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目的观察常见ER基因联合型妇女的骨密度在断奶补钙后的自我恢复状况,以及补钙对其骨密度的影响。方法在湖北省武汉地区满月产妇中筛选雌激素受体(ER)基因代表型ppxx、Ppxx、PpXX和PPXx各40名,每种基因型别产妇随机分为2组,一组为补钙组(每日600mg钙,碳酸钙),另一组为对照组。产后3个月时,使用双能X线吸收骨密度测定仪测量母亲腰椎和左髋基线骨密度,并通过3d、24h的膳食调查计算其平均每日钙摄入量,随即补钙(补钙组)或给予安慰剂(对照组),1年后再次测定相同部位的骨密度。结果所有产妇,无论补钙与否,1年后腰椎和左髋的骨密度都增加或显著增加(P<0.05)。与对照组相比,仅ppxx型产妇补钙后左髋骨密度增加率差异没有显著性(P>0.05),其余型别产妇差异均有显著性(P<0.05)。逐步回归分析表明,产妇哺乳时间是髋部骨密度增加率的主要影响因素。结论尽管武汉地区产妇的钙日摄入量较少,产后3个月起的1年内其腰椎和左髋骨密度仍明显增加;补钙至少对某些ER等位基因代表型产妇有益。
OBJECTIVE: To investigate the self-recovery of bone mineral density (BMD) in common ER gene-combined women after weaning and calcium supplementation and the effects of calcium supplementation on their BMD. Methods 40 pregnant women with full-term estrogen receptor (ER) gene of ppxx, Ppxx, PpXX and PPXx were screened in full-term mothers in Wuhan, Hubei Province. Forty pregnant women of each genotype were randomly divided into two groups, 600mg daily calcium, calcium carbonate), the other for the control group. At 3 months postpartum, baseline BMD of the lumbar spine and left hips of the mother were measured by dual energy X-ray absorptiometry and their average daily calcium intake was calculated by dietary injections of 3d and 24 h followed by calcium supplementation Group) or placebo (control group). One year later, the same site of bone mineral density was measured again. Results BMD of lumbar and left hip all increased or significantly increased (P <0.05) after 1 year in all mothers, regardless of calcium supplement or not. Compared with the control group, there was no significant difference in the increase rate of left hip BMD among ppxx type maternal women only (P> 0.05). The other maternal differences were significant (P <0.05). Stepwise regression analysis showed that maternal lactation time was the main influencing factor of hip BMD. Conclusions Although the maternal calcium intake in Wuhan is less, the BMD of lumbar spine and left hip are still significantly increased within one year from 3 months postpartum. Calcium supplementation is at least beneficial for some ER alleles.