JaLCDOI 10.18926/15319
Title Alternative Effects of vitamin D and exercise on bone mineral density (BMD) measuured by QCT
FullText URL 064_071_074.pdf
Author Hiramatsu, Junnichi| Kawaraya, Masashi| Yokota, Satoshi| Sugimoto, Keisuke| Mitsunobu, Fumihiro| Mifune, Takashi| Kajimoto, Kazuhiro| Kitani, Hikaru| Tanizaki, Yoshiro| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 40才~84才(平均64.1才)の患者38例における骨塩量を,ある期間(1~15カ月,平均8.2カ月)をおいて2回,定量的QCT(quantitative computed tomography)法を用いて測定し,その経時的変化によって,骨粗鬆症に対する治療法の効果判定を試みた。その結果,(1)全体として骨塩量に有意の増加は認められなかった。(2)骨強化剤使用例についても骨塩量に有意の増加は認められなかった。(3)運動療法施行者においても骨塩量に有意の増加は認められなかった。以上のことから骨粗鬆症の治療においては,約1年弱の経過では著明な反応は得られにくいものと思われた。ただし,一部の運動療法施行者,骨強化剤使用者において,骨塩量の著明な上昇が認められており,さらに経時的な観察が必要と思われた。
Abstract Alternative Bone mineral density (BMD) was measured twice in 38 patients aged 40 to 84 years old for the last one year to evalute the effects of vitamin D and exercise on BMD. 1) In all patients, The BMD did not significantly increase. 2) In patients with vitamin D for osteoprosis, the BMD did not significantly increse compared to those without the drug. 3) In patients with exercise therapy, the BMD did not show any significant increase compared to those without exercise.
Keywords 骨粗鬆症 (Osteoprosis) 定量的QCT法 (QCT) 加齢 (Aging) 運動療法 (Exercise) ビタミンD (Vitamin D)
Publication Title 岡大三朝分院研究報告
Published Date 1993-06
Volume volume64
Start Page 71
End Page 74
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307358
JaLCDOI 10.18926/15309
Title Alternative Correlations between bone mineral density measured by QCT and risk factors of Osteoporosis
FullText URL 063_030_033.pdf
Author Honke, Naoko| Kusaura, Yasuhiro| Tanimizu, Masakuni| Mitsunobu, Fumihiro| Mifune, Takashi| Okazaki, Morihiro| Kitani, Hikaru| Tanizaki, Yoshiro| Takatori, Akimasa| Okuda, Hiroyuki| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 27~85才の女性143例における骨塩量を,定量的QCT法 (quantitative computed tomography)を用いて測定し,年令,身長,体重及び原疾患(慢性関節リウマチ),使用薬剤(ステロイド・骨強化剤)の因子の骨塩量に及ぼす影響について検討した。その結果,1)加令とともに骨塩量は低下するが,特に40才代後半から60才代にかけての低下が顕著であり,また, 他因子の影響を受けやすい。2)体型的因子としては.痩せ型で低身長の人に低値の傾向がある。3)ステロイド使用の有無における検討において,特に50才代で使用群が著明に低値であることが明らかとなった。また,薬剤の因子の考察に関しては,さらに経時的検討か必要であると思われた。
Abstract Alternative Bone mineral density (BMD) was measured in 143 females aged 27 to 85 years old to investigate the correlations between BMD and several factors such as age, height, presence of rheumatoid arthritis and corticosteroid or bone intensifying drug therapy. 1) BMD values decreased with aglng and the most remarkable decrease was observed at the age of latter half of 40's to 60's. 2) Women with slim and low stature tended to have low BMD values. 3) BMD values of women with steroid therapy were significantry lower than those without corticosteroid at the age of 50's (p<0.01). However, further study is necessary to confirm the effect of drugs on BMD.
Keywords 骨粗鬆症 (Osteoporosis) 定量的コンピューター断層法 (QCT (quantitative computed tomograpy))
Publication Title 岡大三朝分院研究報告
Published Date 1992-06
Volume volume63
Start Page 30
End Page 33
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002307603
JaLCDOI 10.18926/15158
Title Alternative Changes of bone mineral densities in women and prevention and treatment of osteoporosis
FullText URL 065_082_086.pdf
Author Kobayashi, Yasuaki| Nakagiri, Yoshiyasu| Ishida, Makoto| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 当科では3年ほど前よりQCT法を用いて骨塩量測定を行い,骨粗鬆症の管理治療を行っている。264名の測定値について分析をしたところ,40歳頃から60歳にかけて急速に低下すること,肥満度が増すにつれ骨塩量も増加する傾向がみられた。また,閉経前に卵巣を両側摘出した場合ホルモン補充療法を行っているが,卵巣を温存した場合と差がでなかった。治療に結合型エストロゲンを用いた群の12カ月後の骨塩量の増加率は,任用しなかった群にくらべ有意の差があった。
Abstract Alternative Bone mineral density (BMD) was measured in 264 females by QCT. BMD was rapidly decreased between 40's and 60's. There was a tendency for BMD increase in proportion to obesity. HRT was made without bilateral ovaries at operation, then there were no differencis between removal of ovaries and preserve of ovaries. The increase rate of BMD treated by conjugated-estrogens was higher than that of no treated BMD (p<0.05).
Keywords 骨塩量 (Bone mineral density) 骨粗鬆症 (osteoporosis) ホルモン補充療法 (HRT)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 82
End Page 86
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307221
JaLCDOI 10.18926/15156
Title Alternative Study on the relatjonship between the bone mineral density mesured by QCT and the osteoporosis therapy.
FullText URL 065_069_076.pdf
Author Kajimoto, Kazuhiro| Takata, Ichiro| Yokota, Satoshi| Mitsunobu, Fumihiro| Mifune, Takashi| Kitani, Hikaru| Tanizaki, Yoshiro| Kobayashi, Yasuaki| Nakagiri, Yoshiyasu| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 当院通院あるいは入院中の女性患者54例を対象に骨塩量を経時的に3回測定し検討を行った。54例の骨塩量の平均は3回とも有意差はなく,年次骨塩変化量は-3.1±14.6mg/cm(3)/yearであった。平均骨塩量の年齢別比較では40才台,50才台,60才台の順に有意な減少がみられ,60才台と70才以上との間には差は認めなかった。また50才台及び70才以上の年代で1年当たりの骨塩量の減少が大きい傾向が窺われた。身長と骨塩量との間に有意の正の相関を認めたが,体重との間には有意の相関を認めなかった。血清中Ca,P及びALPと骨塩量との検討ではいずれも有意の相関を認めなかった。骨塩変化量減少群と増加群との比較では,平均骨塩量及び背景因子の間に差を認めなかった。女性,特にステロイド療法を必要とする患者については閉経の時期にあたる40~50才台より積極的に骨粗髭症対策を考える必要性があると考えられた。また運動療法については温泉プール療法自体を再検討するとともに,骨粗髭症に特異的な運動療法の確立が必要と思われた。
Abstract Alternative Bone mineral densities (BMD) were mesured 3 times in 54 females aged 40 to 84 years old to evaluate about relationship between BMD and osteoporosis therapy or patient background factors. BMD decreased 3.1±14.6mg/cm(3) per year, and BMD values were more decreased in subjects with the age of 50's and over 70's than in those with the age of 40's and 60's. In patients with bronchial asthma or rheumatoid arthritis, treated with corticosteroids (predonisolone : 3-7.5mg/day), BMD were sigfnificantly more decreased than in patients without corticosteroid therapy. There was a significant positive correlation between BMD and body height, but no correlation between BMD and body weight, serum Ca, P, or alkaline phosphatase. No differences in background factors were found between subjects with increased BMD and those with decreased BMD. These results indicate that female patients with corticosteroids need active treatments for the prophylaxis of osteoporosis at the age of 40's or 50's.
Keywords 骨粗鬆症 (Osteoporosis) 骨塩量 (Bone mineral density) 運動療法 (Exercise therapy) QCT (quantitative computed tomograpy)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 69
End Page 76
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307602
JaLCDOI 10.18926/15122
Title Alternative Study on the relationship between the bone mineral densities measured by QCT and biochemical parameters.
FullText URL 066_037_043.pdf
Author Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Yokota, Satoshi| Hosaki, Yasuhiro| Tanizaki, Yoshiro| Nakai, Mutsuro| Akiyama, Tsuneo|
Abstract 当院内科に通院または入院中の女性患者24例(57~89才,平均71.8才)を対象とし,定量的QCT法による骨塩量測定と同時に血中骨代謝マーカーを測定し検討を行った。年齢についての検討では,カルシウム(Ca)が70才台で60才台に比べ有意に高値であった以外は年代による有意差は認められなかった。オステオカルシン(OC)とイオン化Ca(Ca(2+))との間にr=-0.50,p<0.01の有意の逆相関を認め,OCとBody mass indexとの間に有意の正の相関(r=0.41,p<0.05)を認めた。平均骨塩量と各生化学parameterとの間には有意な相関はみられなかった。副腎皮質ステロイド剤(ステロイド)投与群では非投与群に比べ,投与群でALP骨型アイソザイム(ALP3)高値,OC低値の傾向がみられた。またステロイド投与症例はすべてOC値が8.4ng/mℓ以下であり,ステロイドによる骨粗鬆症誘発の機序として骨形成の抑制が関与している可能性が考えられた。今後骨塩量と骨代謝マーカーとの関連について,若年者を含めた検討が必要と考えられた。
Abstract Alternative Bone mineral densities (BMD) were measured with QCT (quantitative computed tomography) in 24 females aged 57 to 89 years old to evaluate about relationship between BMD and biochemical parameters on bone metabolism (calcium : Ca, ionized calcium : Ca(2+), alkaline phosphatase : ALP, bone type isozyme of alkaline phosphatase : ALP 3 and osteocalcin : OC) in blood. As for exception that Ca was significantly higher in patients aged of 60's in comparison with those of 70's in the examination with regard to age, no significant differences were observed. Significant opposite correlation (r=-0.50, p<0.01) between OC and Ca(2+) and significant positive correlation (r=0.41, p<0.05) between OC and body bass index were observed. No significant correlation was observed between mean BMD and biochemical parameters. A trend of higher ALP 3 and lower OC was observed in adrenocortical steroid (steroid) administration group in comparison with patients with no steroid therapy. Also in steroid administration group, OC value was below 8.4ng/mℓ in all patients. Thus, it was suspected that the suppression of bone formation was related to the mechanism of osteoporosis induced by steroid. Then, the further studies on the relationship of BMD and these biochemical parameters including those of younger cases were considered necessary to clarify the mechanism of osteoporosis.
Keywords 骨粗鬆症 (Osteoporosis) 骨塩量 (Bone mineral desity) オステオカルシン (Osteocalcin) 骨型アルカリフォスファターゼ (alkaline phosphatase (bone type isozyme)) イオン化カルシウム (ionized calcium)
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 37
End Page 43
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307374
JaLCDOI 10.18926/14986
Title Alternative 気管支喘息患者における腰椎海綿骨骨塩量と脊椎圧迫骨折の臨床的特徴
FullText URL 068_045_050.pdf
Author Tsugeno, Hirofumi| Nakai, Mutsuro| Okamoto, Makoto| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract Clinical risk factors associated with the development of osteoporosis and vertebral fractures were evaluated in patients with asthma in relation to sex, age, and dose of glucocorticoids (GC). In 75 asthmatic patients including 44 steroid-dependent asthma, the bone mineral density (BMD) of the lumber spines was measured by quantitative computed tomography (QCT). Thirty five patients of them were followed up with radiographs over a period of 0.5 to 4 years (average: 2.6±1.3 years). The BMD was significantly lower in older (p<O.01) or female (p<0.05) patients. All the five patients developing vertebral compression fractures were female and more than 64 y.o., and received systemic glucocorticoid (GC) therapy for more than 3 years with a lot of cumulative gramdosage of GC. No significant correlation was demonstrated between the BMD and the dose of systemic GC per day, but multiple regression analysis demonstrated a significant relationship (p<O.o1) between the BMD and lifetime cumulative gramdosage of GC. Multiple regression analysis also demonstrated significant relationships (p<O.01) between the BMD and clinical factors such as age and sex. These results indicates that the bone loss and vertebral fractures of patients with asthma are influenced by the patient's age, sex, and the lifetime cumulative GC dose.
Abstract Alternative 対象は気管支喘息75症例。このうち44例はステロイド依存性難治症例であった。35症例については,0.5年から4年間(平均:2.6±1.3年間)の経時的観察もおこなわれた。これらの症例の骨塩量に影響を及ぼす因子について検討をおこなった。高齢者,女性に有意な低骨塩量を認めた。重回帰分析にて年齢,性別,経口副腎ステロイド投与総量などの項目に骨塩量と有意な関連が認められた。また,35症例中5例に脊椎圧迫骨折が発生し,いずれも骨塩量が低く,高齢者,女性,長期ステロイド内服例であった。これらのことから気管支喘息患者においては,女性,高齢者,長期ステロイド内服例に骨塩量減少や脊椎圧迫骨折のリスクが高いと考えられた。また,ステロイド続発性骨粗鬆症の発生には,ステロイドの現在の一日内服量よりもこれまでの総積算内服量が重要と考えられた。
Keywords 気管支喘息 (bronchial asthma) 骨粗鬆症 (osteoporosis) 椎体骨折 (vertebral fracture) ステロイド療法 (glucocorticoid therapy)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 45
End Page 50
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308467
JaLCDOI 10.18926/14934
Title Alternative 気管支喘息症例における皮質骨海綿化
FullText URL 070_053_060.pdf
Author Tsugeno, Hirofumi| Nakai, Mutsuro| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Mifune, Takashi| Mitsunobu, Fumihiro| Ashida, Kozo| Hosaki, Yasuhiro| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract In previous studies, we have demonstrated that chronic administration of systemic glucocorticoids decreases cortical bone mineral density (BMD), cortical bone volume, bone strength, and induces development of pathologic fractures in asthmatic patients. We have also demonstrated that glucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites in postmenopausal asthmatic patients. There is a difference of gonadal hormones between male and female. To investigate the influence of hormonal difference on glucocorticoid-induced cortical bone porosity, we studied cortical bone volume and BMD in both male and female patients with asthma in this report. A total of 99 asthmatic patients (male 26 cases, female 73 cases) were enrolled in the study. Peripheral quantitative computed tomography (pQCT) was used to measure cortical BMD and relative cortical volume. The cortical volume-density relationship appeared to remain constant regardless of the level of systemic glucocorticoid administration, age or sex, suggesting cortical bone porosity causes similar and simultaneous decreases in cortical bone volume and density. In conclusion, glucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites despite the gonadal hormonal differences.
Abstract Alternative 【目的】これまでに我々は,気管支喘息症例において経口ステロイドによる皮質骨骨密度,容積の減少が骨折に関与する新知見を報告し,閉経後女性では皮質骨骨密度一容積の減少はステロイド投与量にかかわらず一定であることを報告してきた。この皮質骨骨密度-容積の関係において性差による違いを検討するために,男性,女性患者の両方について検討を行った。【方法】対象はステロイド依存性喘息99例(男性26例,女性73例)。性別,年齢,経口ステロイド積算総投与量により6群に分類した。椎体圧迫骨折はⅩ線側面像にて評価 し,皮質骨容積比および皮質骨骨密度はpQCT(Stratec XCT960)を用いて測定した。それぞれの群の皮質骨骨密度-容積比の関係を算出し比較検定をおこなった。【結果】それぞれの群の皮質骨の骨密度と容積比は有意に相関した。それぞれの群の皮質骨骨密度-容積比の傾きは,いずれも有意差を認めなかった。【結論】気管支喘息症例におけるステロイド投与による皮質骨の骨密度と容積の減少は,性別にかかわらずほぼ一定で,皮質骨は内側と外側において同様に海綿化してゆくと考えられた。
Keywords bronchial asthma systemic glucocorticoid cortical bone cortical porosity peripheral quantitative computed tomography
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 53
End Page 60
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308477
JaLCDOI 10.18926/14910
Title Alternative ステロイド依存性気管支喘息症例の病的骨折と皮質骨傷害の検討
FullText URL 071_059_067.pdf
Author Tsugeno, Hirofumi| Goto, Bunrei| Nakai, Mutsuro| Okamoto, Makoto| Takata, Singo| Mifune, Takashi| Hosaki, Yasuhiro| Mitsunobu, Fumihiro| Ashida, Kozo| Akiyama, Tsuneo| Tsuji, Takao| Tanizaki, Yoshiro|
Abstract In a previous study, we demonstrated that chronic administration of systemic glucocorticoids decreases cortical bone mineral density (BMD) and induces development of pathologic fractures in asthmatic patients. To investigate cortical bone porosity due to glucocorticoids, we studied cortical bone volume, BMD, bone strength, and fractures in patients with asthma in this report. A total of 82 postmenopausal asthmatic patients were enrolled in the study. Vertebral fractures were diagnosed via plain spinal radiograms. Peripheral quantitative computed tomography (pQCT) was used to measure cortical BMD, relative cortical volume, and Strength Strain Index (SSI). Multiple regression analysis, Student's t test, and other statistical analyses were performed. Patients with systemic glucocorticoids therapy had lower cortical BMD, relative cortical volume, SSI, and more number of vertebral fractures than patients without it. Lifetime cumulative dose of glucocorticoids was related to cortical BMD, relative cortical volume, SSI, and the number of vertebral fractures. The cortical volumedensity relationship appeared to remain constant regardless of systemic glucocorticoid administration. The number of vertebral fractures correlated highly with cortical BMD, relative cortical volume, and SSI at the radius. In conclusion, systemic glucocorticoid administration decreases cortical bone density, cortical bone volume, and bone strength. G lucocorticoid administration appears to be responsible for the process of cortical bone porosity at both endosteal and intracortical sites. Given that both cortical bone density and volume provide bone strength, cortical bone porosity was seen to contribute to glucocorticoid - induced bone strength loss and fractures.
Abstract Alternative 【目的】骨強度には皮質骨の状態が主に関与するため,全身ステロイド療法に伴う病的骨折と皮質骨障害について検討した。【方法】閉経後女性気管支喘息患者82例で,ステロイド依存性群と非依 存群において,椎体骨折数,槙骨皮質骨骨密度,皮質骨容量,骨強度(SSI)をⅩ線側面像とpQCTを用いて検討した。 【結果】ステロイド依存群はステロイド非依存群に比べて,椎体圧迫骨折数は有意に多く,榛骨皮質骨骨密度,皮質骨容積比,骨強度は各々有意に低下していた。また,皮質骨骨密度と容積は一定の割合で減少していた。椎体圧迫骨折数は皮質骨骨密度,皮質骨容積比,骨強度の全てと高い相関を認めた。 【結論】ステロイド依存性気管支暗息症例においては,皮質骨の骨 密度と容量が同時に減少して骨強度が減少することによって,病的骨折が発症すると考えられた。
Keywords glucocorticoid cortical bone pQCT osteoporosis
Publication Title 岡大三朝分院研究報告
Published Date 2001-02-01
Volume volume71
Start Page 59
End Page 67
ISSN 0918-7839
language 英語
File Version publisher
NAID 120002308222