Objective: In this study, we compared the biochemical markers of imminent abortion, missed abortion, and healthy pregnant women in the first trimester to see if there were any differences. Materials and Methods: The s...Objective: In this study, we compared the biochemical markers of imminent abortion, missed abortion, and healthy pregnant women in the first trimester to see if there were any differences. Materials and Methods: The study method is prospective. Pregnant women who applied to the obstetrics clinic of Istanbul Training and Research Hospital between 01.04.22 and 31.10.22 were diagnosed with abortion imminens or missed abortion between 6 weeks and 12 weeks or had normal pregnancy follow-up, had no chronic diseases, and did not take magnesium and calcium supplements were included in the study. 20 pregnant women with missed abortion, 20 pregnant women with abortion imminens diagnosis and 20 normal pregnant women who met the criteria were included in the study. Magnesium (Mg), calcium (Ca), copper (Cu), zinc (Zn) and hemogram (CBC) levels were checked in pregnant women included in the study. Results: The Mg, Cu, Zn, and CBC values of the study participants’ women did not differ in a statistically significant way. When compared to pregnant women who had a normal pregnancy process, the difference in Ca value was found to be statistically substantially smaller in pregnant women who were diagnosed with abortion imminens and missed abortion. The findings of our study suggest that serum Ca levels be measured prior to conception or at the initial visit. Conclusion: Serum Ca levels were found to be significantly lower in the missed abortion group than in the abortus imminens and normal pregnant groups in our study (p 0.05).展开更多
The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorat...The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.展开更多
Background:The training program promoted improvements of jump abilities throughout the musculoskeletal system including bone markers.The aim of this study is to examine both the acute and chronic response of bone mark...Background:The training program promoted improvements of jump abilities throughout the musculoskeletal system including bone markers.The aim of this study is to examine both the acute and chronic response of bone markers to resistance training program.Methods:Ten female students(age:18±0.7 years,body mass:63±3.6 kg;height:164±5.2 cm)participated in this study.They were recruited for a back-squat training program for 12 weeks,two days/week.The full-back squat protocol consisted of 3–5 sets×3–8 repetitions at 45–55%one repetition maximum.Testing sessions included a 5 jump test(5JT),standing long jump(SLJ),drop jump(DJ),and vertical jump(VJ).Results:Substantial improvements in all testing jumps(5JT:∆10%;P=0.000;ES=1.72;SLJ:∆7%;P=0.000;ES=1.33;DJ:∆11%;P=0.000;ES=0.72;VJ:∆20%;P=0.000;ES=1.84)were found during post program in comparison to pre-program results.Moreover,a significant change(P≤0.05)of bone markers during post-exercise compared to pre-exercise either before or after the training program.Only collagen type I carboxy-terminal peptide(CICP)levels elevated after the training program(pre-exercise only)compared to former levels.Conclusion:12 weeks of back-squat training program resulted greater acute improvements of jump abilities with adaptation in all musculoskeletal system including bone formation.展开更多
BACKGROUND: It has been proved by many experimental studies from the aspects of morphology and immunocytochemistry in recent years that bone marrow stromal cells (BMSCs) can in vitro induce and differentiate into the ...BACKGROUND: It has been proved by many experimental studies from the aspects of morphology and immunocytochemistry in recent years that bone marrow stromal cells (BMSCs) can in vitro induce and differentiate into the cells possessing the properties of nerve cells. But the functions of BMSCs-derived neural stem cells(NSCs) and the differentiated neuron-like cells are still unclear. OBJECTIVE: To observe whether bone marrow-derived NSCs can secrete norepinephrine (NE) under the condition of in vitro culture, induce and differentiation, and analyze the biochemical properties of BMSCs-derived NSCs. DESIGN: A non-randomized and controlled experimental observation. SETTING: Institute of Neuromedicine of Chinese PLA, Zhujiang Hospital, Southern Medical University. MATERIALS: This experiment was carried out in the Institute of Neuromedicine of Chinese PLA, Zhujiang Hospital, Southern Medical University. The bone marrow used in the experiment was collected from 1.5- month-old healthy New Zealand white rabbits. METHODS: This experiment was carried out in the Institute of Neuromedicine of Chinese PLA, Zhujiang Hospital, Southern Medical University. The bone marrow used in the experiment was collected from 1.5 month-old healthy New Zealand white rabbits. BMSCs of rabbits were isolated and performed in vitro culture, induce and differentiation with culture medium of NSCs and differentiation-inducing factor, then identified with immunocytochemical method. Experimental grouping: ①Negative control group: L-02 hepatic cell and RPMI1640 culture medium were used. ② Background culture group: Only culture medium of NSCs as culture solution was added into BMSCs to perform culture, and 0.1 volume fraction of imported fetal bovine serum was supplemented 72 hours later. ③Differentiation inducing factor group: After culture for 72 hours, retinoic acid and glial cell line-derived neurotrophic factors were added in the culture medium of BMSCs and NSCs as corresponding inducing factors. The level of NE in each group was detected on the day of culture and 5, 7, 14 and 20 days after culture with high performance liquid chromatography(HPLC). The procedure was conducted 3 times in each group.Standard working curve was made according to the corresponding relationship of NE concentration and peak area. The concentration of NE every 1×107 cells was calculated according to standard curve and cell counting. MAIN OUTCOME MEASURES: The level of NE of cultured cells was detected with HPLC; immunocytochemistrical identification of Nestin and neuron specific nuclear protein was performed. RESULTS: ① On the 14th day after cell culture, BMSCs turned into magnus and round cells which presented Nestin-positive antigen, then changed into neuron-like cells with long processus and presented neuron specific nuclear protein -positive antigen at the 20th day following culture. ② The ratio of NE concentration and peak area has good linear relationship, and regression equation was Y=1.168 36+0.000 272 8X,r=0.998 4.Coefficient variation (CV) was < 5% and the recovery rate was 92.39%(Y referred to concentration and X was peak area).③NE was well detached within 10 minutes under the condition of this experiment. ④ NE was detected in NSCs and their culture mediums, which were cultured for 7, 14 and 20 days respectively, but no NE in BMSCs, NSCs-free culture medium and L-02 hepatic cell which were as negative control under the HPLC examination. Analysis of variance showed that the level of NE gradually increased following the elongation of culture time (P < 0.01). No significant difference in the level of NE existed at the same time between differentiation inducing factor group and basic culture group(P > 0.05). CONCLUSION: BMSCs of rabbits can proliferate in vitro and express Nestin antigen; They can differentiate into neuron-like cells, express specific neucleoprotein of mature neurons, synthesize and secrete NE as a kind of neurotransmitter.展开更多
AIM: To evaluate different biochemical markers and their ratios in the assessment of primary biliary cirrhosis (PBC) stages. METHODS: This study included 112 patients with PBC who underwent a complete clinical investi...AIM: To evaluate different biochemical markers and their ratios in the assessment of primary biliary cirrhosis (PBC) stages. METHODS: This study included 112 patients with PBC who underwent a complete clinical investigation. We analyzed the correlation (Spearman's test) between ten biochemical markers and their ratios with different stages of PBC. The discriminative values were compared using areas under receiver operating characteristic (ROC) curves. RESULTS: The mean age of patients included in the study was 53.88 ± 10.59 years, including 104 females and 8 males. We found a statistically significant correlation between PBC stage and Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) to platelet ratio (APRI), ALT/platelet count, AST/ALT, ALT/AST and ALT/Cholesterol ratios, with the values of Spearman's rho of 0.338, 0.476, 0.404, 0.356, 0.351 and 0.325, respectively. The best sensitivity and specificity was shown for AST/ALT, with an area under ROC of 0.660. CONCLUSION: Biochemical markers and their ratios do correlate with different sensitivity to and specificity of PBC disease stage. The use of biochemical markers and their ratios in clinical evaluation of PBC patients may reduce, but not eliminate, the need for liver biopsy.展开更多
Objective To investigate plasma leptin concentrations in adolescent female dancers and to determine whether leptin has some effects on their bone mineral density (BMD) and bone turnover markers. Methods Sixty dancers ...Objective To investigate plasma leptin concentrations in adolescent female dancers and to determine whether leptin has some effects on their bone mineral density (BMD) and bone turnover markers. Methods Sixty dancers aged 15-17 years and 77 healthy controls were enrolled in the study. Bone mineral density (BMD) and body composition were detected by dual energy X-ray absorptiometry. Serum leptin concentrations were measured by radioimmunoassay (RIA). Two bone turnover markers, bone-specific alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase(TRACP), were determined by ELISA. Results The dancers had a lower fat mass and a lower leptin level than the controls, while they had a relatively higher BMD of the total body and legs after adjustment for BMI and age. The levels of bone resorption and formation of markers were higher in the dancers than in the controls. Leptin was positively correlated with BMI, body weight, fat mass, and percentage of body fat. In dancers, Leptin was positively correlated with the BMD of the total body and the left leg. However, after adjustment for BMI, no correlation of serum leptin concentrations with BMD values was found in either dancers or controls. Nor correlation was found between leptin and bone turnover markers after adjustment for BMI. Conclusion The leptin profile is different between the controls and the dancers with a lower BMI and a lower fat mass. Circulating plasma leptin level depends on BMI and is not a direct determinant of BMD in Chinese adolescent dancers.展开更多
BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) is now increasing rapidly. The tumor grade of PNETs significantly affects the treatment strategy and prognosis. However, there is still no effective...BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) is now increasing rapidly. The tumor grade of PNETs significantly affects the treatment strategy and prognosis. However, there is still no effective way to non-invasively classify PNET grades. Machine learning (ML) algorithms have shown potential in improving the prediction accuracy using comprehensive data. AIM To provide a ML approach to predict PNET tumor grade using clinical data. METHODS The clinical data of histologically confirmed PNET cases between 2012 and 2018 were collected. A method of minimum P for the Chi-square test was used to divide the continuous variables into binary variables. The continuous variables were transformed into binary variables according to the cutoff value, while the P value was minimum. Four classical supervised ML models, including logistic regression, support vector machine (SVM), linear discriminant analysis (LDA) and multi-layer perceptron (MLP) were trained by clinical data, and the models were labeled with the pathological tumor grade of each PNET patient. The performance of each model, including the weight of the different parameters, were evaluated. RESULTS In total, 91 PNET cases were included in this study, in which 32 were G1, 48 were G2 and 11 were G3. The results showed that there were significant differences among the clinical parameters of patients with different grades. Patients with higher grades tended to have higher values of total bilirubin, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4. Among the models we used, LDA performed best in predicting the PNET tumor grade. Meanwhile, MLP had the highest recall rate for G3 cases. All of the models stabilized when the sample size was over 70 percent of the total, except for SVM. Different parameters varied in affecting the outcomes of the models. Overall, alanine transaminase, total bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4 affected the outcome greater than other parameters. CONCLUSION ML could be a simple and effective method in non-invasively predicting PNET grades by using the routine data obtained from the results of biochemical and tumor markers.展开更多
Goal: Determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study...Goal: Determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study of 75 pre-eclamptic women in three maternities in Kinshasa, Democratic Republic of Congo, during the January to December 2013. The values of the following biochemical markers: uricemia, proteinuria and creatinemia were correlated with maternal and fetal prognosis. Results: This study showed that hyper uricemia associated with massive proteinuria and a high creatinine level correlated with an unfavorable pregnancy outcome and the occurrence of major materno-fetal complications such as eclampsia (X-squared = 24.3598, ddl = 2, p-value = 0.000005) and low birth weight (p = 0.001, R2 = 0.08). Conclusion: In view of these results, it appears necessary to ensure these biochemical markers systematically in the monitoring of pre-eclampsia.展开更多
Objective:To study the effect of Chongcao Bushen Capsules on bone turnover markers in patients with diabetic osteoporosis.Methods:107 patients with diabetic osteoporosis treated in the Hospital from December 2016 to N...Objective:To study the effect of Chongcao Bushen Capsules on bone turnover markers in patients with diabetic osteoporosis.Methods:107 patients with diabetic osteoporosis treated in the Hospital from December 2016 to November 2019were enrolled.They were divided into a control group(n=54)and an observation group(n=53)by random number table.The control group was treated with calcium carbonate,and the observation group was treated with Chongcao Bushen Capsules.The treatment effects,TCM syndrome scores,and bone turnover markers[including osteocalcin,type 1 procollagen amino-terminal propeptide(tP1NP),parathyroid hormone(PTH),25-hydroxyvitamin D,andβ-isomerized c-terminal peptide(β-CTx)],and the incidence of adverse reactions in the two groups were observed and compared.Results:After treatment,the total effective rate of treatment in the observation group(94.44%)was higher than that in the control group(73.58%),and the difference was statistically significant(P<0.05).The scores of symptoms including waist and knee weakness,back and waist pain,lower limb weakness,fatigue and tiredness,difficult walking and dizziness in the observation group were shown to be lower than the control group,and the difference was statistically significant(P<0.05).The levels of osteocalcin,PTH,tP1NP,andβ-CTx in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The 25-hydroxyvitamin D in the observation group was higher than the control group,and the difference was statistically significant(P<0.05).Bone density in both male and female in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:For patients with diabetic osteoporosis,Chongcao Bushen Capsule can help improve their clinical symptoms,bone density and the level of bone turnover markers.展开更多
Objective:To investigate the correlation of sex hormones with adipocytokines and bone metabolism biochemical indexes in women with menopausal osteoporosis.Methods: A total of 118 female patients who were diagnosed wit...Objective:To investigate the correlation of sex hormones with adipocytokines and bone metabolism biochemical indexes in women with menopausal osteoporosis.Methods: A total of 118 female patients who were diagnosed with menopausal osteoporosis in the West China Second University Hospital of Sichuan University between September 2015 and October 2017 were selected as menopausal osteoporosis group, and 100 menopausal women with normal bone density who received medical examination in the West China Second University Hospital of Sichuan University during the same period were selected as normal control group. The contents of sex hormones, adipocytokines and bone metabolism biochemical indexes in peripheral blood were compared between two groups of women, and Pearson test was used to evaluate the correlation between sex hormones and disease severity in women with menopausal osteoporosis.Results: E2 content in the peripheral blood of menopausal osteoporosis group was significantly lower than that of control group whereas FSH and LH contents were not significantly different from those of control group;Resistin and chemerin contents in peripheral blood were higher than those of control group whereas LEP and Visfatin contents were lower than those of control group;OC, NBAP, TRACP and ICTP contents in peripheral blood were significantly higher than those of control group. Pearson test showed that the sex hormone E2 content in women with menopausal osteoporosis was directly correlated with the contents of adipocytokines and bone metabolism biochemical indexes.Conclusion: The sex hormone expression is abnormal in women with menopausal osteoporosis, and the specific abnormal level can objectively reflect the condition of osteoporosis.展开更多
Cachexia is a multifactorial syndrome related to unintentional weight loss and to loss of muscle and fat mass. In head and neck cancer (HNC) its incidence is important and not only related to a deficient intake of foo...Cachexia is a multifactorial syndrome related to unintentional weight loss and to loss of muscle and fat mass. In head and neck cancer (HNC) its incidence is important and not only related to a deficient intake of food due to the impact of the disease in the vital functions. A complex disturbance in the normal metabolism of the patient promotes a persistent inflammatory state and a shifting in the metabolism balance toward a catabolic predominance affecting primarily the skeletal muscle. This leads to severe impairment of the functional, emotional and social status and quality of life of the patients that will compromise response to treatment and the disease prognosis. Understanding this deleterious syndrome and mainly identifying it in early stages of the disease is of a major importance in achieving better outcomes to head and neck cancer patients. This study pretends to identify clinical aspects related to cachexia in HNC in a clinical perspective for application on the routine clinical practice. In our study, 30 HNC patients were enrolled and evaluated in terms of nutritional values (actual and loss of weight in the past 6 months, body mass index (BMI), nutritional risk index (NRI), malnutrition universal screening tool), serum biochemical markers (albumin, total proteins, cholesterol, triglycerides, urea, C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and myostatin) and health related quality of life (HRQoL) evaluation (using European Organisation for the Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQ): EORTC QLQ-C30 and EORTC QLQ-HN43). A minimum follow-up of 48 months was considered for all patients. Our results showed that NRI is a good and sensitive index to identify cachexia. This index uses two parameters, one constitutional (loss of weight) and one biochemical (level of serum albumin). According to this criterion, 16 patients were assigned to the No-cachexia group and 14 patients to the Cachexia group. Significant differences in the constitutional and nutritional values between the two groups were found: the median weight loss was 4.44 kg in the No-cachexia group and 11.29 kg in the Cachexia group, while the BMI was 21.88 and 18.33, respectively. In terms of biochemical markers, significant low values of albumin and cholesterol in the Cachexia group were encountered when compared to the No-cachexia group. Regarding the inflammatory and cachexia biomarkers studied, the results show that patients in the Cachexia group had significantly higher levels of CRP and of the proinflammatory cytokines IL-6 and TNF-α and presented significantly raised levels of the myostatin. In terms of HRQoL evaluation, the scores of the EORTC QLQ-C30 revealed that all the scales and the Summary Score showed lower scores in the Cachexia group, indicating worst quality of life evaluation. The items scores were globally higher in the Cachexia group indicating more important problems related to those items in the Cachexia group. The difference encountered between the groups was significant (p < 0.001) in all considered scales but two: Dyspnoea and Constipation. Considering the EORTC QLQ-HN43 all the scales and in all single items but one (Wound Healing) the scores were higher in the Cachexia group, indicating a worst degree of problems affecting these group of patients. The difference found between the groups was significant (p < 0.001) in all scales and items but six: Dry Mouth and Sticky Saliva, Skin problems, Problems with Teeth, Trismus, Social Contact and Wound Healing. There were no significant differences in the clinical presentation of the disease between the two groups. The median survival was of 13.5 months in the Cachexia group, significantly lower when compared to the No-cachexia group (p < 0.0001), confirming the major impact of cachexia in survival and clinical outcomes in HNC patients. These results of our study show that HRQoL evaluation and serum biochemical markers are sensitive and important tools in identifying and screening cachexia in HNC patients. The methodology followed in this study correlating HRQoL with biochemical markers supports the development of clinical protocols in HNC that include cachexia evaluation. Hopefully this new approach can help to improve prognosis of the disease.展开更多
BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To e...BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.展开更多
At the base of experimental animal model construction of bone defect in New Zealand rabbit, the promoting repair effect of bioactive ceramics on bone defect as well as its machanism was studied through testing body mi...At the base of experimental animal model construction of bone defect in New Zealand rabbit, the promoting repair effect of bioactive ceramics on bone defect as well as its machanism was studied through testing body mineral elements, enzymes related to bone morphogenetic proteins and some biochemical indexes. Refering to some documents, materials of TCP, CHA and HA were combined and TCP/BMP/ TCP-β1 and CHA/BMP/ TCP-β1,HA/BMP/ TCP-β1 composite materials were made. All kinds of them were implanted into the radial defect site of rabbit, respectively. The chosen blood indexes (Ca, P, ALP, GGT, AST, ALT, TPA, BUN and Cr) were tested by colorimetry, speed rate and bromocresol green testing methods. No abnormal effects were found in any animal after operation. Serum concentrations of Ca, P and ALP were increased with the length of time in all groups of the three kinds of composite material, mixed material and pure materials. The increases in composite material groups were more significant (P<0.05). Comparison of the three kinds of material showed TCP>CHA>HA. There was a tendency of increased TPA and decreased BUN with the length of time. There was no significant difference between the composite material groups and pure material group (P>0.05). The three kinds of bioactive ceramics composed of extracellular matrix could increase the serum concentrations of Ca and P and activity of ALP after being implanted into defect bone and showed some repairing capacity. This provided a new area of machanism study of bone defect repair by biomaterials.展开更多
目的了解骨质疏松性椎体压缩骨折二级预防失败患者骨代谢指标及骨密度的特点。方法选择2015年1月至2020年1月在我院骨科因骨质疏松性椎体压缩骨折行2次或2次以上手术治疗的患者为观察组研究对象,共65例,同时选择同时期行手术治疗的非多...目的了解骨质疏松性椎体压缩骨折二级预防失败患者骨代谢指标及骨密度的特点。方法选择2015年1月至2020年1月在我院骨科因骨质疏松性椎体压缩骨折行2次或2次以上手术治疗的患者为观察组研究对象,共65例,同时选择同时期行手术治疗的非多次脊柱压缩骨折患者219例作为配对资料对照组,回顾性分析这284例患者临床资料,记录其术前骨代谢标志物水平及骨密度(bone mineral density,BMD)结果并进行两组患者间比较。结果观察组患者骨代谢标志物中人血清和血浆中的总I型前胶原氨基端肽(tP1NP)、N⁃MID骨钙素(OCN)以及血清25⁃羟维生素D(25⁃hydroxy vitamin D,25OHD)水平与对照组相比差异无统计学意义(P>0.05),骨代谢标志物I型胶原羧基端肽β特殊序列(β⁃CTX)水平明显高于对照组(P<0.05)。两组患者髋部BMD值、股骨颈BMD值差异无统计学意义(P>0.05),观察组腰椎BMD值明显低于对照组(P<0.05)。结论骨质疏松性椎体压缩骨折二级预防失败患者具有更为活跃的骨吸收状态及更低的腰椎骨密度。展开更多
文摘Objective: In this study, we compared the biochemical markers of imminent abortion, missed abortion, and healthy pregnant women in the first trimester to see if there were any differences. Materials and Methods: The study method is prospective. Pregnant women who applied to the obstetrics clinic of Istanbul Training and Research Hospital between 01.04.22 and 31.10.22 were diagnosed with abortion imminens or missed abortion between 6 weeks and 12 weeks or had normal pregnancy follow-up, had no chronic diseases, and did not take magnesium and calcium supplements were included in the study. 20 pregnant women with missed abortion, 20 pregnant women with abortion imminens diagnosis and 20 normal pregnant women who met the criteria were included in the study. Magnesium (Mg), calcium (Ca), copper (Cu), zinc (Zn) and hemogram (CBC) levels were checked in pregnant women included in the study. Results: The Mg, Cu, Zn, and CBC values of the study participants’ women did not differ in a statistically significant way. When compared to pregnant women who had a normal pregnancy process, the difference in Ca value was found to be statistically substantially smaller in pregnant women who were diagnosed with abortion imminens and missed abortion. The findings of our study suggest that serum Ca levels be measured prior to conception or at the initial visit. Conclusion: Serum Ca levels were found to be significantly lower in the missed abortion group than in the abortus imminens and normal pregnant groups in our study (p 0.05).
基金supported by the National Natural Science Foundation of China (32072191)Daxing District Major Scientific and Technological Achievements Transformation Project (2020006)+1 种基金Beijing Innovation Team Project of Livestock Industry Technology SystemBeijing Science and Technology Special Project (Z201100002620005)。
文摘The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.
文摘Background:The training program promoted improvements of jump abilities throughout the musculoskeletal system including bone markers.The aim of this study is to examine both the acute and chronic response of bone markers to resistance training program.Methods:Ten female students(age:18±0.7 years,body mass:63±3.6 kg;height:164±5.2 cm)participated in this study.They were recruited for a back-squat training program for 12 weeks,two days/week.The full-back squat protocol consisted of 3–5 sets×3–8 repetitions at 45–55%one repetition maximum.Testing sessions included a 5 jump test(5JT),standing long jump(SLJ),drop jump(DJ),and vertical jump(VJ).Results:Substantial improvements in all testing jumps(5JT:∆10%;P=0.000;ES=1.72;SLJ:∆7%;P=0.000;ES=1.33;DJ:∆11%;P=0.000;ES=0.72;VJ:∆20%;P=0.000;ES=1.84)were found during post program in comparison to pre-program results.Moreover,a significant change(P≤0.05)of bone markers during post-exercise compared to pre-exercise either before or after the training program.Only collagen type I carboxy-terminal peptide(CICP)levels elevated after the training program(pre-exercise only)compared to former levels.Conclusion:12 weeks of back-squat training program resulted greater acute improvements of jump abilities with adaptation in all musculoskeletal system including bone formation.
基金the National Natural Science Foundation of China, No. 30270491 the Natural Science Foundation of Guangdong Province, No. 04020422 Science and Technology Plan Program of Guangdong Province, No. 2003A3020304
文摘BACKGROUND: It has been proved by many experimental studies from the aspects of morphology and immunocytochemistry in recent years that bone marrow stromal cells (BMSCs) can in vitro induce and differentiate into the cells possessing the properties of nerve cells. But the functions of BMSCs-derived neural stem cells(NSCs) and the differentiated neuron-like cells are still unclear. OBJECTIVE: To observe whether bone marrow-derived NSCs can secrete norepinephrine (NE) under the condition of in vitro culture, induce and differentiation, and analyze the biochemical properties of BMSCs-derived NSCs. DESIGN: A non-randomized and controlled experimental observation. SETTING: Institute of Neuromedicine of Chinese PLA, Zhujiang Hospital, Southern Medical University. MATERIALS: This experiment was carried out in the Institute of Neuromedicine of Chinese PLA, Zhujiang Hospital, Southern Medical University. The bone marrow used in the experiment was collected from 1.5- month-old healthy New Zealand white rabbits. METHODS: This experiment was carried out in the Institute of Neuromedicine of Chinese PLA, Zhujiang Hospital, Southern Medical University. The bone marrow used in the experiment was collected from 1.5 month-old healthy New Zealand white rabbits. BMSCs of rabbits were isolated and performed in vitro culture, induce and differentiation with culture medium of NSCs and differentiation-inducing factor, then identified with immunocytochemical method. Experimental grouping: ①Negative control group: L-02 hepatic cell and RPMI1640 culture medium were used. ② Background culture group: Only culture medium of NSCs as culture solution was added into BMSCs to perform culture, and 0.1 volume fraction of imported fetal bovine serum was supplemented 72 hours later. ③Differentiation inducing factor group: After culture for 72 hours, retinoic acid and glial cell line-derived neurotrophic factors were added in the culture medium of BMSCs and NSCs as corresponding inducing factors. The level of NE in each group was detected on the day of culture and 5, 7, 14 and 20 days after culture with high performance liquid chromatography(HPLC). The procedure was conducted 3 times in each group.Standard working curve was made according to the corresponding relationship of NE concentration and peak area. The concentration of NE every 1×107 cells was calculated according to standard curve and cell counting. MAIN OUTCOME MEASURES: The level of NE of cultured cells was detected with HPLC; immunocytochemistrical identification of Nestin and neuron specific nuclear protein was performed. RESULTS: ① On the 14th day after cell culture, BMSCs turned into magnus and round cells which presented Nestin-positive antigen, then changed into neuron-like cells with long processus and presented neuron specific nuclear protein -positive antigen at the 20th day following culture. ② The ratio of NE concentration and peak area has good linear relationship, and regression equation was Y=1.168 36+0.000 272 8X,r=0.998 4.Coefficient variation (CV) was < 5% and the recovery rate was 92.39%(Y referred to concentration and X was peak area).③NE was well detached within 10 minutes under the condition of this experiment. ④ NE was detected in NSCs and their culture mediums, which were cultured for 7, 14 and 20 days respectively, but no NE in BMSCs, NSCs-free culture medium and L-02 hepatic cell which were as negative control under the HPLC examination. Analysis of variance showed that the level of NE gradually increased following the elongation of culture time (P < 0.01). No significant difference in the level of NE existed at the same time between differentiation inducing factor group and basic culture group(P > 0.05). CONCLUSION: BMSCs of rabbits can proliferate in vitro and express Nestin antigen; They can differentiate into neuron-like cells, express specific neucleoprotein of mature neurons, synthesize and secrete NE as a kind of neurotransmitter.
文摘AIM: To evaluate different biochemical markers and their ratios in the assessment of primary biliary cirrhosis (PBC) stages. METHODS: This study included 112 patients with PBC who underwent a complete clinical investigation. We analyzed the correlation (Spearman's test) between ten biochemical markers and their ratios with different stages of PBC. The discriminative values were compared using areas under receiver operating characteristic (ROC) curves. RESULTS: The mean age of patients included in the study was 53.88 ± 10.59 years, including 104 females and 8 males. We found a statistically significant correlation between PBC stage and Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) to platelet ratio (APRI), ALT/platelet count, AST/ALT, ALT/AST and ALT/Cholesterol ratios, with the values of Spearman's rho of 0.338, 0.476, 0.404, 0.356, 0.351 and 0.325, respectively. The best sensitivity and specificity was shown for AST/ALT, with an area under ROC of 0.660. CONCLUSION: Biochemical markers and their ratios do correlate with different sensitivity to and specificity of PBC disease stage. The use of biochemical markers and their ratios in clinical evaluation of PBC patients may reduce, but not eliminate, the need for liver biopsy.
基金supported by the China Research Grant 2006 from Danone Institute (No. DIC 2006-14)
文摘Objective To investigate plasma leptin concentrations in adolescent female dancers and to determine whether leptin has some effects on their bone mineral density (BMD) and bone turnover markers. Methods Sixty dancers aged 15-17 years and 77 healthy controls were enrolled in the study. Bone mineral density (BMD) and body composition were detected by dual energy X-ray absorptiometry. Serum leptin concentrations were measured by radioimmunoassay (RIA). Two bone turnover markers, bone-specific alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase(TRACP), were determined by ELISA. Results The dancers had a lower fat mass and a lower leptin level than the controls, while they had a relatively higher BMD of the total body and legs after adjustment for BMI and age. The levels of bone resorption and formation of markers were higher in the dancers than in the controls. Leptin was positively correlated with BMI, body weight, fat mass, and percentage of body fat. In dancers, Leptin was positively correlated with the BMD of the total body and the left leg. However, after adjustment for BMI, no correlation of serum leptin concentrations with BMD values was found in either dancers or controls. Nor correlation was found between leptin and bone turnover markers after adjustment for BMI. Conclusion The leptin profile is different between the controls and the dancers with a lower BMI and a lower fat mass. Circulating plasma leptin level depends on BMI and is not a direct determinant of BMD in Chinese adolescent dancers.
基金Supported by “Miaopu”Innovation Foundation of the Chinese PLA General Hospital,No.17KMM07
文摘BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) is now increasing rapidly. The tumor grade of PNETs significantly affects the treatment strategy and prognosis. However, there is still no effective way to non-invasively classify PNET grades. Machine learning (ML) algorithms have shown potential in improving the prediction accuracy using comprehensive data. AIM To provide a ML approach to predict PNET tumor grade using clinical data. METHODS The clinical data of histologically confirmed PNET cases between 2012 and 2018 were collected. A method of minimum P for the Chi-square test was used to divide the continuous variables into binary variables. The continuous variables were transformed into binary variables according to the cutoff value, while the P value was minimum. Four classical supervised ML models, including logistic regression, support vector machine (SVM), linear discriminant analysis (LDA) and multi-layer perceptron (MLP) were trained by clinical data, and the models were labeled with the pathological tumor grade of each PNET patient. The performance of each model, including the weight of the different parameters, were evaluated. RESULTS In total, 91 PNET cases were included in this study, in which 32 were G1, 48 were G2 and 11 were G3. The results showed that there were significant differences among the clinical parameters of patients with different grades. Patients with higher grades tended to have higher values of total bilirubin, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4. Among the models we used, LDA performed best in predicting the PNET tumor grade. Meanwhile, MLP had the highest recall rate for G3 cases. All of the models stabilized when the sample size was over 70 percent of the total, except for SVM. Different parameters varied in affecting the outcomes of the models. Overall, alanine transaminase, total bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4 affected the outcome greater than other parameters. CONCLUSION ML could be a simple and effective method in non-invasively predicting PNET grades by using the routine data obtained from the results of biochemical and tumor markers.
文摘Goal: Determining the place of Uricemia associated with other biochemical makers in the prediction of fetal-maternal complications during preeclampsia. Material and method: This is a prospective, cross-sectional study of 75 pre-eclamptic women in three maternities in Kinshasa, Democratic Republic of Congo, during the January to December 2013. The values of the following biochemical markers: uricemia, proteinuria and creatinemia were correlated with maternal and fetal prognosis. Results: This study showed that hyper uricemia associated with massive proteinuria and a high creatinine level correlated with an unfavorable pregnancy outcome and the occurrence of major materno-fetal complications such as eclampsia (X-squared = 24.3598, ddl = 2, p-value = 0.000005) and low birth weight (p = 0.001, R2 = 0.08). Conclusion: In view of these results, it appears necessary to ensure these biochemical markers systematically in the monitoring of pre-eclampsia.
基金Traditional Chinese medicine research project of Hebei administration of traditional Chinese medicine(No.2016092)。
文摘Objective:To study the effect of Chongcao Bushen Capsules on bone turnover markers in patients with diabetic osteoporosis.Methods:107 patients with diabetic osteoporosis treated in the Hospital from December 2016 to November 2019were enrolled.They were divided into a control group(n=54)and an observation group(n=53)by random number table.The control group was treated with calcium carbonate,and the observation group was treated with Chongcao Bushen Capsules.The treatment effects,TCM syndrome scores,and bone turnover markers[including osteocalcin,type 1 procollagen amino-terminal propeptide(tP1NP),parathyroid hormone(PTH),25-hydroxyvitamin D,andβ-isomerized c-terminal peptide(β-CTx)],and the incidence of adverse reactions in the two groups were observed and compared.Results:After treatment,the total effective rate of treatment in the observation group(94.44%)was higher than that in the control group(73.58%),and the difference was statistically significant(P<0.05).The scores of symptoms including waist and knee weakness,back and waist pain,lower limb weakness,fatigue and tiredness,difficult walking and dizziness in the observation group were shown to be lower than the control group,and the difference was statistically significant(P<0.05).The levels of osteocalcin,PTH,tP1NP,andβ-CTx in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The 25-hydroxyvitamin D in the observation group was higher than the control group,and the difference was statistically significant(P<0.05).Bone density in both male and female in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:For patients with diabetic osteoporosis,Chongcao Bushen Capsule can help improve their clinical symptoms,bone density and the level of bone turnover markers.
文摘Objective:To investigate the correlation of sex hormones with adipocytokines and bone metabolism biochemical indexes in women with menopausal osteoporosis.Methods: A total of 118 female patients who were diagnosed with menopausal osteoporosis in the West China Second University Hospital of Sichuan University between September 2015 and October 2017 were selected as menopausal osteoporosis group, and 100 menopausal women with normal bone density who received medical examination in the West China Second University Hospital of Sichuan University during the same period were selected as normal control group. The contents of sex hormones, adipocytokines and bone metabolism biochemical indexes in peripheral blood were compared between two groups of women, and Pearson test was used to evaluate the correlation between sex hormones and disease severity in women with menopausal osteoporosis.Results: E2 content in the peripheral blood of menopausal osteoporosis group was significantly lower than that of control group whereas FSH and LH contents were not significantly different from those of control group;Resistin and chemerin contents in peripheral blood were higher than those of control group whereas LEP and Visfatin contents were lower than those of control group;OC, NBAP, TRACP and ICTP contents in peripheral blood were significantly higher than those of control group. Pearson test showed that the sex hormone E2 content in women with menopausal osteoporosis was directly correlated with the contents of adipocytokines and bone metabolism biochemical indexes.Conclusion: The sex hormone expression is abnormal in women with menopausal osteoporosis, and the specific abnormal level can objectively reflect the condition of osteoporosis.
文摘Cachexia is a multifactorial syndrome related to unintentional weight loss and to loss of muscle and fat mass. In head and neck cancer (HNC) its incidence is important and not only related to a deficient intake of food due to the impact of the disease in the vital functions. A complex disturbance in the normal metabolism of the patient promotes a persistent inflammatory state and a shifting in the metabolism balance toward a catabolic predominance affecting primarily the skeletal muscle. This leads to severe impairment of the functional, emotional and social status and quality of life of the patients that will compromise response to treatment and the disease prognosis. Understanding this deleterious syndrome and mainly identifying it in early stages of the disease is of a major importance in achieving better outcomes to head and neck cancer patients. This study pretends to identify clinical aspects related to cachexia in HNC in a clinical perspective for application on the routine clinical practice. In our study, 30 HNC patients were enrolled and evaluated in terms of nutritional values (actual and loss of weight in the past 6 months, body mass index (BMI), nutritional risk index (NRI), malnutrition universal screening tool), serum biochemical markers (albumin, total proteins, cholesterol, triglycerides, urea, C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and myostatin) and health related quality of life (HRQoL) evaluation (using European Organisation for the Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQ): EORTC QLQ-C30 and EORTC QLQ-HN43). A minimum follow-up of 48 months was considered for all patients. Our results showed that NRI is a good and sensitive index to identify cachexia. This index uses two parameters, one constitutional (loss of weight) and one biochemical (level of serum albumin). According to this criterion, 16 patients were assigned to the No-cachexia group and 14 patients to the Cachexia group. Significant differences in the constitutional and nutritional values between the two groups were found: the median weight loss was 4.44 kg in the No-cachexia group and 11.29 kg in the Cachexia group, while the BMI was 21.88 and 18.33, respectively. In terms of biochemical markers, significant low values of albumin and cholesterol in the Cachexia group were encountered when compared to the No-cachexia group. Regarding the inflammatory and cachexia biomarkers studied, the results show that patients in the Cachexia group had significantly higher levels of CRP and of the proinflammatory cytokines IL-6 and TNF-α and presented significantly raised levels of the myostatin. In terms of HRQoL evaluation, the scores of the EORTC QLQ-C30 revealed that all the scales and the Summary Score showed lower scores in the Cachexia group, indicating worst quality of life evaluation. The items scores were globally higher in the Cachexia group indicating more important problems related to those items in the Cachexia group. The difference encountered between the groups was significant (p < 0.001) in all considered scales but two: Dyspnoea and Constipation. Considering the EORTC QLQ-HN43 all the scales and in all single items but one (Wound Healing) the scores were higher in the Cachexia group, indicating a worst degree of problems affecting these group of patients. The difference found between the groups was significant (p < 0.001) in all scales and items but six: Dry Mouth and Sticky Saliva, Skin problems, Problems with Teeth, Trismus, Social Contact and Wound Healing. There were no significant differences in the clinical presentation of the disease between the two groups. The median survival was of 13.5 months in the Cachexia group, significantly lower when compared to the No-cachexia group (p < 0.0001), confirming the major impact of cachexia in survival and clinical outcomes in HNC patients. These results of our study show that HRQoL evaluation and serum biochemical markers are sensitive and important tools in identifying and screening cachexia in HNC patients. The methodology followed in this study correlating HRQoL with biochemical markers supports the development of clinical protocols in HNC that include cachexia evaluation. Hopefully this new approach can help to improve prognosis of the disease.
文摘BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.
基金National Natural Science Foundation of China,Grant number:30170273
文摘At the base of experimental animal model construction of bone defect in New Zealand rabbit, the promoting repair effect of bioactive ceramics on bone defect as well as its machanism was studied through testing body mineral elements, enzymes related to bone morphogenetic proteins and some biochemical indexes. Refering to some documents, materials of TCP, CHA and HA were combined and TCP/BMP/ TCP-β1 and CHA/BMP/ TCP-β1,HA/BMP/ TCP-β1 composite materials were made. All kinds of them were implanted into the radial defect site of rabbit, respectively. The chosen blood indexes (Ca, P, ALP, GGT, AST, ALT, TPA, BUN and Cr) were tested by colorimetry, speed rate and bromocresol green testing methods. No abnormal effects were found in any animal after operation. Serum concentrations of Ca, P and ALP were increased with the length of time in all groups of the three kinds of composite material, mixed material and pure materials. The increases in composite material groups were more significant (P<0.05). Comparison of the three kinds of material showed TCP>CHA>HA. There was a tendency of increased TPA and decreased BUN with the length of time. There was no significant difference between the composite material groups and pure material group (P>0.05). The three kinds of bioactive ceramics composed of extracellular matrix could increase the serum concentrations of Ca and P and activity of ALP after being implanted into defect bone and showed some repairing capacity. This provided a new area of machanism study of bone defect repair by biomaterials.
文摘目的了解骨质疏松性椎体压缩骨折二级预防失败患者骨代谢指标及骨密度的特点。方法选择2015年1月至2020年1月在我院骨科因骨质疏松性椎体压缩骨折行2次或2次以上手术治疗的患者为观察组研究对象,共65例,同时选择同时期行手术治疗的非多次脊柱压缩骨折患者219例作为配对资料对照组,回顾性分析这284例患者临床资料,记录其术前骨代谢标志物水平及骨密度(bone mineral density,BMD)结果并进行两组患者间比较。结果观察组患者骨代谢标志物中人血清和血浆中的总I型前胶原氨基端肽(tP1NP)、N⁃MID骨钙素(OCN)以及血清25⁃羟维生素D(25⁃hydroxy vitamin D,25OHD)水平与对照组相比差异无统计学意义(P>0.05),骨代谢标志物I型胶原羧基端肽β特殊序列(β⁃CTX)水平明显高于对照组(P<0.05)。两组患者髋部BMD值、股骨颈BMD值差异无统计学意义(P>0.05),观察组腰椎BMD值明显低于对照组(P<0.05)。结论骨质疏松性椎体压缩骨折二级预防失败患者具有更为活跃的骨吸收状态及更低的腰椎骨密度。