),其他指标男性、女性之间差异仍均有统计学意义(t=2.057、6.581、5.207、4.673、3.045、8.053、2.331,P值均<0.05)。而滑车沟角男性为139.43°±4.78°,女性为138.29°±4.22°,无论是否控制年龄、身高、体质量偏倚,差异均无统计学意义(P值均＞0.05)。Pearson相关分析结果显示,滑车沟角与年龄、髌骨关节面厚度、前股骨偏心距之间呈负相关,其他观察指标之间均呈正相关。在呈正相关的指标中,前股骨偏心距与其他指标相关系数均＜0.30,呈弱相关性;滑车沟角除与髌骨外侧关节面宽度相关系数为0.32外,与其他指标相关系数均＜0.30,呈弱相关性。结论 不同性别间正常髌股关节CT影像相关解剖学测量数据存在差异,即使在同样大小的股骨或髌骨时,前股骨偏心距与滑车沟角也可能存在较大的变异性。因此,在设计膝关节假体时不仅要根据性别不同满足患者的需要,同时应注意股骨前髁设计的多样性。     

定量CT与双能X线骨密度仪测量腰椎骨密度准确性比较

目的:观察并比较定量CT与双能X线骨密度仪测量腰椎各椎体间骨密度的准确性。 方法:100例研究对象选自健康体检者,将其按照不同测量方式分为观察组和对照组。观察组采取双能X线方式,对照组采取定量CT方式,测量腰椎体的骨密度,观察两种方式的测量准确性。 结果:对照组男性和女性的L2-L4椎体骨密度不尽相同,椎体间骨密度值存在明显差异（P<0.05）,且由L2-L4以递增趋势呈现。观察组男性和女性的L2-L4椎体骨密度数值无显著差异（P>0.05）。 结论:对腰椎各椎体间骨密度采用定量CT进行测量,可有效提升测量准确度,为临床诊断和治疗疾病提供有效参考。     

CT三维重建青少年胸椎椎弓根断面测量的解剖学研究

目的　为青少年胸椎椎弓根内固定术提供解剖学数据。　方法　多排螺旋CT对正常青少年（14～17岁）46例自愿者进行胸椎扫描,三维重建后,测量椎弓根高、椎弓根宽、椎弓根骨松质宽及椎弓根骨松质高,观察椎弓根内部骨质分布情况。　结果　椎弓根宽呈两端大、中段小的变化趋势,T4最小（3.85±0.77）mm,T1最大（8.12±1.39）mm;椎弓根高为逐渐增加的波浪形曲线,T3小峰：（10.93±0.88）mm,　T12最大：（15.68±1.25）mm;椎弓根骨松质宽为先减小后增大,T11最大（5.24±1.3）mm;椎弓根骨松质高T4最小（5.74±2.4）mm,T11最大（13.18±2.3）mm。　结论　青少年胸椎真正能决定螺钉直径的是骨松质宽,椎弓根螺钉置入时应结合影像学资料,选择合适的螺钉及进钉部位和方向。     

成年国人大网膜多层螺旋CT应用解剖学研究

目的研究成人大网膜的多层螺旋CT解剖,探讨相关临床意义,为影像诊断和外科应用提供理论基础。方法利用成人腹部16层螺旋CT的横、冠、矢状断层及三维图像,观察大网膜的解剖分布、与周围脏器毗邻关系、血管的形态特点,探讨不同断面的显示优势以及临床应用。结果1.各种断面的优势:横断位在于观察大网膜的分布以及脂肪情况;冠状位在于观察血管情况;矢状位在于观察大网膜与邻近脏器的解剖毗邻关系。2.三维重建图像可满意地显示胃网膜静脉回流情况。3.胃结肠静脉(包括典型及非典型)出现率为67.2%;游离部具“游走性”:20.7%移位于上腹腔,17.2%偏右下腹腔分布;大网膜脂肪密度CT值为(-104.97±10.78)Hu,与皮下脂肪差别无统计学意义。结论胃网膜动静脉为寻找大网膜的标志,3种断面及三维图像相结合可充分显示大网膜的解剖学特征,并可为影像诊断、修复外科、胰腺及门静脉高压外科提供有价值的信息。     

Discrepancies between vertebral bone density values: the least dense vertebra

Vertebral bone mineral density (BMD) measurements by DXA are considered reliable indicators of local fracture risk in the absence of radiographic deformities. The clinical evaluation of one individual vertebra presenting a BMD value significantly less than the others is attempted in this study. For a period of 30 months, BMD measurements of L1–L4 vertebrae and femoral neck (FN) were performed by DXA in 817 postmenopausal women, aged under 65 years, with a BMI less than 33 kg/m². In 204 (25%) of these women (group A), the least dense vertebra (LDV) presented a BMD value lower than 92.4% from the immediate denser vertebra. The remaining 613 women comprised group B. Women with X-ray proven vertebral degenerative lesions or deformities were excluded from the study. Among the four measured vertebrae, L1 was the most frequent LDV (47%), whilst L3 was the most rare (2%). Absolute and age-adjusted BMD values of L1–L4 and FN, as well as the proportions of osteopenic or osteoporotic women, did not differ significantly between the two groups. A significant positive correlation was observed between either L1–L4 or LDV and FN BMD values in both groups, but stepwise multiple regression analysis revealed that in group A the LDV did not participate in the model explaining the variability of the FN BMD values. In group B, the least dense vertebra was the only variable participating in the respective model (adjusted-R² = 37.7%). It is concluded that in a significant proportion of relatively young postmenopausal women, a wide variance of BMD values exists between individual vertebral BMD values without radiographic background. L1 was the most frequent LDV and L3 the most rare. In such cases, the evaluation of the least dense vertebra seems to offer an alternative estimation of vertebral bone mass, instead of mean L1–L4.     

Evaluation of methods for prediction of bone mineral density by clinical and biochemical variables in perimenopausal women

Objectives: to predict spinal and femoral bone mineral density (BMD) in perimenopausal women from simple clinical and biochemical variables. Methods: 2016 women 3–24 months past last menstrual bleeding. Mean age 50.1±2.8 years. Age, height, weight, number of full term pregnancies, weekly hours of physical activity, sunbathing habits, use of sun bed, daily intake of calcium and vitamin D, smoking habits, consumption of alcohol, coffee, and tea, history of forearm or femoral neck fractures among the parents, serum osteocalcin (S-OC), serum bone specific isoenzyme of alkaline phosphatase (BSAP), and urine hydroxyproline/creatinine ratio (U-OHP) were used as predictors in three different mathematical models. Lumbar spine (L2–L4) and femoral neck BMD were measured by DEXA. Three mathematical models (multiple regression, logistic regression, and discriminant analysis) were applied. Results: the multiple regression explained 19–21% of the total variation, and the logistic regression and discriminant function had a sensitivity between 53 and 67% with specificity ranging from 67 to 80%. Age, S-OC, serum bone specific alkaline phosphatase, and a maternal history of forearm or femoral neck fractures seemed to be reproducible risk factors for low bone mineral density irrespective of the mathematical model applied. When applied to a separate population, the models performed poorly. Conclusions: Simple clinical and biochemical variables are not useful to predict spinal and femoral BMD in the individual perimenopausal woman.     

螺旋CT结合CA19-9在胰腺癌可切除性评价中的应用

目的 探索螺旋CT双期扫描与CA19-9检测相结合在胰腺癌术前可切除性评价中的应用价值. 方法 回顾分析2002年2月至2006年2月本院52例胰腺癌患者的临床资料,根据螺旋CT双期扫描结果和血清CA19-9检测结果进行胰腺癌术前可切除性评价. 结果 CT判断胰腺癌不可切除的准确率为100%,而判断可切除的准确率为73.30%.随着胰腺癌浸润程度的进展,CA19-9水平有增高的趋势.局部侵犯组CA19-9均值与可切除组和转移组CA19-9均值差异无统计学意义.以CA19-9大于150 U/ml作为不可切除判断的临界值,在不可切除组41例患者中,只有10例患者的血清CA19-9水平大于150 U/ml,占24.39%. 结论 血清CA19-9水平随胰腺癌浸润进展程度有逐渐升高的趋势,但CA19-9水平并不能反应胰周大血管受侵犯.CA19-9检测与CT结合在胰腺癌术前可切除性评价中的临床实用价值有限.     

Sustained swimming increases the mineral content and osteocyte density of salmon vertebral bone

This study addresses the effects of increased mechanical load on the vertebral bone of post-smolt Atlantic salmon by forcing them to swim at controlled speeds. The fish swam continuously in four circular tanks for 9 weeks, two groups at 0.47 body lengths (bl) × s(-1) (non-exercised group) and two groups at 2 bl × s(-1) (exercised group), which is just below the limit for maximum sustained swimming speed in this species. Qualitative data concerning the vertebral structure were obtained from histology and electron microscopy, and quantitative data were based on histomorphometry, high-resolution X-ray micro-computed tomography images and analysis of bone mineral content, while the mechanical properties were tested by compression. Our key findings are that the bone matrix secreted during sustained swimming had significantly higher mineral content and mechanical strength, while no effect was detected on bone in vivo architecture. mRNA levels for two mineralization-related genes bgp and alp were significantly upregulated in the exercised fish, indicating promotion of mineralization. The osteocyte density of the lamellar bone of the amphicoel was also significantly higher in the exercised than non-exercised fish, while the osteocyte density in the cancellous bone was similar in the two groups. The vertebral osteocytes did not form a functional syncytium, which shows that salmon vertebral bone responds to mechanical loading in the absence of an extensive connecting syncytial network of osteocytic cell processes as found in mammals, indicating the existence of a different mechanosensing mechanism. The adaptive response to increased load is thus probably mediated by osteoblasts or bone lining cells, a system in which signal detection and response may be co-located. This study offers new insight into the teleost bone biology, and may have implications for maintaining acceptable welfare for farmed salmon.     

伤椎内球囊扩张植骨治疗胸腰椎爆裂骨折的应用价值研究

目的探讨后路钉棒复位固定联合经椎弓根伤椎内球囊扩张后植骨手术,在胸腰椎爆裂骨折治疗中的应用价值。方法 31例胸腰段及腰椎爆裂骨折,采用后路椎弓根钉棒复位固定,经伤椎椎弓根置入PKP系统球囊,扩大伤椎内骨质空腔,植入人工骨填充的方法进行治疗,并在手术时间、透视次数、植骨量、出血量、椎体前后缘平均高度、Cobb角、椎管占位等方面,与钉棒复位经椎弓根单纯植骨方法做初步对比。结果31例爆裂骨折复位固定良好,神经功能ASIA评分无一例加重,伤椎内植骨区域填充良好,22例患者术后坚持随访,无一例断钉断棒,骨折愈合良好,伤椎内无空腔形成,取出内固定物后6月复查,无一例伤椎塌陷;在手术时间、透视次数、出血量、椎体前后缘平均高度、Cobb角、椎管占位等方面,与经椎弓根单纯植骨手术无明显差异,但植骨量更加充分,有明显的统计学差异(P0.01)。结论本术式治疗胸腰椎爆裂骨折理论上是一种有效手段,但与传统的简单钉棒复位固定方式比较,是否可以明显减少钉棒取出后伤椎塌陷的发生,还需深入研究及大宗病例随访。     

Reduced bone mineral density and low parathyroid hormone levels in patients with the adult form of hypophosphatasia

Summary Hypophosphatasia is a heritable metabolic bone disease with characteristically reduced levels of alkaline phosphatase (ALP) in the blood, liver, kidney and bone. ALP levels are normal in the intestine and placenta. About 300 patients have been reported so far in the literature. Three kindreds with 52 known subjects are described here, whereby 12 subjects could be examined osteologically. Four subjects were patients and had clinical signs of the disease: spontaneous fractures of the metatarsals or femora and low ALP serum levels ranging between 8 and 23 U/1 (normal range 40–170 U/1). Four other members without fractures had reduced ALP levels; they might be carriers of the disease and develop symptoms later in life. The four remaining subjects had normal ALP levels and no signs of the disease. Serum levels of intact parathyroid hormone (iPTH) were found to be in the lower normal range and serum calcium levels in the upper normal range. There was a significant (P<0.05) negative correlation between iPTH and serum calcium levels (r=–0.78). Urinary calcium excretion was increased in 3 subjects with fractures. 25-OH-D₃ levels were increased in 6 of 8 subjects without any treatment. The bone mineral density (BMD) was measured using dual X-ray absorptiometry of the lumbar spine, representing mainly trabecular bone, and single-photon absorptiometry of the forearm, measuring mainly cortical bone. Z-scores of the spinal bone mass ranged between 0.38 and –1.95 SD; Z-scores of the forearm bone mass ranged between 0.53 and –2.47 SD with the lowest values in patients with fractures. There was a significant (P<0.05) correlation between serum ALP levels and forearm BMD (r=0.83). We conclude from these data that patients with the adult form of hypophosphatasia have decreased forearm and subnormal spinal bone mass, as well as reduced serum levels of iPTH.Abbreviations BMD bone mineral density - ALP alkaline phosphatase - iPTH intact parathyroid hormone - 25-OHD₃ 25-hydroxyvitamin D₃ - SD standard deviation - PEA phosphoethanolamine - PPi inorganic pyrophosphate - PLP pyridoxal-5-phosphate - cDNA clonal desoxyribonucleic acid - U/S Ca²⁺ urinary/serum calcium - DXA dual X-ray absorptiometry - DPA dual photon absorptiometry - SPAD bone density of distal forearm measured by single photon absorptiometry - SPAP bone density of proximal forearm measured by single photon absorptiometry     

Complex segregation analyses of bone mineral density in Chinese

China has the largest population in the world; approximately 7% of the total population suffers from primary osteoporosis. Osteoporosis is mainly characterized by low bone mineral density (BMD). In the present study, familial correlation and segregation analyses for spine and hip BMDs have been undertaken for the first time in a Chinese sample composed of 401 nuclear families with a total of 1,260 individuals. The results indicate a major gene of additive inheritance for hip BMD, whereas there is no evidence of a major gene influencing spine BMD. Significant familial residual effects are found for both traits, and heritability estimates (±SE) for spine and hip BMDs are 0.807(0.099) and 0.897(0.101), respectively. Sex and age differences in genotype‐specific average BMD are also observed. This study provides the first evidence quantifying the high degree of genetic determination of BMD variation in the Chinese.     

Association between depression and bone mineral density in community-dwelling older men and women in Korea

Objectives

Previous research suggested a significant correlation between depression and osteoporosis, but little is known for the elderly Asian population. We investigated an association between depression and bone mineral density (BMD) in the Korean elderly.

Study design

Cross-sectional data analysis of a community-based study, Kangwha Island, South Korea.

Main outcome measures

BMD, measured at the os calcis using a quantitative ultrasound device, was expressed as stiffness index and T-score. Depressive symptoms were evaluated by the Korean version of Beck Depression Inventory (K-BDI). Depression was defined as a K-BDI score of 16 or higher. Participants also completed a questionnaire, including demographic factors, metabolic abnormalities, and health-related lifestyle factors.

Results

A total of 932 local residents (422 men and 510 women) aged 60–80 years completed the questionnaires and baseline BMD evaluation. Men with depression had a significantly lower stiffness index compared to those without depression in an age-adjusted (77.2 ± 5.2 vs. 86.0 ± 1.5, p = 0.002) and a multivariate-adjusted model (78.5 ± 5.2 vs. 85. 9 ± 1.5, p = 0.007). Correspondingly, men with depression had an increased probability of having an osteoporosis (T-score ≤ −2.5) compared to those without depression; the age-adjusted odds ratio was 2.86 (95% CI, 1.36–6.01) and the multivariate-adjusted odds ratio was 2.69 (95% CI, 1.26–5.76). However, no significant association was observed in older women.

Conclusions

Depression was significantly associated with lower BMD in Korean older men, but not in women.     

Association of KIT gene polymorphisms with bone mineral density in postmenopausal Korean women

Bone mineral density (BMD) is a major factor for determining bone strength and osteoporotic fracture risk, and is determined by environmental and multiple genetic factors. KIT, which encodes a transmembrane receptor with tyrosine kinase activity, plays an important role in the differentiation of osteoclasts. We examined the associations between KIT gene polymorphisms and BMD in postmenopausal Korean women. All exons, their boundaries, and the promoter region (approximately 1.5 kb) from 24 individuals were directly sequenced. Eighteen polymorphisms were identified, and three single-nucleotide polymorphisms (SNPs) were genotyped in all study participants (n = 946). BMD at the lumbar spine and femoral neck was measured using dual-energy X-ray absorptiometry. The mean age of the study subjects was 58.9 ± 7.5 years, and the mean number of years since menopause was 9.6 ± 7.9 years. None of the three SNPs (−1694G>T, +41894A>G, and +49512G>A) was significantly associated with BMD value. However, multivariate analysis showed that the ht3 (−1694T-+41894A-+49512G) was significantly associated with lower BMD at the femoral neck (P = 0.007 in the recessive model). These findings indicate that KIT-ht3 may be a useful genetic marker for osteoporosis and that KIT may have a role on bone metabolism in humans. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. S.-Y. Kim and J.-Y. Lee are co-first authors.