ObjectiveTo preliminarily explore the effect of Osteoporosis Self-assessment Tool for Asians (OSTA) and Fracture Risk Assessment Tool (FRAX) on predicting osteoporosis and osteoporosis fracture in postmenopausal patients with maintenance hemodialysis (MHD).MethodsThirty-six postmenopausal patients undergoing MHD from August 2017 to October 2018 in Hemodialysis Center of Nephrology Department, West China Hospital of Sichuan University were selected. Relevant data such as age, height, and weight were collected. OSTA index and the 10-year probability of major osteoporotic fractures and 10-year probability of hip fractures of FRAX score were calculated. Bone mineral densities (BMD) of the hip and lumbar spine were measured by dual energy X-ray absorptiometry (DXA) at the same time. The value of OSTA index and FRAX scale in evaluating the risk of osteoporosis predicated on T value ≤−2.5 determined by DXA BMD and fracture in postmenopausal patients with MHD were analyzed.ResultsThe DXA BMD of the 36 patients showed that 50.0% (18/36) had a T value≤−2.5, and 30.6% (11/36) had a fracture history. BMD in postmenopausal patients with MHD was negatively correlated with FRAX score (model without BMD values), and positively correlated with OSTA index. The sensitivity and specificity of OSTA in the prediction of osteoporosis were 94.4% and 61.1%, respectively; and the sensitivity and specificity of FRAX (the model without BMD values) in the prediction of osteoporosis were 88.9% and 50.0%, respectively. The FRAX score with or without BMD had the same clinical value in predicting osteoporosis.ConclusionsPostmenopausal MHD patients have a higher risk of osteoporosis and fracture. Both OSTA index and FRAX scale can predict osteoporosis risk among postmenopausal MHD patients, and the FRAX scale with or without BMD has the same clinical value in predicting osteoporosis risk. In clinical work, for primary hospitals and dialysis centers lacking DXA, preliminary screening of osteoporosis in MHD patients can be performed with OSTA and FRAX scales.
Postmenopausal osteoporosis (PMOP) is a significant metabolic bone disease triggered by estrogen deficiency. Macrophages, as pivotal cells in bone metabolism regulation, participate in bone remodeling and inflammatory modulation through differentiation into osteoclasts and polarization phenotype switching. This article systematically reviews the mechanistic roles of macrophages in PMOP, encompassing their interactions with osteoclasts, polarization effects, immune-inflammatory responses, and impacts of oxidative stress. Furthermore, it explores the potential applications of macrophages in molecular diagnosis and pharmacological interventions for PMOP, while proposing future research directions.
Postmenopausal osteoporosis is a type of osteoporosis with high bone transformation rate, caused by a decrease of estrogen in the body, which is a systemic bone disease characterized by decreased bone mass and increased risk of fracture. In recent years, as a kind of non-pharmacologic treatment of osteoporosis, defined by whole-body vibration less than 1 g (g = 9.81 m/s2), low magnitude whole-body vibration is widely concerned, mainly because of its small side effects, simple operation and relative safety. Studies have shown that low magnitude whole-body vibration can improve bone strength, bone volume and bone density. But a lot of research found that, the therapeutic effects of low magnitude whole-body vibration are different depending on ages and hormone levels of subjects for animal models or human patients. There has been no definite vibration therapy can be applied to each subject so far. Studies of whole-body and cellular level suggest that low magnitude whole-body vibration stimulation is likely to be associated with changes of hormone levels and directed differentiation of stem cells. Based on the analysis of related literature in recent years, this paper made a review from vibration parameters, vibration effects and the mechanisms, to provide scientific basis and clinical guidance for the treatment of postmenopausal osteoporosis with low magnitude whole-body vibration.
Objective To explore the relationship between periodontitis and postmenopausal osteoporosis.Methods Databases were electronically searched from PubMed (1966 to December, 2010), EMbase (1974 to December, 2010), CBM (1978 to December, 2010), VIP (1989 to December, 2010), CNKI (1979 to December, 2010) and WanFang Data (January, 2007 to December, 2010), and the references listed in all papers were also retrieved. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently; the methodology quality was evaluated after data abstraction; and then the RevMan 5.0 software was used for meta-analyses. Results Four trials were included. Among the total 678 patients involved, 263 were postmenopausal osteoporosis patients, while the other 415 were non-osteoporosis patients. The results of meta-analyses showed that: a) Clinical attachment loss (CAL) of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.60, 95%CI 0.23 to 0.96); b) The level of gingival recession of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.78, 95%CI 0.41 to 1.14); c) There were no significant differences in plaque index (PI), gingival index (GI) and periodontal probing depth (PPD) between the two groups (WMD=0.17, 95%CI 0.00 to 0.35; WMD=0.05, 95%CI –0.09 to 0.19; and WMD=–0.08, 95%CI –0.24 to 0.09); d) The results of one study indicated that the rate of periodontitis in the postmenopausal osteoporosis patients was higher than that of the non-osteoporosis patients (OR=2.45, 95%CI 1.38 to 4.34, Plt;0.01); the severe alveolar crest height loss was related to osteoporosis (OR=4.20, 95%CI 1.57 to 11.22, Plt;0.01). Conclusion Postmenopausal osteoporosis patients are more prone to suffer from periodontitis or turn to the worse stage of periodontitis. In consideration of the factors such as small scales and incomplete measure indexes of the included studies, which have influences on the intensity and comprehensiveness of this conclusion, more high-quality studies are required.
目的 探讨绝经后健康女性的稳定极限范围（LOS）与育龄期健康成年女性相比有无下降，了解绝经后女性是否开始出现LOS的下降。 方法 选取2012年1月－10月期间于四川大学华西医院健康体检的女性共40例，绝经组：20例绝经后健康女性，年龄（56.2 ± 3.3）岁；对照组：20名育龄期健康女性，年龄（24.3 ± 3.5）岁。对所有受试者分别使用压力平板仪测定前后左右4个方向LOS，使用SPSS 17.0统计学软件比较两组LOS的差异性。 结果 前、后、左、右4个方向的LOS在绝经组与对照组之间差异无统计学意义（P＞0.05）。绝经组及对照组的左右侧LOS大于前后侧、前侧LOS大于后侧，差异具有统计学意义（P＜0.05）；左右侧LOS差异无统计学意义（P＞0.05）。 结论 绝经后女性仍保持较好的LOS，提示其仍具备良好的主动姿势控制能力。
Objective To evaluate the effectiveness of hormone replacement therapy (HRT) for osteoporosis in postmenopausal women. Method Systematic reviews and meta-analyses were searched in Cochrane Library (Issue 4, 2008), MEDLINE (1978-2008) and Clinical Evidence database. Search terms included Postmenopausal (post-menopausal) osteoporosis, therapy, vertebral fracture, hormone replacement therapy, randomized controlled trial, meta analysis, female,human. Result A total of 4 protocols were found in Cochrane Library and a meta-analyse was found in MEDLINE. The result demonstrated that both cancellous and cortical bone mineral density increased after HRT. Statistically significant reductions in the risk of vertebral and non-vertebral fracture were also found. Conclusion HRT can reduce the risk of osteoporotic fracture by increasing bone density. However, other disease and adverse event were also associated with the BMD increase. Therefore, both advantage and disadvantage should be considered before applying HRT therapy to postmenopausal osteoporosis patients.
目的 检测基质金属蛋白酶13（MMP-13）和组织金属蛋白酶抑制因子1（TIMP-1）的血清含量，分析其在妇女绝经后骨质疏松发病中的作用。 方法 2009年3月－2012年9月选取武汉附近地区129例49～63岁绝经后妇女，根据双能X线吸收法检测的骨密度数值，分为正常组、低骨量组和骨质疏松组。采取酶联免疫吸附试验检测MMP-13、TIMP-1以及雌二醇（E2）、Ⅰ型原胶原N端前肽（PINP）和Ⅰ型胶原交联C末端肽（CTX）、骨保护蛋白（OPG）及其配体（OPGL）的含量，统计MMP-13/TIMP-1比值。 结果 ① 骨质疏松组中血清MMP-13水平[（44.25 ± 1.21） μg/L]高于正常组[（27.08 ± 1.41）μg/L]（P＜0.05）；② 骨质疏松组中血清MMP-13与骨密度、血清E2、OPGL水平存在明显负相关性 （P＜0.05），和OPG、PINP和CTX存在明显正相关性（P＜0.05）；③ 低骨量组中MMP-13略高于骨质疏松组，且两者差异无统计学意义（P＞0.05），但是明显高于正常组（P＜0.05），同时与骨密度和血清E2、OPG、OPGL、PINP和CTX存在明显相关性（P＜0.05）。 结论 血清MMP-13和MMP-13/TIMP-1比值与绝经后骨质疏松症妇女和绝经后低骨量组妇女骨代谢指标具有关联性。两者升高可能为绝经后妇女早期骨代谢尤其是胶原代谢过程增快的表现。
Hot flashes are a common syndrome in postmenopausal women. The treatment is complex and different for specific patients. A clinical case and hormonal replacement therapy selection are provided to show evidence-based practice in this field.
ObjectiveTo explore the role of toremifene in postmenopausal operable patients with luminal subtype of breast cancer in China. MethodsA total of 618 eligible patients diagnosed with luminal subtype of breast cancer from January 2000 to December 2009 in the Cancer Center of Sun Yat-sen University were analyzed. One hundred and fifteen patients were treated with toremifene(toremifene group) and 503 patients were treated with tamoxifen(tamoxifen group) as adjuvant endocrine therapy. Survival was compared by Kaplan-Meier with log-rank test in two groups. Cox analysis was used to compare different prognostic factors. ResultsThe general clinical data had no significant differences between the toremifene group and tamoxifen group (P > 0.05). After a median follow-up of 76 months, there was no statistical difference in the 5-year disease free survival rate and 5-year overall survival rate between the toremifene group and the tamoxifen group (5-year disease free survival rate:78.5% versus 85.5%, P=0.083;5-year overall survival rate:86.4% versus 92.0%, P=0.334). Univariated analysis showed that the histological grade, tumor size, lymph node status, TNM stage, HER-2 positive expression were associated with the disease free survival rate and overall survival rate(P < 0.05). Multivariated analysis showed that the tumor size and lymph node status were the independent risk factors of disease free survival rate and overall survival rate for postmenopausal operable patients with luminal subtype of breast cancer(P < 0.05). HER-2 positive expression was the independent risk factor in predicting disease free survival rate for patients with tamoxifen or toremifene. There was no grade 3 or 4 toxicity for all the patients according to CTC AE 4.0 grade. ConclusionsSimilar benefit is found in disease free survival rate and overall survival rate in Chinese postmenopausal patients with operable luminal subtype of breast cancer between patients receiving toremifene and tamoxifen with tolerable adverse effects. HER-2 status is associated with disease free survival rate.
Objective To summarize the research progress of postmenopausal breast cancer and estrogen metabolites, which is aimed at providing the basis for early diagnosis and early treatment of postmenopausal breast cancer, at the same time, providing beneficial information for the future study. Methods In recent years, the literatures about postmenopausal breast cancer and estrogen metabolites were reviewed from the databases of WanFang, VIP, CNKI, PubMed, and so on, to make an review. Results Estrogen metabolites had a dual role for postmenopausal breast cancer, such as 2-hydroxyestrone (2-OHE1), 2-methoxyestrone1 (2-MeOE1), and 4-methoxyestrone1 (4-MeOE1) played a protective role for postmenopausal breast cancer, but 4-hydroxyestrone (4-OHE1) and 16α-hydroxyestrone (16α-OHE1) played a carcinogenic role for postmenopausal breast cancer, so it needed to be further studied. Conclusions Estrogen metabolites may be a reliable predictor for the risk of postmenopausal breast cancer, it is not only to provide clues for the mechanism of postmenopausal breast cancer, but also provide new train of thought for early diagnosis and treatment of postmenopausal breast cancer.