骨质疏松杂志

骨质疏松症和帕金森病（PD）是两个重要的年龄有关的疾病，这对疼痛，体力活动，残疾和死亡的影响。这项研究的目的是研究骨密度（BMD），频率和女性患有帕金森病（PD）骨质疏松性骨折（OFS）的10年概率的参数。我们已经研究了年龄在50-74岁113名绝经后妇女随机分成2组（I，对照组（CG），ñ = 53 and II, subjects with PD,ñ = 60). Bone mineral density of lumbar spine, femoral neck, distal radius, and total body were measured, and quantity and localization of vertebral deformities were performed by the vertebral fracture assessment (VFA). Ten-year probability of OFs was assessed by Ukrainian version of FRAX®. It was established that BMD of lumbar spine, femoral neck, distal radius, and total body in PD women was reliably lower compared to CG. The frequency of OFs in PD subjects was higher compared to CG (51.7 and 11.3%, respectively) with prevalence of vertebral fractures (VFs) in women with PD (52.6% among all fractures). 47.4% of the females had combined VFs: 74.2% of VFs were in thoracic part of the spine and 73.7% were wedge ones. Ten-year probability of major OFs and hip fracture were higher in PD women compared to CG with and without BMD measurements. Inclusion of PD in the FRAX calculation increased the requirement of antiosteoporotic treatment from 5 to 28% (without additional examination) and increased the need of additional BMD measurement from 50 to 68%. Anterior/posterior vertebral height ratios (Th₈第₁₁没有确认脊椎畸形在PD雌性通过测定VFA）的下部相比CG的索引。总之，女性PD具有较低BMD指标，率较高的骨质疏松症，和未来的低能量骨折风险应该考虑到他们的骨质疏松症的风险和临床管理的评估。

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骨质疏松性髋部骨折与发病率，死亡率和医疗保健支出较高的影响有关。智利卫生系统是由混合保健系统，一个名为FONASA公示制度，并呼吁ISAPRE私有制度。收入较低的人都列在FONASA和对应人口的80.8％。这项研究的目的是从45岁描述髋部骨折的发生率在智利的人口，并估计本病的直接医疗成本。健康统计与卫生部的新闻部的记录被使用，从中获得（代码S720，S721，和ICD-10的S722）国家出院由于髋部骨折的数量，在成人年龄在45岁或以上，按性别，从2006年至2017年从手术治疗的数据根据​​与诊断（PAD奖金）相关联的支付方法得到骨质疏松性髋部骨折的治疗在公共卫生系统的成本。外科手术的预算是在一家私人诊所用于计算私有制度骨质疏松性髋部骨折的直接成本。2006年至2017年间，出院由于年龄在45岁以上逐渐地增加成人骨质疏松性髋部骨折的次数，注册9.583出院这项事业在2017年，这相当于50％以上，比那些记录在2006年，有3 : 1 F/M ratio. The mean annual rate of hip fractures is 148.7 per 100,000 inhabitants aged above 45 years. The individual cost of managing an osteoporotic hip fracture in the public system was USD$ 3,919, and USD$ 9,092 in the private health system. The incidence of hip fracture was comparable with data from Southern European countries and from neighboring countries, such as Argentina and Uruguay. Hospitalization cost of hip fracture in Chile was 34 million USD per year. Hip fracture constitutes a serious healthcare problem in Chile, and efforts for the prevention and management of osteoporosis are needed.

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以往的研究评估骨折联络服务（FLS）计划已经发现他们是成本效益，高效率，并降低骨折的风险。然而，很少有研究评估这些方案的临床效果。我们比较了那些由FLS在安大略省简称为骨质疏松症治疗那些由初级保健医生（PCP）称，加拿大的医疗系统内的患者群。具体而言，我们调查，如果从FLS转诊是在PCP在为未来的骨质疏松性骨折和骨质疏松症，如果治疗已经先前发起的风险识别患者同样有效。进行了回顾性的由2014年1月1日，和2017年12月31日之间，与FLS附属单安大略风湿病实践评估患者，识别两组：内汉密尔顿由FLS称为和那些可以通过PCP为骨质疏松症管理称作。使用FRAX确定每个患者的骨折风险。总共有573名患者（ñ = 225 (FLS group) andñ = 227 (PCP group)) were evaluated. Between the FLS and PCP groups, there were no significant differences in the absolute 10-year risk of a major osteoporotic fracture (15.6% (SD = 10.2) vs 15.3% (SD = 10.3)) and 10-year risk of hip fracture (4.7% (SD = 8.3) vs 4.7% (SD = 6.8)), respectively. 10.7% of patients referred by FLS and 40.5% of patients referred by their PCP were on osteoporosis medication prior to fracture. Our study suggests that referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures, and clinically effective at identifying the care gap with the previous use of targeted osteoporosis therapies from referral from PCP being low and much lower in those referred by FLS. Interventional programs such as FLS can help close the treatment gap by providing appropriate care to patients that were not previously identified to be at risk for fracture by their primary care physician and initiate proper medical management.

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的N-末端肽（NTX）是在临床实践中经常引用的骨吸收标记物。骨重建还与矿物成分的变化有关。傅里叶变换红外光谱（FTIR）被用在骨材料性能评估的，且一些参数报道具有与骨重塑的关联。这横断面研究的目的是调查uNTx水平级别和FTIR参数之间的关系，利用前瞻性收集研究数据患者谁接受腰椎融合手术。骨样品从髂嵴（IC）和椎骨（V）截取。皮质（C）和小梁（T）的骨头分别进行了分析。22patients (mean age 60.0 years (35.9–73.3), male : female 9 : 13) were included in the final analysis. Women showed significantly higher uNTX levels (male : female, median [range] 21.0 [11.0–39.0] : 36.0 [15.0–74.0] nM·BCE/mM, ）。在女性中，uNTx水平和矿物到矩阵比之间观察到显著正相关于IC-C。在男性中，uNTx水平表明与胶原交联显著负相关（XLR：成熟为未成熟的胶原交联的比例）在IC-C，V-T，和V-C。此外，uNTx水平呈正丙酸磷酸盐替换相关（HPO₄，新骨形成在IC-C，IC-T，和V-C的参数）。经过年龄调整，HPO₄在IC-T和男性中V-Ç显示显著正相关与uNTx水平（IC-T： ，[R² = 0.544; V-C: ，[R² = 0.672). We found associations between FTIR parameters and uNTX in men, but not in women. The correlations between uNTX and FTIR parameters in men might suggest a better balance of bone breakdown (uNTX) and new bone formation (FTIR parameters: XLR, HPO₄）高于女性。

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虽然以其凝血级联重要性，维生素K具有其它功能。这对骨骼健康的必需的维生素，参与许多骨相关蛋白的羧化，调节成骨细胞标记基因的转录，并调节骨重吸收。维生素K缺乏症并不少见，因为存款是稀缺的，取决于膳食补充和吸收。维生素K拮抗剂口服抗凝血剂，其被规定为许多患者，也诱导维生素K缺乏。大多数研究发现，低血清K1浓度，高浓度undercarboxylated骨钙素（ucOC）和低膳食摄入量两个K1和K2都与骨折风险较高和较低的骨密度。研究探讨了维生素K的补充和骨折风险的关系还发现，骨折的风险与补充减少，但需要设计来评估骨折作为其主要终点高质量的研究。与使用非维生素K拮抗剂口服抗凝血剂，而不是华法林的骨折风险的降低也感兴趣虽然再次，现有的证据提供不同的结果。稀缺和有限的证据，其中包括低质量的研究达到了完全不同的结论，因此无法提取有关这个主题的可靠的结论，特别是关于使用维生素K补充剂。

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介绍。适当摄入的女性的饮食钙和维生素d的是骨骼系统的正确维护显著。研究目标。这项研究的目的是评估在妇女经常从事体育运动饮食中的钙和维生素d的供应。方法。这项研究是由593名妇女的18-50（中位数为25）谁经常玩运动（每周至少2次）的年龄完成。为了评估钙和维生素d摄入，被用于钙和维生素d（VIDEO-FFQ）短食物频率问卷。该研究组提供通过社交媒体的调查问卷。To assess intake levels, the authors applied the group-based cutoff point method (calcium norm was EAR 800 mg/day; vitamin D norm was AI 15 μ克/天）。结果。The median of calcium and vitamin D intake in a diet was 502 mg/day and 5.2 μg/day, respectively (Q25 and Q75 for calcium was 387 mg/day and 627 mg/day, respectively, and for vitamin D was 3.4 μ克/天和8.2 μ克/天，分别地）。相对于EAR规范钙和维生素d AI规范，一组中的检查参与者的92.0％比推荐的钙摄取水平表现出低和97.3％显示出比推荐的维生素d摄入水平低。使用钙和维生素d补充了13.1％（在该亚组中，检查组成员的11.5％并不需要它）和被检查的女性56.8％（在该亚组中，检查组的2.4％并不需要它）， 分别。After including the calcium and vitamin D intake, the supply median for the whole group was 535 mg/day and 28.8 μg/day, respectively (Q25 and Q75 for calcium was 402 mg/day and 671 mg/day, and for vitamin D was 6.3 μ克/天及55.7 μ克/天，分别地）;该研究的参与者不符合规范的EAR钙和42.0％，没有达到维生素D在女性补钙的AI标准的87.5％，58.9％，未达到参考摄入量的值;然而，经过补充维生素d所有妇女实现预期的营养需要。结论。重要的是要教育妇女了解有必要为身体提供的饮食适当补充钙和维生素d摄入量，以便从营养的赤字造成避免的健康问题是很重要的。

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