Objective To explore the correlation of risk factors affecting the L2-4BMD level in patients with post-menopausal osteoporosis. Methods Ninety-two patients with post-menopausal osteoporosis were surveyed with a retrospective questionnaire. We used the findings to set up a multiple stepwise regression model and perform correlation analysis with L2-4BMD levels as the dependent variable and risk factors as the independent variables. Results Assuming that age has a definite effect on the L2-4BMD level of menopausal women, menopausal age limit, history of milk drinking, menopausal age, menarche age, fracture history and bend-back entered into the multiple stepwise regression equation. Conclusions Menopausal age limit, history of milk drinking, menopausal age, menarche age, fracture history, and bend-back influence patients with menopausal osteoporosis.The menopausal age limit is especially important. Awareness of the risk factors of osteoporosis should be raised.
Methods of evidence-based medicine were used to discuss the drug treatment of postmenopausal osteoporosis. After clinical problems were put forward, we searched for and assessed the evidence. A rational treatment plan for osteoporosis patients with fractures was developed according to the results of systematic reviews and Meta-analysis.
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.
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 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。
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.
We investigated the effects and optimal treatment frequency of pulsed electromagnetic fields (PEMFs) on postmenopausal osteoporosis (PMO). A comparison was performed with the cyclical alendronate and a course of PEMFs in the treatment for postmenopausal osteoporosis on bone mineral density (BMD), pain intensity and balance function. There was no significant difference between the two groups on mean percentage changes from baseline of BMD within 24 weeks after random treatments (P≥0.05). However, at the ends of 48 weeks and 72 weeks, the BMD of the PEMFs group were significantly lower than that of the alendronate group (P<0.05). No significant difference was detected between the two groups with regard to treatment effects on Visual Analogue Scale score, the Timed Up & Go Test and Berg Balance Scale score. Compared with cyclical alendronate, a course of PEMFs was as effective as alendronate in treating PMO for at least 24weeks. So its optimal treatment frequency for PMO may be one course per six months.
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.