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Young adults with juvenile arthritis in remission attain normal peak bone mass at the lumbar spine and forearm

ARTHRITIS AND RHEUMATISM 2000年第7期43卷 1504-1510页

作者： Haugen, M Lien, G Flato, B Kvammen, J Vinje, O Sorskaar, D Forre, O Natl Hosp Norway Ctr Rheumat Dis N-0027 Oslo Norway

Objective. To assess the impact of disease activity on acquired peak bone mass and bone turnover in young adult patients with either persistent juvenile arthritis (JA) or a history of JA (JA in remission), Methods, Two hundred twenty-nine patients with JA were studied after a mean a SD of 15.6 +/- 2.4 years in women and 14.9 +/- 2.1 years in men since disease onset. One hundred forty-five women and 84 men were over the age of 20 at the Lime of examination (mean a SD age 24.9 +/- 2.9 years for women and 25.2 +/- 3.1 years for men), Forty-one healthy women (mean a SD age 27.4 +/- 3.1 years) and 55 healthy men (mean a SD age 25.7 +/- 3.1 years) served as a reference group. Bone mineral density (BMD) was analyzed by dual x-ray absorptiometry, Serum osteocalcin concentrations and urinary concentrations of deoxypyridium (D-Pyd) were measured. Linear regression analyses were performed to evaluate the impact of disease on BMD, Results, Patients with persistent disease had significantly lower BMD compared with healthy subjects (P < 0.001 for women at all measured sites and for men at the femoral neck and total body;P < 0.05 for men at the radius and lumbar spine), Of the patients with a history of JA, only women had significantly lower BMD at the femoral neck and total body (P < 0.05), Patients with persistent JA had significantly more osteopenia and osteoporosis than healthy subjects, while patients with a history of JA had more frequent osteopenia only in the total body. Weight, urinary concentration of D-Pyd, and belonging to the patient group significantly affected BMD at all measured sites in the entire study population, while analysis of all patients found that only the number of months taking corticosteroids significantly affected BMD at all measured sites, However, the impact of the variables differed from site to site. Conclusion, Our findings imply that most young adults with JA attain the same BMD as healthy subjects if the disease goes into remission, while young

关键词：氨基酸类/尿关节炎幼年型类风湿/并发症关节炎幼年型类风湿/代谢关节炎幼年型类风湿/放射摄影术骨密度骨疾病代谢性/并发症骨疾病代谢性/代谢骨疾病代谢性/放射摄影术疾病恶化股骨颈/代谢股骨颈/放射摄影术腰椎/代谢腰椎/放射摄影术骨钙素/血液骨质疏松/并发症骨质疏松/代谢骨质疏松/放射摄影术桡骨/代谢桡骨/放射摄影术缓解诱导成年人女(雌)性人类男(雄)性

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BONE-MINERAL MEASUREMENT - SKYLAB EXPERIMENT M-078

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ACTA ASTRONAUTICA 1975年第1-2期2卷 129-139页

作者： VOGEL, JM UNIV CALIF SCH MEDDEPT RADIOLNUCL MED SECTDAVISCA 95616

The observation that bone mineral is lost in patients who are either immobilized or remain in bed for extended periods of time formed the basis for the concern that large amounts of bone mineral may be lost during long periods of weightlessness. This concern was magnified when early X-ray densitometry studies suggested that rather large amounts of mineral could be lost during rather short periods of weightlessness (4-14 days). Even though these Gemini results have recently been modified, they still reflect substantial losses in the upper extremity. This led to a series of prolonged bed-rest studies (30-36 weeks) which, in addition to careful calcium balance, also employed a newer, more precise method of estimating bone mineral in the radius, ulna, and os calcis. It employed an essentially monoenergetic photon source (125I) and a scintillation detector operating in a rectilinear scanning mode to measure bone mineral by the absorptiometric technique. Bed-rest studies revealed variable mineral losses but suggested that little if any is lost during 4-6 weeks, with variable amounts being lost in 8 weeks. Losses up to 40% were noted in the os calcis after 9 months, with essentially none in the radius and ulna. When this technique was employed during the Apollo 14, 15, and 16 missions, only one crewman (CMP Apollo 15) showed significant losses in the os calcis and none in the radius or ulna. These results were, therefore, in concert with the bed-rest data but at variance with the earlier Gemini data. The variability observed during bed rest was reconciled when it was observed that the rate of loss could be correlated with the initial 24-hour urinary hydroxyproline excretion and the initial os calcis mineral content. Prediction terms were established. Measurements of the SL-II crew after 28 days of weightlessness revealed no significant bone mineral losses. The Skylab data lie within the predicted limits obtained from the bed-rest data. The relevance of the prediction terms

关键词：吸收测定法光子/方法航天医学卧床休息骨密度/生理学骨和骨组织/代谢骨和骨组织/生理学骨和骨组织/放射摄影术钙/代谢跟/生理学跟/放射摄影术羟脯氨酸/代谢羟脯氨酸/尿桡骨/代谢桡骨/生理学桡骨/放射摄影术宇宙飞行时间因素尺骨/代谢尺骨/生理学尺骨/放射摄影术失重失重模拟人类男(雄)性

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PROLONGED WEIGHTLESSNESS AND CALCIUM LOSS IN MAN

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ACTA ASTRONAUTICA 1979年第9期6卷 1113-1122页

作者： RAMBAUT, PC JOHNSTON, RS National Aeronautics and Space Administration Lyndon B. Johnson Space Center Houston TX 77058 USA.

Data have been accumulated from a series of studies in which men have been subjected to weightlessness in orbital space flight for periods of up to 12 weeks. These data are used to predict the long term consequences of weightlessness upon the skeletal system. Space flight induced a loss of calcium which accelerated exponentially from about 50 mg/d at the end of 1 week to approx. 300 mg/d at the end of 12 weeks. The hypercalciuria reached a constant level within 4 weeks while fecal calcium losses continued to increase throughout the period of exposure. This apparent diminution of gastrointestinal absorptive efficiency was accompanied by a slight decline in the plasma level of parathyroid hormone and a slight elevation in the plasma level of calcium and phosphorus. Although losses in mineral from the calcaneus were closely correlated with the calcium imbalance, no changes were detected in the mineral mass of the ulna and radius. From the data presented it is concluded that the process of demineralization observed in space flight is more severe than would be predicted on the basis of observations in immobilized, bed rested, or paralyzed subjects. It is, moreover, suggested that the process may not be totally reversible.

关键词：骨脱矿质病理性/病因学骨脱矿质病理性/代谢跟骨/代谢跟骨/病理生理学钙/血液钙/缺乏钙/代谢钙/尿脱钙作用病理性/病因学脱钙作用病理性/代谢粪便羟脯氨酸/代谢羟脯氨酸/尿甲状旁腺素/血液甲状旁腺素/代谢磷酸盐类/血液磷酸盐类/代谢蛋白质类/代谢桡骨/代谢宇宙飞行硬脂酸类/代谢尺骨/代谢人类男(雄)性

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