OBJECTIVE:A forearm fracture (Colles' fracture) is often the first sign of osteoporosis and should alert the patient and physician to the possibility of underlying skeletal fragility. Therefore, the establishment of a more accurate and reliable method for the measurement of bone mineral density (BMD) at the distal radius would be beneficial for the patients who suffer from osteoporosis. The objective of the present study was to evaluate the usefulness of peripheral quantitative computed tomography (pQCT) to assess the change of BMD at the distal radius in early postmenopausal women who receive hormone replacement therapy (HRT). METHODS:Twenty healthy early postmenopausal women who were diagnosed as osteoporosis or osteopenia were randomized to either HRT or placebo treatment. We analyzed BMD of the distal radius by pQCT, lumbar spine by dual-energy X-ray absorptiometry (DXA) and the biochemical markers of bone turn over (osteocalcin, deoxypyridinoline) every 6 months. RESULTS:The placebo group showed a significant decrease from the baseline in the trabecular BMD of the radius at 12 months (7.4+/-2.5%) (p<0.05), whereas the HRT group showed a slight increase (0.7+/-2.2%). The changes in the trabecular BMD of the radius between the HRT and placebo groups were statistically different at 12 months (p<0.05). On the other hand, in the cortical BMD of the radius, no significant differences were seen between the changes of bone densities in the HRT and control groups after 1 year of treatment. pQCT could detect a significant loss of BMD of the radius in early postmenopausal women after 1 year and HRT prevented its loss. CONCLUSION:Our preliminary clinical trial showed that pQCT might be useful for the early detection of bone loss in early postmenopausal women and for the monitoring BMD of the patients who receive HRT.

译文

目的:前臂骨折(Colles骨折)通常是骨质疏松的最初征兆,应提醒患者和医生潜在的骨骼脆弱性。因此,建立一种更准确和可靠的方法来测量远端radius骨的骨矿物质密度(BMD)对于患有骨质疏松症的患者将是有益的。本研究的目的是评估外围定量计算机体层摄影术(pQCT)的有效性,以评估接受激素替代疗法(HRT)的绝经后早期女性the骨远端骨密度的变化。
方法:将20名被诊断为骨质疏松或骨质减少的健康早期绝经后妇女随机分为HRT或安慰剂治疗组。我们每6个月分析一次pQCT对远端B骨的BMD,双能X射线吸收法(DXA)对腰椎的影响,以及骨翻倒的生化标志物(骨钙蛋白,脱氧吡啶并啉)。
结果:安慰剂组在12个月时the骨小梁BMD较基线显着降低(7.4 /-2.5%)(p <0.05),而HRT组则略有增加(0.7 /-2.2%) 。 HRT组与安慰剂组之间的radius骨小梁BMD变化在12个月时有统计学差异(p <0.05)。另一方面,在治疗1年后,HRT和对照组的骨密度变化在B骨的BMD中没有显着差异。 pQCT可以检测到绝经后早期女性在1年后B骨BMD的显着减少,而HRT可以防止这种情况的发生。
结论:我们的初步临床试验表明,pQCT可能对早期绝经后妇女的骨丢失早期检测以及监测接受HRT的患者的BMD有用。

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