Study On Early Diagnosis And Prevention Of Postmenopausal Women With Osteoporosis

Osteoporosis(OP)is a systematic disease that is characterized by the loss of bone mass and the destruction of the bones' micro-structures.The incidence of osteoporosis is related to age.With the continuous improvement of the medical level,the aging of the population is increasing,making the number of people with osteoporosis increasingly large.Diagnosis and prevention of osteoporosis has been a hot topic of research.This topic aims to explore the early diagnosis and prevention of osteoporosis in postmenopausal women.The topic is divided into three parts.Part 1Objective: Using dual-energy X-ray absorptiometry to detect bone mineral density in middle-aged and old people in Danyang,Jiangsu,and to study the prevalence of osteoporosis in the middle-aged and elderly population in this region,providing a theoretical basis for primary prevention and treatment of osteoporosis.Methods: A total of 1026 patients(408 males and 618 females)in Danyang,Jiangsu Province were examined for bone mineral density at the lumbar spine and hips.The test results were grouped at the age of 10 years to analyze the prevalence of osteoporosis in men and women in each group.Results: The prevalence of bone mass loss and osteoporosis in men was 25.5% and 14.7%,respectively;the prevalence of bone mass loss and osteoporosis in women was 43.4% and 38.0%,respectively;With the increase of age,the number of normal bone mass decreased significantly(P<0.01),while the number of osteoporosis increased significantly(P<0.01).The prevalence of osteoporosis among women of all ages was significantly higher than that of men(P<0.01).Conclusion: The prevalence of osteoporosis in people aged over 50 years in Danyang,Jiangsu Province was 28.7%.The prevalence of females in all age groups was higher than that of males in the same age group.Therefore,strategies should be undertaken to prevent and treat osteoporosis earlier.Part 2Objective: To detect the levels of serum undercarboxylated osteocalcin(ucOC)in postmenopausal women,and to explore its influence factors and its significance in the diagnosis and treatment of osteoporosis in postmenopausal women.Methods: Totally 108 patients in Nanjing Medical Hospital Affiliated to Nanjing Medical University orthopedics ward were enrolled from July,2015 to December,2016.The experimental and control groups were set up according to the T-score of bone mineral density(BMD)and the history of fracture.Age,height,weight,body mass index(BMI)and BMD were recorded,and draw peripheral blood to test blood alkaline phosphatase(ALP),serum calcium,phosphorus,ucOC.These indicators are for statistical analysis.Results: 1)The level of ucOC of the patients with osteoporosis was significant higher than the control group(P<0.05).Serum ucOC level was the influence factors of osteoporosis(OR=2.806,P<0.05).2)Serum ucOC level revealed a significant and negatively correlated with lumber BMD(r=-0.395,P<0.05),but there was no significant correlation with hip BMD(r=-0.248,P>0.05).Conclusion: The change of serum ucOC level closely associated with the occurrence of osteoporosis in postmenopausal women,the high level of serum ucOC is a risk factor for osteoporosis in postmenopausal women.Furthermore,serum ucOC level has a reference for the early prediction and screening for osteoporosis in postmenopausal women.Part 3Objective: To evaluate the efficacy of different health education frequencies on anti-osteoporosis treatments in postmenopausal female patients.Methods: 373 postmenopausal women who were diagnosed osteoporosis and treated in Nanjing Medical Hospital Affiliated to Nanjing Medical University from July 2014 to December 2015 were divided into 4 groups(A,B,C and D).Groups were decided according to the times that patients have attended health educations within a year.Group A: 83 people who have never attended any health education;group B: 117 patients who have attended 1 to 4 times of health education;group C: 101 people who have attended 5 to 8 times;group D: 72 people who have attend 9 to12 times.All of the 373 patients were treated with standardized anti-osteoporosis treatments.Beyond that,patients were encouraged to attend health education events once every month within the year of treatment.The effects of anti-osteoporosis treatments were evaluated by comparing the result of osteoporosis knowledge tests(OKT),a self-designed health-related behavior questionnaire and bone mineral density reports in four groups before and after the treatments.Results: Comparing to the data before the treatments,bone mineral density of all groups of patients increased significantly(P<0.05)after a year;the increase of OKT scores is significant in group B,C and D(P<0.05);the improvement of patients' healthy habits is significant in all groups(P<0.05).One year after the treatment,both OKT scores and the healthy habits of the patients in group B,C and D were significantly better(P<0.05)comparing to the scores of group A's patients.However,no significant difference was found in the OKT scores between group C and D(P>0.05).Comparing to group A after the treatments,the increase of BMD in group B,C,D is significant(P<0.05).Notably,no significant difference was found in the increase of BMD between group C and D(P>0.05).Conclusions: In addition of receiving standardized anti-osteoporosis treatments,attending health educations every two month within the year afterwards can significantly improve the patients' understanding of osteoporosis,therefore promote the development of healthy habits,and thus enhance the therapeutic effects of anti-osteoporosis treatments.