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1.
目的:探讨左旋多巴治疗帕金森病(PD)时测定血同型半胱氨酸水平的临床意义。方法:收集我院内科2012年3月到2014年3月住院和门诊的PD患者50例(病例组),选取健康体检者50例作为对照组,比较两组同型半胱氨酸、叶酸以及维生素B12差异以及同型半胱氨酸与叶酸、维生素B12和左旋多巴剂量和PD患者评分(UPDRS评分)相关性。结果:病例组血浆同型半胱氨酸水平显著高于对照组、差异具有的统计学意义(P0.05),叶酸以及维生素B12低于对照组,两组之间的差异具有统计学意义(P0.05);按照血浆同型半胱氨酸剂量将病例组分为两个亚组,高剂量组(≥14μmol/L)和低剂量组(14μmol/L),两亚组叶酸、维生素B12、左旋多巴剂量和UPDRS评分之间差异均无统计学意义(P0.05);相关性分析发现,同型半胱氨酸与叶酸、维生素B12以及UPDRS评分呈负相关(r=-0.545,-0.337,-0.233,P=0.001,0.009,0.013),与左旋多巴剂量呈正相关(r=0.518,P=0.001)。结论:左旋多巴治疗PD可使血同型半胱氨酸水平升高并降低叶酸、维生素B12的含量,临床上应加强叶酸、维生素B12等营养支持治疗。  相似文献   

2.
目的:探讨老年女性类风湿关节炎(RA)合并骨质疏松症的代谢特点。方法:选择老年绝经后女性RA患者共59例,检测患者血生化代谢指标如血糖、血脂、CRP等和骨代谢指标如骨钙素(OC)、β-胶原特殊序列(β-Crosslaps)甲状旁腺素(iPTH)等,并进行统计分析。结果:骨质疏松患者的绝经时间、病程长度、OC、β-Crosslaps、iPTH显著高于骨量正常和骨量减少的患者,25羟基维生素D显著低于骨量正常和骨量减少的患者(P均0.05)。RA患者的骨密度水平与是否使用激素和X线分期情况无关。结论:老年女性RA患者易发生骨质疏松,出现骨质疏松的RA女性患者绝经时间更长,可出现脂代谢紊乱及明显的维生素D缺乏,并具有高转换型骨代谢特点。  相似文献   

3.
目的:考察强直性脊柱炎(ankylosing spondylitis,AS)患者骨代谢生化指标变化,并分析其与RNAKL-RANK-OPG系统表达之间的相关性.方法:研究对象为40名强直性脊柱炎男性患者,40名健康男性为对照组,记录强直性脊柱炎AS患者的病程,体重指数(body mass index,BMI),甲状旁腺素(parathyroid hormone,PTH),血钙,血磷,碱性磷酸酶(alkaline phosphatase,ALP)等临床指标,采用双能X线吸收法测定AS患者的骨密度(bone mineral density,BMD),利用免疫分析法检测血清中骨吸收指标骨钙素(bone glutamyl protein,BGP),Ⅰ型强胶原羧基肽(carboxyterminal propeptide of type Ⅰ procollagen,PICP),骨碱性磷酸酶(bonealkaline phosphatase,BALP),骨吸收指标抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatase,TRAP)及sRANKL,OPG的表达.分析骨代谢指标,RANKL-RANK-OPG与各项临床指标的相关性.结果:AS患者PICP,BALP,TRAP及sRANKL、OPG的表达较正常对照组存在明显的差异,具有统计学意义.不同部位的骨密度发生不同程度的骨量减少和骨质疏松,股骨颈、大转子、转子间和股骨颈分别为28%、45%、40%和50%,与骨代谢指标存在一定的相关性,TRAP与大转子的骨密度成负相关(r=-0.369,P=0.019),PICP与大转子的骨密度成正相关(r=0.391,P=0.013),BGP与转子间的骨密度成负相关(r=-0.419,P=0.009),sRANKL/OPG与腰椎密度均呈现负相关(r=-0.134,P=0.011).骨代谢指标之间以及与临床指标也存在不同程度的相关性,sRANKL与OPG存在正相关(r=0.369,P=0.019)sRANKL/OPG与sRANKL、OPG存在负相关(r=-0.334,P=0.035;r=-0.983,P=0.000).结论:AS患者骨代谢发生异常,骨吸收增强.RANKL-RANK-OPG系统失衡可能是AS骨量减少和伴随发生骨质疏松的机制之一.  相似文献   

4.
目的:探讨血清雌激素水平的变化与绝经后骨质疏松妇女血清骨硬化蛋白含量之间的关系.方法:比较分析100例健康妇女和100例绝经后骨质疏松妇女血清SO和E2水平的变化特点及相关性.结果:PMOP组血清E2水平显著下降(P<0.01),sost基因的mRNA水平和蛋白水平则明显上调(P<0.05),两者之间呈负相关(r=-0.57).结论:PMOP患者存在sost基因表达显著上调的现象,该变化可能是由E2水平下降所至.  相似文献   

5.
目的:本研究的目的是评估绝经后女性冠心病患者心血管危险因素与骨密度的相关关系。方法:评估216例拟行冠脉造影的绝经后女性冠心病患者的危险因素,并于冠脉造影检查前日或次日行骨密度检测,依据T值将受试者分为2组:骨量正常组(T值大于-1SD)、低骨量组(T值小于-1SD)。结果:2组患者在BMI、糖尿病、高血压及吸烟等均无显著性差异。低骨量组冠心病的发生率及年龄显著高于骨量正常组。Logistic回归分析显示绝经后女性冠心病患者年龄与骨密度独立相关(OR=1.072 CI:1.036~1.11p=0.001)。结论:年龄与绝经后女性冠心病患者骨密度负相关,心血管病危险因素或冠心病与骨量不相关。  相似文献   

6.
目的:探讨冠心病患者血浆中同型半胱氨酸、内皮素、循环内皮细胞水平与冠状动脉粥样硬化性心脏病发生过程的关系。方法:对62例冠心病患者组和50例健康对照组分别采用高效液相色谱分析法和放射免疫分析法测定血浆中同型半胱氨酸水平和内皮素水平,同时测定血浆中循环内皮细胞的数量。结果:冠心病组同型半胱氨酸(21.27±5.73)μmol/L、内皮素(84.30±13.68)ng/L、循环内皮细胞(12.08±5.85)和cells/0.9μl明显高于对照组同型半胱氨酸(9.12±4.87)μmol/L、内皮素(47.65±12.71)ng/L、循环内皮细胞(2.35±1.02)cells/0.9μl,P均小于0.001。同型半胱氨酸与内皮素、循环内皮细胞呈正相关(r=0.601,P0.01;r=0.645,P0.01),且冠心病组血浆循环内皮细胞和内皮素呈正相关(r=0.850,P0.01)。结论:同型半胱氨酸及内皮素对冠状动脉粥样硬化性心脏病的发生发展有促进作用,对其检测有临床实用价值。  相似文献   

7.
目的:研究联合应用重组人甲状旁腺素(1-34)和双磷酸盐对双侧卵巢切除(OVX)骨质疏松大鼠模型的治疗作用.方法:选用3月龄健康SD雌性大白鼠40只作为实验动物,随机分为五组:假手术组(S组)、卵巢切除组(o组)、OVX +RhPTH(1-34)组(R组)、OVX+阿仑磷酸钠组(A组)、OVX+联合用药组(RA组).术后12周开始给药,持续给药6周.给药后6周取血行相关生化指标检测,取股骨进行骨密度测定、骨组织形态计量学分析.结果:O组的大鼠股骨骨密度值较假手术组有明显减少,血清磷、骨钙素和血清雌二醇水平减少(P<0.01),血清碱性磷酸酶水平增加(P<0.01),使用甲状旁腺素和阿仑膦酸钠治疗后,大鼠股骨骨密度值、血清磷、骨钙素和血清雌二醇水平增加,血清碱性磷酸酶水平相应下降,尤其是两种药物联合应用后效果更为明显(P<0.01);荧光双标显示,O组骨形成速率较R组及RA组低(P<0.05),S组、O组、A组骨形成速率无明显差别(P>0.05).结论:联合应用RhPTH(1-34)和双磷酸盐可以减少去卵巢大鼠骨量的丢失,预防骨质疏松的发生.  相似文献   

8.
目的:探讨绝经期女性血脂及血压与糖尿病骨质疏松发生的关系。方法:选取2014 年3 月-2015 年5 月在我院接受治疗的 绝经期女性糖尿病患者100 例作为研究对象,根据骨密度不同将患者分为骨质疏松组和非骨质疏松组。检测并比较两组研究对 象的血脂及血压水平,分析其与骨质疏松发生的关系。结果:骨质疏松组患者总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固 醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平均高于非骨质疏松组,差异具有统计学意义(P<0.05);与非骨质疏松组比较,骨 质疏松组患者舒张压(DBP)升高,而收缩压(SBP)降低,差异具有统计学意义(P<0.05);Pearson相关性分析结果显示,年龄、总胆 固醇(TC)及低密度脂蛋白胆固醇(LDL-C)与双股骨骨密度呈正相关关系(P<0.05),与腰椎骨密度呈负相关关系(P<0.05);Logistic 回归分析结果显示,年龄、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及收缩压(SBP)是糖尿病骨质疏松发生的危险因素 (P<0.05)。结论:绝经期女性糖尿病患者的年龄、总胆固醇、LDL-C 及收缩压与骨质疏松密切相关,临床应给予重视并采取有效措 施进行预防。  相似文献   

9.
目的:研究甲亢低骨量患者131I治疗后干预治疗的效果.方法:对100例甲亢低骨量患者,随机分为两组:A组50例,131I治疗后口服钙尔奇D及罗盖全治疗;B组50例,131I治疗后骨质自然恢复.另设C组50例为正常对照组.于131I治疗前、治疗后3、6及12个月测定A、B两组骨密度(BMD),观察其骨质变化并评价治疗效果.结果:(1)A组随治疗时间延长BMD逐渐升高,具有一定的规律性,腰椎(L2-4)骨密度3个月提高明显(t=-2.111,P=-0.04)且12个月时达到与C组无统计学差异(t=-2.290,P=0.202).(2)B组3个月时腰椎BMD有所降低,12个月时升高明显(股骨颈t=-2.327,P=0.043;腰椎(L2-4)t=-2.798,P=0.000).(3)6个月时两组腰椎骨密度改善幅度出现统计学差异(t=-2.416,P=0.018),12个月时差异显著(t=-3.259,P=-0.002).结论:131I联合钙尔奇D与罗盖全治疗甲亢低骨量患者,其恢复时间及疗效均用131I治疗,能有效防止骨量的进一步下降及减少骨质疏松症的发生.  相似文献   

10.
目的:研究甲亢低骨量患者131I治疗后干预治疗的效果。方法:对100例甲亢低骨量患者,随机分为两组:A组50例,131I治疗后口服钙尔奇D及罗盖全治疗;B组50例,131I治疗后骨质自然恢复。另设C组50例为正常对照组。于131I治疗前、治疗后3、6及12个月测定A、B两组骨密度(BMD),观察其骨质变化并评价治疗效果。结果:(1)A组随治疗时间延长BMD逐渐升高,具有一定的规律性,腰椎(L2-4)骨密度3个月提高明显(t=-2.111,P=0.04)且12个月时达到与C组无统计学差异(t=-2.290,P=0.202)。(2)B组3个月时腰椎BMD有所降低,12个月时升高明显(股骨颈t=-2.327,P=0.043;腰椎(L2-4)t=-2.798,P=0.000)。(3)6个月时两组腰椎骨密度改善幅度出现统计学差异(t=-2.416,P=0.018),12个月时差异显著(t=-3.259,P=0.002)。结论:131I联合钙尔奇D与罗盖全治疗甲亢低骨量患者,其恢复时间及疗效均用131I治疗,能有效防止骨量的进一步下降及减少骨质疏松症的发生。  相似文献   

11.
摘要 目的:探讨绝经后骨质疏松症患者血清白细胞衍生趋化因子2(LECT2)水平的临床意义及其预测价值。方法:选择2020年1月~2022年1月湖南师范大学第一附属医院收治的绝经后骨质疏松症患者125例作为研究组,另选取同期体检的绝经后健康女性志愿者120例作为对照组。比较两组血清LECT2水平,并分析血清LECT2水平与腰椎和股骨颈骨密度(BMD)及骨代谢相关指标的相关性;应用受试者工作特征(ROC)曲线分析血清LECT2对绝经后骨质疏松症患者的预测价值。结果:研究组血清LECT2、骨钙素(OC)、I型原胶原N端前肽(PINP)、 I型胶原交联C末端肽(S-CTX)显著高于对照组,腰椎和股骨颈BMD显著低于对照组(P<0.05)。Pearson相关分析显示,绝经后骨质疏松症患者血清LECT2水平与OC、PINP、S-CTX水平呈正相关(P<0.05),与腰椎和股骨颈BMD呈负相关(P<0.05)。ROC曲线分析显示,血清LECT2、OC、PINP、S-CTX联合检验对绝经后骨质疏松症患者的预测价值的曲线下面积(AUC)为0.856,大于各单一指标预测。结论:绝经后骨质疏松症女性血清LECT2水平升高,其水平与骨代谢指标OC、PINP、S-CTX水平呈正相关,与腰椎BMD和股骨颈BMD呈负相关,血清LECT2联合OC、PINP、S-CTX对绝经后骨质疏松症患者的预测价值较高。  相似文献   

12.
目的:研究唑来膦酸注射液联合骨肽注射液治疗绝经后骨质疏松症的临床效果以及安全性。方法:选择2014年1月~2018年1月我院收治的100例绝经后骨质疏松症患者,将其随机分为两组。对照组采用静脉滴注唑来膦酸注射液5 mg一次,观察组在对照组基础上静脉注射骨肽注射液,每次30 mg,每天1次。治疗6个月后,检测并比较两组治疗前后的骨代谢指标(血清骨特异性碱性磷酸酶(BAP)、甲状旁腺素(PTH)、血磷(P)、血钙(Ca)和碱性磷酸酶(ALP))以及骨转换指标(骨钙素(OC)和Ⅰ型胶原交联C-末端肽(CTX-1))的变化及不良反应的发生情况。结果:治疗后,观察组总有效率明显高于对照组(P0.05);两组血清ALP、PTH以及BAP等骨代谢指标均较治疗前明显降低(P0.05),且观察组以上指标明显低于对照组(P0.05);两组的OC均较治疗前明显升高(P0.05),CTX-1均较治疗前明显降低(P0.05),且观察组的骨转换指标改善的程度较对照组更为明显(P0.05)。观察组的不良反应发生率为8.00%(4/50),明显低于对照组[18.00%(9/50)](P0.05)。结论:唑来膦酸注射液联合骨肽注射液治疗绝经后骨质疏松症的效果明显优于单独使用唑来膦酸注射液,其可以显著改善患者的骨代谢及骨转换状态,且安全性更高。  相似文献   

13.
[Purpose] Dehydroepiandrosterone (DHEA) administration reportedly recovers osteoporosis, a bone disorder associated with bone deficiency in postmenopausal women. However, the physiological mechanism of DHEA in osteoporosis remains elusive, especially in terms of intestinal calcium absorption. Therefore, we investigated the effect of DHEA administration on calcium absorption in ovariectomized (OVX) female rats using an estrogen receptor antagonist.[Methods] Female Sprague-Dawley rats (n=23, 6 weeks old) were randomized into three groups: OVX control group (OC, n=7), OVX with DHEA treatment group (OD, n=8), and OVX with DHEA inhibitor group (ODI, n=8) for 8 weeks.[Results] Intestinal calcium accumulation, as well as the rate of absorption, demonstrated no significant differences during the experimental period among investigated groups. The bone mineral density (BMD) of the tibia at the proximal metaphysis was higher in the OD group than that in the OC group (p<0.05); however, BMD of the ODI group showed no significant difference from investigated groups. Furthermore, the BMD of the tibia at the diaphysis did not significantly differ among these groups.[Conclusion] We revealed that DHEA administration does not involve intestinal Ca absorption, although this treatment improves BMD levels in OVX rats. These observations indicate that the effect of DHEA on the bone in postmenopausal women is solely due to its influence on bone metabolism and not intestinal calcium absorption.  相似文献   

14.
《Endocrine practice》2008,14(6):665-671
ObjectiveTo assess the prevalence of osteoporosis in healthy ambulatory postmenopausal Indian women as measured by dual-energy x-ray absorptiometry and to study the dietary calcium intake and vitamin D status and their influence on bone mineral density (BMD).MethodsWe conducted a community-based crosssectional study in a semiurban region. A randomized cluster sampling technique was used. The study cohort consisted of 150 ambulatory postmenopausal women (≥ 50 years old). Dual-energy x-ray absorptiometry for BMD was performed at the lumbar spine and femoral neck. Dietary calcium intake and biochemical variables were assessed.ResultsThe prevalence of osteoporosis was 48% at the lumbar spine, 16.7% at the femoral neck, and 50% at any site. The mean dietary calcium intake was much lower than the recommended intake for this age-group. There was a significant positive correlation between body mass index and BMD at the lumbar spine and the femoral neck (r = 0.4; P = .0001). BMD at the femoral neck was significantly less (mean, 0.657 versus 0.694 g/cm2) in the vitamin D-insufficient study subjects in comparison with the vitamin D-sufficient women (P = .03).ConclusionThe high prevalence of osteoporosis and vitamin D insufficiency in this semiurban group of postmenopausal women in India is a major health concern. Measures such as adequate calcium intake and vitamin D supplementation in women of this age-group may be beneficial. (Endocr Pract. 2008;14:665-671)  相似文献   

15.
Objective: To evaluate the effects of body adiposity on bone mineral density in the presence and absence of ovarian hormones in female mice and postmenopausal women. Research Methods and Procedures: We assessed percentage body fat, serum leptin levels, and bone mineral density in ovariectomized and non‐ovariectomized C57BL/6 female mice that had been fed various calorically dense diets to induce body weight profiles ranging from lean to very obese. Additionally, we assessed percentage body fat and whole body bone mineral density in 37 overweight and extremely obese postmenopausal women from the Women's Contraceptive and Reproductive Experiences study. Results: In mice, higher levels of body adiposity (>40% body fat) were associated with lower bone mineral density in ovariectomized C57BL/6 female mice. A similar trend was observed in a small sample of postmenopausal women. Discussion: The complementary studies in mice and women suggest that extreme obesity in postmenopausal women may be associated with reduced bone mineral density. Thus, extreme obesity (BMI > 40 kg/m2) may increase the risk for osteopenia and osteoporosis. Given the obesity epidemic in the U.S. and in many other countries, and, in particular, the rising number of extremely obese adult women, increased attention should be drawn to the significant and interrelated public health issues of obesity and osteoporosis.  相似文献   

16.
目的:研究右归丸联合液体钙片对老年骨质疏松症患者血清雌激素水平、骨钙素(BGP)水平及临床疗效的影响。方法:选取2014年10月至2015年9月本院收治的82例老年骨质疏松症患者,根据入院顺序分为观察组和对照组,每组41例。对照组使用骨化三醇软胶囊和液体钙软胶囊进行治疗,观察组在此基础上加以右归丸进行治疗。比较两组患者治疗前和治疗1个月后血清雌二醇(E2)水平、BGP水平、骨密度变化,分析两组患者的临床疗效。结果:治疗后,观察组的血清E2水平显著高于对照组(P0.05),BGP水平显著低于对照组(P0.05),腰椎L1-4正位、右侧股骨颈、左侧股骨颈骨密度显著高于对照组(p0.05),总临床疗效率显著高于对照组(P0.05)。结论:右归丸联合液体钙片治疗老年骨质疏松症患者能明显改善患者血清雌激素、BGP水平,增加骨密度,临床疗效良好。  相似文献   

17.
Background:Irisin as an exercise-induced myokine was proposed to improve bone health. This study investigated the role of serum irisin (s-irisin) in patients with osteoporosis (OP) through correlating to most biological bone markers and oxidative stress.Methods:A cross-sectional study recruited an eligible 175 postmenopausal women at Al-Hussien Teaching Hospital, Iraq. They were scanned by DEXA and stratified into two groups based on T-score; the first 95 patients as control group (GI) with −1 ≤ T-score and the second 80 patients as cases group (GII) with T-score ≤ −2.5. Demographic criteria were age, bone mineral density (BMD, g/cm2) and T-score. Serum irisin, total serum calcium (s-calcium), serum inorganic phosphate (s-phosphate), serum alkaline phosphatase (s-ALP), serum 25 [OH] vitamin D, the serum parathyroid hormone (s-PTH), serum Carboxy terminal collagen crosslinks (CTx), serum procollagen type I C-termidnal peptide (s-PICP), serum malondialdehyde (s-MDA) and serum superoxide dismutase (s-SOD) were collected from blood samples.Results:Serum irisin were 31.84 ± 2.65 vs. 20.88 ± 2.71 ng/mL for control and trial groups, respectively. Lower levels of BMD, T-score, 25 [OH] vitamin D, and s-irisin along with a higher serum levels of PTH, CTx, PICP, MDA and SOD were observed in patients with osteoporosis. All parameters were statistically meaningful upon correlation (p< 0.0001), except age and s-calcium (p= 0.0088 and p= 0.187, respectively).Conclusion:The results showed that, a significantly lower serum irisin levels among osteoporosis women, was intimately correlated to most bone turnover markers and it can be considered as encouraging results for clinical application in prediction and treatment of osteoporosis.Key Words: Bone turnover markers, DEXA scan, Irisin, T-score, BMD, osteoporosis, post-menopause  相似文献   

18.
摘要 目的:分析不同程度老年骨质疏松患者血清骨特异性碱性磷酸酶(BALP)、骨保护素(OPG)/吡啶啉(PYR)比值变化及其与骨密度、骨折发生的相关性。方法:选择我院自2020年11月至2023年7月接诊的70例老年骨质疏松患者作为观察组,其中轻-中度骨质疏松44例、重度骨质疏松26例;另选70例老年非骨质疏松者作为对照组。检测所有受试者血清BALP、OPG/PYR比值、腰椎、股骨颈和髋部的骨密度(BMD),分析BALP、OPG/PYR比值与不同骨骼部位BMD的关系,使用受试者工作特征(ROC)曲线分析BALP、OPG/PYR比值对老年骨质疏松骨折的预测效能。结果:观察组血清BALP水平高于对照组,OPG/PYR比值小于对照组(P<0.05);重度骨质疏松组血清BALP水平高于轻-中度骨质疏松组,OPG/PYR比值小于轻-中度骨质疏松组(P<0.05);观察组腰椎、股骨颈及髋部的BMD均小于对照组(P<0.05);经Pearson相关性分析,腰椎、股骨颈及髋部的BMD与血清BALP水平呈负相关(P<0.05),与OPG/PYR比值呈正相关(P<0.05);经ROC曲线分析,血清BALP联合OPG/PYR比值预测老年骨质疏松骨折的AUC为0.890。结论:老年骨质疏松患者血清BALP水平升高、OPG/PYR比值减小,与病情严重程度及骨密度有关,联合预测骨折的效能较好,值得进一步研究应用。  相似文献   

19.
《Endocrine practice》2008,14(9):1102-1107
ObjectiveTo study the relationship between bone markers and bone mineral density (BMD) in an effort to identify their utility in postmenopausal women with osteoporosis.MethodsEighty-two consecutive postmenopausal women with untreated osteoporosis were included in the study. Forearm, spinal, and femoral BMD by dual-energy x-ray absorptiometry and markers of bone formation (serum osteocalcin and bone-specific alkaline phosphatase) and bone resorption (urinary free deoxypyridinoline) were measured in all patients. Patients with low serum vitamin D levels, secondary osteoporosis, or clinically significant systemic disease were excluded from the study. The patients were classified on the basis of BMD of the lumbar spine into the following 3 groups: mild (n = 23) (T score -2.5 through -3), moderate (n = 42) (T score -3.1 through -4), or severe (n = 17) (T score ≤-4.1) osteoporosis. One-way analysis of variance and Pearson correlation were used for statistical analysis, with a P value < .05 being considered significant.ResultsSerum osteocalcin was significantly different among the 3 study groups (4.1 ± 2.7, 4.5 ± 3.1, and 6.7 ± 5.6 ng/mL, respectively; P = .0349) and had a significant negative correlation with BMD (r2 = -0.0779; P = .0168). Other bone markers such as bone-specific alkaline phosphatase and urinary free deoxypyridinoline did not correlate with the underlying BMD.ConclusionIn our study, osteocalcin was significantly correlated with BMD in postmenopausal women with osteoporosis. Other bone markers did not correlate with BMD. Further large-scale population data and analyses are needed to confirm these findings. (Endocr Pract. 2008;14:1102-1107)  相似文献   

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