中華民國骨質疏鬆症學會 98 年度第七屆第一次會員大會暨學術研討會
The 2009 Annual Meeting of The Taiwanese Osteoporosis Association
Agenda 議程
時間：2009 年 8 月 30 日
星期日
Date: August 30th, 2009
地點：台北國際會議中心 102 會議室
Venue: Taipei International Convention Center (TICC) Room 102
時間
演講題目
講者
主持人
Time
Topic
Speaker
Moderator
08:00~08:30
Registration 報到
08:30~08:40
Opening Remark
宋永魁
Oral Papers 論文口頭發表(一)
08:40~08:50
08:50~09:00
09:00~09:10
15-deoxy-∆12,14-prostaglandin-J2 Inhibits
Inflammation-Induced Matrix Metalloproteinase 13
Production via the Anatagonism of NF-κB Activation in
Human Synovial Fibroblasts
15d-PGJ2 在人類滑囊細胞中經由拮抗轉錄因子 κB 的
活化來抑制腫瘤壞死因子所誘導的基質金屬蛋白酵素
(MMP-13)的表現
林子閎(台大
藥理學科研
究所)
楊榮森
黃兆山
Mesenchymal Stem Cells and Age-related Bone Loss
間葉幹細胞和年齡相關骨量流失之關聯性
史中(三總口
腔外科)
副甲狀腺素治療骨質疏鬆症之研究
陳榮福(高雄
長庚新陳代
謝科)
Oral Papers 論文口頭發表(二)
09:10~09:20
09:20~09:30
The Correlation Between the Radiological and the
Histopathologic Findings in the Osteoporotic Fractures of
Vertebral Bodies
骨質疏鬆性椎體骨折在影像學和組織病理學之間的關
連性
Awareness and conception of osteoporosis in young adult
─ cross-sectional study of an university in Southern
Taiwan
1
黃國淵(成大
骨科部)
張尹凡(成大
家庭醫學部)
吳至行
高義然
青少年對骨質疏鬆症之認知調查──以南部某大學為
例之橫斷面研究
09:30~09:40
Investigation of The Adherence to Anti-osteoporotic
Regimen
病患接受骨質疏鬆症藥物治療之遵醫囑性分析報告
鄭添財(高雄
長庚風濕過
敏免疫科)
Foreign guest Lecture 外賓演講
09:40~10:20
Comparison of Peak Bone Mass of Different Races,
Various Counties and Regions
不同種族、不同國家和地區峰值骨量的比較
10:20~10:40
劉忠厚
(中國老年學
學會骨質疏
鬆委員會)
宋永魁
Coffee Break
Stuart L.
10:40~11:20
Impact of Osteoporosis on Quality of Life
骨質疏鬆症對病患生活品質的衝擊
Strontium Ranelate: A New Paradigm in Osteoporosis
11:20~12:00
12:00~12:30
Silverman
加州大學洛
杉磯分校醫
學院
Serge Ferrari
日內瓦大學
陳榮福
黃泓淵
附設醫院老
年暨復健醫
學部骨病科
Management
骨質疏鬆症治療的新趨勢
The 7th Annual Meeting
第七屆第一次會員大會暨理監事選舉
Lunch Symposium 午餐研討會
12:30-12:50
Avery Basil
Ince
美商默沙東
藥廠股份有
限公司台灣
New Standard of Osteoporosis Care
骨質疏鬆症治療的新標準
分公司醫藥
處
12:50~13:30
Treatment of GIOP: Who? When? What?
類固醇引起骨質疏鬆症的治療
2
Nancy E.
Lane
加州大學戴
維斯分校醫
學院
宋永魁
13:30~13:45
Panel Discussion
Symposium 專題演講
14:00~14:20
The Effect of Soy Isoflavone on Postmenopausal
Osteoporosis
植物雌激素對骨質疏鬆症的治療
戴東原(台北
仁濟院)
14:20~14:40
The Effect of Traditional Chinese Herb Medicine on
Postmenopausal Osteoporosis.
中藥對骨質疏鬆症的治療
劉華昌(台大
骨科)
14:40~15:20
The Recent Recommendation on HRT for Osteoporotic
Men and Women
對骨質疏鬆男人及婦女荷爾蒙療法之新近建言
黃國恩(高雄
長庚婦產科)
周松男
15:20~16:00
A Novel Device for Vertebral Augmentation for
Patient with Osteoporotic Compression Fracture
骨鬆壓迫性骨折強固椎體之新式手術治療方式
陳博光(台大
骨科)
許文蔚
16:00~16:20
蔡克嵩
Coffee Break
Academic research of TOA 學會學術研究報告
宋永魁(林口
16:20~16:40
Compliance of Alendronate in Taiwan
台灣骨質疏鬆症病患對雙磷酸鹽藥物之遵醫囑性研究
16:40~17:00
Mobile DXA Screening of Osteoporosis in Taiwan
以移動式雙能量 X 光吸收儀篩檢骨質疏鬆症在台灣的
經驗
吳至行(成大
家庭醫學部)
Gap of Post Fracture Osteoporosis Care in Asia Survey
骨折後骨質疏鬆症的照護在亞洲的落差調查
林瑞模(成大
骨科部)
臺灣 GAP 研
究小組
17:00~17:20
3
長庚婦產部)
楊再興
鄭添財
5-deoxy-Δ12,14-prostaglandin-J2 Inhibits Inflammation-Induced Matrix
Metalloproteinase 13 Production via the Antagonism of NF-κB Activation in Human
Synovial Fibroblasts
Tzu-Hung Lin1, Chih-Hsin Tang2, Karl Wu3, Yi-Chin Fong4, Rong-Sen Yang5*, and Wen-Mei Fu1*
Departments of Pharmacology1 and Orthopaedics5, College of Medicine, National Taiwan University, Taipei,
Taiwan
2
Department of Pharmacology and Orthopaedics4, College of Medicine, China Medical University,
Taichung, Taiwan
3
Department of Orthopaedics , Far Eastern Memorial Hospital, Taipei, Taiwan
Abstract:
A matrix metalloproteinase (MMP) that plays an important role in the degradation of cartilage in
pathologic conditions is collagenase-3 (MMP-13). MMP-13 is found to be elevated in joint tissues in both
rheumatoid arthritis (RA) and osteoarthritis (OA) patients. In addition, inflammation-stimulated synovial
fibroblasts are able to release MMP-13 and other cytokines in these syndrome. The peroxisome
proliferator-activated receptor-γ (PPARγ) controls adipogenesis and glucose metabolism. A growing
evidences reported that PPARγ plays a critical role in inflammatory arthritis by regulating B cell response
and inhibiting MMP-13 production in stimulated synovial fibroblasts and chondrocytes and natural PPARγ
ligand, 15-deoxy-Δ -Prostaglandin J2 (15d-PGJ2) was reported to be more potent than other synthetic
PPARγ compounds in the inhibition of inflammatory arthritis. 15d-PGJ2 may exert its effects via
PPARγ-dependent and also PPARγ-independent pathways. In this study, it was found that 15d-PGJ2
markedly inhibited TNF-α-induced MMP-13 production in human synovial fibroblasts and 15d-PGJ2 was
much more potent than synthetic PPARγ agonist ciglitazone. In addition, activation of nuclear factor κB
(NF-κB) is strongly associated with MMP-13 induction by TNF-α and 15d-PGJ2 markedly attenuated the
translocation of NF-κB by direct inhibition of the activation of IKK via a PPARγ-independent manner.
These results indicate that elevation of 15d-PGJ2 levels in the joint may have therapeutic potential in the
12,14
prevention of cartilage degradation.
4
An economic evaluation of severe osteoporosis in hip or vertebral fracture patients: estimated from a
nationwide health insurance database
嚴重骨鬆導致髖骨或脊椎骨骨折患者的經濟評估: 全國健保資料庫數據估算
陳榮福
Abstract
Summary: This study retrospectively examined the economic outcomes and co-medications of osteoporotic
patients with vertebral or hip fracture treated with teriparatide, as compared with surgical procedures. The
demographics of the osteoporotic patients were also measured.
Introduction The patient number and financial burden of osteoporotic patients with vertebral or hip fracture
are increased in Taiwan. An adequate treatment for these
patients that has good efficacy and will improve their quality of life is needed. Methods We conducted a
population-based observational study using the NHI claim databases. The final sample (1,714 in total)
included 172, 1431 and 111 older osteoporotic patients with hip or vertebral fracture treated with teriparatide,
percutaneous vertebroplasty or spinal fusion surgeries, or total arthroplasty or hemiarthroplasty of the hip,
respectively. Results These results showed that elderly osteoporotic patients have a high risk of vertebral and
hip fracture (14.92%). The patients treated with teriparatide had a lower hospitalization rate, shorter
hospitalization, and lower total cost than those who were treated with vertebral or hip surgeries. Conclusions
The reduced number of hospitalizations and lower hospitalization costs appear to more than offset the higher
medication acquisition costs of teriparatide.
5
骨質疏鬆性椎體骨折在影像學和組織病理學之間的關連性
Correlation between the radiological and the histopathologic findings in the osteoporotic fractures of vertebral
bodies
林政立 1、黃國淵 1、顏郁珊 2、林瑞模 1
Cheng-Li Lin1, Kuo-Yuan Huang1, Yu-Shan Yan2, Ruey-Mo Lin1
成大醫院骨科部 1, 成大醫院病理部 2
1Orthopedics,
2Pathology,
National Cheng Kung university hospital, Taiwan
National Cheng Kung university hospital, Taiwan
Purpose :
“Vacuum phenomenon” in radiograph and “fluid aign” in MRI are considered as radiographic signs of osteonecrosis
of the vertebral body. They are thought to be secondary to nonunion of vertebral compression fractures. However, the
correlation between the radiological and the pathologic findings were seldom reported before. The purpose of this study
is to investigate the correlation between the radiological and the histopathologic findings in the osteoporotic fractures of
vertebral bodies.
Materials and Methods :
We collected the data of 19 patients who had osteoporotic fractures of vertebral bodies and received operation of
anterior corpectomy, open biopsy and anterior spinal fusion in National Cheng Kung University Hospital from 2004 to
2008. They all underwent imaging preoperatively with plain radiographs and magnetic resonance imaging (MRI). All the
images and pathologies were reviewed retrospectively.
Results :
A total of 19 patients, 54–84 years old (mean 73 years; 17 women and 2 men), were included in this study. The
levels of the fractures located from T8 to L3. Most of fractures (17/19) had more than 50 percent vertebral body height
loss. Intravertebral vacuums were identified in the preoperative images in 9 patients. Analyzing MRI, 16 patients had
vertebral body edema and the fluid sign could be recognized in 11 patients.
Bone biopsies of vertebral bodies were done in all 19 patients. The histological analysis revealed that 13 patients
had osteonecrosis. Bone regeneration could be identified in 15 patients. Almost all of the patients who had vertebral
osteonecorsis (11/13) were found to undergo regeneration.
6
Considering the correlation between the radiological and the histopathologic findings, 7 osteonecrosis were identified
in the 9 patients who had intravertebral vacuum phenomenon. The sensitivity and specificity of vacuum phenomenon
are 54 % and 66% respectively. Besides, all of the 11 patients with fluid sign in MRI had vertebral necrosis. The
sensitivity and specificity of fluid sign in diagnosing osteonecrosis are 85 % and 100 % respectively. The diagnosing
power of fluid sign in MRI was better than the intravertebral vacuum phenomenon in plain radiography. Interestingly,
there are 45% of sensitivity and 56% of specificity of the relationship between X-ray and MRI. It seems that they don't
have good correlation.
Conclusion :
Our study indicates MRI fluid sign is more accurate to diagnose vertebral osteonecrosis than vacuum phenomenon
in plain radiography. Thus, MRI study is a useful tool to identify vertebral osteonecrosis, or even the possibility of
pathological fracture and it might also detect the severity of neurological compromise.
7
The Investigation of Adherence to Anti-osteoporotic Regimens And Analysis of
Non-compliance Related factors
TT Cheng, CL Chou, SF Yu, YC Chen, HM Lai, CJ Chen, *JF Chen, @ER Kau
Division of Rheumatology, *Metabolism Department of Internal Medicine, Division of
@
Orthopedics Chang Gung Memorial Hospital- Kaohsiung Medical Center
抗骨鬆用藥依囑性的研究及其影響因素
鄭添財 周靜蘭 楊聰信 尤珊富 邱俊凱 陳英州 賴漢明 陳忠仁 *陳榮福
高雄長庚紀念醫院風濕過敏免疫科 *新陳代謝科 @骨科
@
高義然
Abstract
Objective.
To investigate the adherence to medications for osteoporosis.
Methods.
This is a retrospective, chart review study. Osteoporotic patients prescribed with
anti-osteoporotic medications were searched through the database via computer in
Chang-Gung Memorial Hospital, Kaohsiung between 2001-2006. We reviewed the charts and
collected the demographic data, educational levels, site of fracture, medical history, and bone
mineral density for those who fulfilled the treatment criteria of national osteoporosis
foundation (2008) or treatment guideline for glucocorticoid osteoporosis by american college
of rheumatology (2001). Adherence was defined as medication possession ratio (MPR) and
persitence. The one year and two year’s MPR was defined as proportion of the 365 followup
days covered by days supply(one year MPR) and of the 730 followup days covered by days
supply (two years MPR), respectively. Persistence was calculated as the number of days from
the initial prescription to a gap of >30 days after completion of the previous refill. All of the
medications (anti-resorptives and anabolic agent) for osteoporosis were regarded as one
regimen. Good complicance was defined as MPR≧80% and non-compliance as MPR <80%.
The risk factors of non-compliance were analyzed by logistic regression model.
Results .
Nine thousands one hundred and nine charts were reviewed. Four thousand seven hundred
eighty subjects fulfilled the inclusion criteria and their demographic and clinical data were
collected.
One and two year’s MPR is 72.05 ± 32.31 % and 62.70 ± 39.75%,
respectively. By multi-variate analysis the factors (odds ratio, 90% CI) associated with
non-compliance
include treatment at orthopedic division (2.70, 2.30-3.10), other
sections(1.20, 1.03-1.41) and comorbidity of chronic lung diseases (1.30, 1.01-1.68). The
factors associated with good compliance are comorbidity of hypertension (0.74, 0.64-0.84),
rheumatoid arthritis (0.581, 0.42-0.80), and history of malignancy (0.73, 0.56-0.96). In
addition, pretreatment survey of bone mineral density was associated with better compliance
(0.67, 0.59-0.76) ,
Conclusions.
In this retrospective study, we found one and two year’s MPR of anti-osteoporotic regimens
8
was 72.05 ± 32.31 %
and 62.70 ±39.75%, respectively. The factors associated with better
compliance to anti-osteoporotic medications are follow-up at rhematology section,
pretreatment survey of bone mineral density and comorbidity including hypertension, ,
rheumatoid arthritis, history of malignancy.
9
Intravertebral Expansible Pillars for Osteoporotic Compression Fracture. A Preliminary Report.
謝瑞洋, 陳博光
國立台灣大學附設醫院骨科部
Background: Osteoporotic vertebral compression fracture (OVCF) is a leading cause of disability
and morbidity in the elderly people. It is also a challenging entity to treat. Kyphoplasty or
vertebroplasty may relieve pain and increase vertebral body height, however, leakage of
polymethyl methacrylate (PMMA) cement into the spinal canal is undoubtedly a disaster to the
patient and surgeon. We hereby used a new device, called Intravertebral expansible pillar (IVEP, or
pillar), with the hope to provide long-lasting relief of pain and reducing of kyphosis of these
patients.
Methods: Twenty-three patients had single or two-level implantation of IVEP between September
2006 and October 2007. The procedures include bone chip grafting and IVEP insertion through
bilateral dilated pedicle tracts into the collapsed vertebral body (VB). The mean duration of
follow-up was 11.0 months. Clinical results were evaluated by assessing preoperative and
postoperative lumbar pain by the Visual Analog Scale (VAS) Pain Scores. Pre- and postoperative
radiographs were evaluated as well to measure the anterior vertebral body height and kyphotic
angle of the lesion site. There were sixteen patients with bone marrow density (BMD) measurement.
The mean t-score of BMD was -2.4. The average numbers of implantation of IVEP were 2.0,
ranged from one to four. Eighteen patients were additionally implanted with pedicle screws (PI) at
adjacent above and below levels for posterior stabilization and/or correction of kyphotic deformity.
Of these 18 patients with PI and fusion, the average numbers of implantation of pedicle screws
were 4.6, ranged from four to ten. Three patients had weakness of the lower limbs before surgery.
Supplementary anti-osteoporotic medications after operation are needed.
Results: The mean VAS was decreased from 8.5 before operation to 2.4 after operation with a final
score of 1.8. The mean anterior VB height was increased from 13.7mm to 20.3mm after operation.
The mean increase was 7.7 mm. The mean VB kyphotic angle was decreased from 14.7° before
operation to 5.9° after operation. The mean individual corrected kyphotic angle was 9.1°. The
neurologic deficit was all recovered in the 3 patients. During follow- up, one had further VB collapse
at T12 with original lesion site L3 at 3 months after operation.
Conclusions: The IVEP appears to be effective and safe for the treatment of symptomatic OVCF.
Back pain could be relieved greatly after operation. Long duration of collapse, broken posterior rim
and sagittal deformity were not the contra-indications. Rather, these could be a good indication by
this method. Longer follow-up is necessary for further confirmation of this procedure.
10
The recent recommendation on HRT
for osteoporotic men and women
Ko-En Huang, MD, FACOG
Professor of Obstetrics and Gynecology
Chang Gung University Kaohsiung Medical Center
August 30, 2009 Annual Meeting of Taiwanese Osteoporosis Association
As the population aging, osteoporosis has become one of the most significant health threatening diseases and
attracts great deal attention of the public, healthcare providers, and, hopefully, the policy makers.
Osteoporosis is a leading cause of morbidity and mortality in elderly people. While less osteoporosis in
men than women, the mortality rate associated with hip fracture, as well as vertebral and other fractures, is
higher in men than in women. Furthermore, men are usually less evaluated for bone mineral density (BMD)
and less treated with antiresorptive agents after a hip fracture than women (4.5% versus 49.5%, respectively).
Osteoporosis is characterizes by low bone mass with micro architectural disruption and skeletal fragility,
thus, may increase the risk of fracture, particularly at the spine, hip, wrist, humerus, rib, and pelvis.
Currently, routine screening for low bone density for both men and women is not recommended. The US
recommendations for BMD measurement are: (1) women age 65 years and over; (2) postmenopausal women
<65 years of age with one or more risk factors for low BMD or with history of fracture; (3) men with
radiographic osteopenia, history of low traumatic fracture, and loss of more than 1.5 inches in height; and (4)
both men and women with long-term glucocorticoid therapy, hypogonadism, primary hyperparathyroidism,
and intestinal disorders. For men, the association of testosterone (T) and estrogen (E) deficiency with rapid
bone loss and osteoporosis in older men has been demonstrated. The prevalence of osteoporosis in men
with T deficiency was almost double (12.3%) of those men with normal T levels (6.0%) and 15.4 and 2.8%
in those with deficient and normal total E. Thus, older men with total T of E deficiency were more likely
to be osteoportic and, therefore, may be relevant for HRT. Studies indicated that, for men, testosterone
administration was found to be effective in increasing BMD among hypogonadotropic subjects, but not in
those men with normal serum testosterone levels. For women, FDA has approved hormone replace therapy
(HRT) for prevention of postmenopausal osteoporosis. HRT has been proved to increase BMD and to
decrease fractures incidence in postmenopausal women by WHI study. However, it is also obvious that
bone mass declines once HRT is discontinued. International Menopause Society (IMS) has recommended
that HRT can be first-line therapy in postmenopausal women presenting with an increased risk for fracture
and for the prevention of bone loss in women with premature menopause.
Osteoporosis is a serious aging
problem in both men and women, however, can be prevented and treated.
11
The Effect of Soy Isoflavone on Postmenopausal Osteoporosis
劉華昌
Abstract
Clinical effect of Gusuibu on osteoporosis has been investigated under the support of
National Concil of Chinese Drugs and Medicine from 2000-2003. Preliminary results
revealed positive effect on osteoporosis and no deviated effects at all on biochemical marks,
such as GOT, GPT, Cr, Sugar, BUN, as well as（CBC complete blood count）20 patients who
had taken the Gsbibu for one year. The results are also compatible to those found in animal
study. However, Gusuibu was used by ancient Chinese herb doctors as a remedy for "injuries
and fractures "of the bone in stead of "osteoporosis" since there was no concept of
"osteoporosis" in the ancient time. Therefore, the present study is aimed to investigate the
clinical effect of Gusuibu on acute fracture（within 10 days after accident）of the young
patients（20-60）as well as of the old >65.
The study will be conducted on a double-blind, random sampling base. Two hundred patients
will be recruited and divided into 2 groups, one received extract of Gusuibu（1.8gm/day）and
Biocal （Calcium 300mg +VIT D3 62.5 IU / tablet x 2 /day）and one received placebo and
Biocal 2 tablets/day only . The evaluation methods includes
A. change of quality of life（QOL）by the chart designed by WHO 1, 2, 3, 6 months after
medication.
B. X ray examined the fracture site 1, 2, 3, 6（option）months after operation.
C. Bone mineral density（BMD）monitoring around the fracture site before and 6 months
（option）after medications.
D. Biochemical examinations, 3 & 6 months after medication.
Expected results:
1. Gusuibu would improve acute fracture healing of the young as well as the aged
2. Gusuibu would improve QOL.
3. Gusuiba would have no deviated effects on blood pictures and blood biochemistries.
12
The Effect of Soy Isoflavone on Postmenopausal Osteoporosis:
Results of Randomized Trial in Taiwan
Tong-Yuan Tai
Taipei Jen-Chi Relief Institution
This study was designed as a 2-year, double-blinded, placebo-controlled, two-arm, parallel group
study that randomized the women to the oral administration of 300 mg isoflavone aglycone/day or placebo.
All participants received a daily supplement of 600 mg calcium and Vitamin D3 125 IU simultaneously. The
primary endpoint of the study was to evaluate the effects of isoflavone aglycone on BMD while the
secondary endpoints focused on assessing the efficacy of isoflavone aglycone in preventing vertebral, wrist
and hip fracture and its effects on the metabolic indicators of bone formation(blood alkaline
phosphatase)and resorption(urinary N-telopeptide/Cr), blood pressure, blood sugar and insulin level, insulin
resistance (HOMA-IR), lipid profiles,and etc.
A total of 431subjects were randomized,with 217 assigned to isoflavone group and 214 in placebo
group.After the deduction of early terminated subjects, 399 cases went through the entire trial.
After two years of treatment with isoflavone, we found no evidence of increase in bone mineral
density (BMD) of the lumbar spine L2-L4 and right hip. There was no statistically significant difference in
the mean change of BMD of lumbar spine L2-L4 and right hip from baseline (p=0.0949 for lumbar spine
and p=0.2106 for right hip). When using the generalized estimating equations (GEE) method to estimate
the efficacy of isoflavone on repeated measures of BMD, we found that there was a significant trend of
decreasing BMD with the progression of time.
Isoflavone treatment did not alter the BMD significantly.
Although there was no significant interaction between isoflavone treatment and the progression of time, the
reduction of BMD over time tended to be less in patients treated with isoflavone. However,this was not
supported by the findings that the reduction of urine N-telopeptide/Cr output was smaller among subjects
receiving isoflavone than those who took placebo (p=0.0967 for mean change from baseline)
In addition,
there was no difference in the prevention of the vertebra, hip or wrist fractures between isoflavone and
placebo groups. Similar proportion of subjects were reported to have experienced adverse events (64.52%
in isoflavone group and 64.49% in placebo group), and 35 participants developed severe adverse events that
resulted in hospitalization or necessity of further treatment (17 in isoflavone and 18 in placebo group,
respectively).
13
Taiwan Osteoporosis Association
August 30,2009
Abstract
Impact of Osteoporosis on Quality of Life
Stuart L. Silverman
The disease burden of osteoporosis and osteoporotic fracture is not only the societal burden of costs and
healthcare utilization but the burden of osteoporotic fracture on the individual’s physical, social and
psychological functioning with resulting effects on health related quality of life (HRQOL).The burden of
fracture also includes the informal care given by family members and friends with impact on their HRQOL.
Fractures differ in their effects on short and long term HRQOL. While fractures impact HRQOL in both men
and women, there are differences in effects on different HRQOL domains between sexes. The greatest
information about loss of HRQOL is known about hip and vertebral fracture with less known about other
fractures.
The development of disease targeted questionnaires as well as use of generic questionnaires and utility
instruments in the last decade has enlarged our understanding of the effects of osteoporotic fracture on
HRQOL. These questionnaires allow us to look at multiple domains and dimensions of HRQOL.
These questionnaires have confirmed the decreased HRQOL seen in patients with prevalent fracture and the
impact of incident vertebral fracture on HRQOL. There is a hierarchy of effects of fracture type on
HRQOL with greatest effects of hip and vertebral and lesser effects of wrist. HRQOL decreases with
increasing number of prevalent vertebral fracture and varies by location.
The International Costs and Utilities Related to Osteoporosis Fracture Study –United States or ICUROS-US
will provide information about disutilities related to hip, wrist, pelvis, tibia, humerus and clinical vertebral
fracture in the United States over 18months subsequent to the fracture event..
Disappointingly, treatment effect of osteoporosis medications on HRQOL has not been observed in
randomized controlled trials, possibly due to sample size or infrequent administration of questionnaires.
In conclusion, HRQOL provides insight into the individual disease burden of osteoporosis.
14
"Strontium ranelate:
a new paradigm in osteoporosis management"
Prof. Serge Ferrari, Division of Bone Diseases, dept of Rehabilitation and Geriatrics, Geneva University
Hospital and Faculty of Medicine
Among the available agents for osteoporosis, antiresorptive drugs do not increase bone formation,
while anabolic agents do not reduce bone resorption. Strontium ranelate (SR) uniquely does both,
rebalancing bone turnover in favour of bone formation. This translates in particularly into an
improvement of bone quality and cortical thickness, i.e. a major component of bone strength, as
observed with both transiliac crest bone biopsies and high-resolution computer tomography of the
distal tibia, the latter in a randomized controlled study against alendronate. In the Spinal
Osteoporosis Therapeutic Intervention (SOTI) study, a 4-year trial, SR treatment reduced vertebral
fracture risk by 33% (P < 0.001) and symptomatic vertebral fracture risk by 36% (P < 0.001). SR
also significantly improved quality of life as assessed by the Quality-of-Life Questionnaire in
Osteoporosis (QUALIOST) instrument. In the Treatment of Peripheral Osteoporosis Study
(TROPOS) study, a 5-year trial, SR significantly reduced any osteoporotic fracture risk by 20%
(29.1% vs 33.9%, P < 0.001) and non-vertebral fracture risk by 15% (18.6% vs 20.9%, P = 0.032),
as well as hip fracture risk by 43% (7.2% vs 10.2%, P = 0.036) in the subgroup at high risk for hip
fracture. Analysis of pooled data from these two studies found that SR is also safe and effective in
patients aged ≥ 80 years, reducing the risk of vertebral fracture over 5 years by 31% (P = 0.010)
and non-vertebral fracture by 26% (P = 0.019). Adherence to treatment in the trials exceeded 80%,
and the adverse event profile of SR was similar to that of placebo. Taken together, these long-term
findings clearly demonstrate that SR is safe and effective in reducing both vertebral and
non-vertebral (particularly hip) fracture risks for at least 5 years of preplanned follow-up.
15
不同种族、不同国家和地区峰值骨量的比较
刘忠厚教授
中国老年学学会骨质疏松委员会主任委员
《中国骨质疏松杂志》主编
Comparison of peak bone mass of different races，countries and regions
Zhonghou Liu, Professor (President of Osteoporosis Committee of China Gerontological Society,
Editor-in-chief of Chinese Journal of Osteoporosis)
骨质疏松症是一种全球性的代谢性疾病，它的诊断目前主要依靠骨密度的测定。从 1993 年开始
WHO 确定的骨质疏松症诊断标准即以该地区的峰值骨量(peak bone mass，PBM)减少 2．5 个标准差为
诊断标准。因此，一个地区的平均峰值骨量的确定是诊断骨质疏松的前提。峰值骨量是正常生理条件
下骨成熟期的最大骨量，是个体在生命过程中所获得的最高骨量。正常人一般在骨骺闭合数年后可以
达到峰值骨量，在此之后数十年中骨强度处于平台期,这时骨骼的强度最大[1]。当成熟期过后骨量逐
渐丢失，骨密度逐渐下降。然而，个体在成长过程中所能获得的峰值骨量受多方面因素的影响。
Osteoporosis is a kind of world-wide metabolic disease. The diagnosis is dependent on
BMD measurements. Since 1993, WHO has definite the osteoporotic diagnosis standard which
was –2.5SD from the peak bone mass in the area. So, one area’s average PBM (peak bone mass)
should be decided before to get the diagnosis of osteoporosis. The peak bone mass is the
maximum bone mass in a normal person. It is that one can get the highest bone mass in his
whole life. In general, one person can get his peak bone mass after his epiphyseal arrest
a few years later. From then on, the bone strength will keep on stable for decades. In this
period, the bone strength is the maximum strength. After the maturation period, the bone
mass will lose gradually and BMD will fall down step by step. However, during one person
growing up, there are a lot of factors that can affect his PBM (peak bone mass).
1. 各人种峰值骨量的差异
1.1 高加索人种
高加索人种又称白色人种，主要分布于欧洲、西亚、北亚、北非等地。Lei 等人[2]归纳了意大利、
英国、北欧、北美等地区的高加索人群的脊柱及股骨颈 PBM 值的范围分别为 1.040-1.590 g/cm2 及
0.821-1.360 g/cm2。表 1 中收集了欧洲和美洲等国家的人群峰值骨量的数值，这些结果表明，白人的
腰椎的 PBM 值范围为 1.042～1.242 g/cm2，股骨颈的 PBM 值为 0.838~1.012 g/cm2,与 Lei 等人的数值
大致吻合。北美与欧洲的人群的峰值骨量大致相仿。
值得注意的是，墨西哥人群为印欧混血人种，其峰值骨量却略高于白色人种，有明显的统计学差异。
1. The difference of PBM among different races
1.1 Caucasian
Caucasian was mainly distributed in Europe, West Asia, North Asia, North Africa and North America.
Lei etc. (2) collected some PBM values of Caucasian’ spine and femoral neck who lived in Italian, Great
England, North Europe and North Africa. The range of PBM values were 1.040-1.590 g/cm2 and
0.821-1.360 g/cm2. Table 1 showed the PBM values of Europe and America. These results showed that the
Caucasian Lumbar PBM value varied from 1.042 to 1.242 g/cm2 and the Caucasian femoral neck PBM
value varied from 0.838 to 1.012 g/cm2. These values were roughly same to Lei’s values. That means,
Europe people and North America people have the similar PBM value. Here what should be paid attention to
is Mexican has higher PBM value than that of Caucasian. There has a significant difference.
16
1.2 尼格罗人种
尼格罗人种又称黑色人种，主要分布于非洲的大部分地区。关于非洲黑人的骨密度的流行病学
调查资料很少，Bachrach 等 [3] 在对 423 例年龄在 9～25 岁的黑人、亚洲人（居住地在美国）、西班
牙人、白人研究后发现，峰值骨量有明显种族差异。与同年龄段的非黑色人种相比，无论男性女性，
黑人在各个骨骼部位（全髋、脊柱、股骨颈）都有着更高的骨密度。Looker 等人[4]的研究发现美国白
人、黑人、墨西哥人群的股骨颈的骨密度均在 20～29 岁出现峰值，黑人的峰值骨量明显高于其他人
种
1.2 Negroes
Negroes lived in the most area of Africa. There was few epidemiological investigation of Negro’s BMD.
Bachrach etc. (3) invested 423 cases Negro, Asian, Spanish and Caucasian who were 9-25 years old. He
found that the PBM values had significant difference according to the different races. In the same ages phase,
Negroes women and men had higher BMD values at each body parts (total hip, spine and femoral neck) than
that of NON-Negroes people. Looker etc. (4) found that the femoral neck BMD of Caucasian, Negroes and
Mexican in America would reach the maximum values at 20-29 years old. The PBM values of Negroes were
higher than that of other races.
1.3 蒙古人种
蒙古人种又称黄色人种，主要分布在亚洲的大部分地区和美洲。新加坡的一项研究发现[5]，当
地男性居民腰椎和股骨颈的峰值骨量出现在 20～24 岁组，峰值骨量值分别为 1.006 g/cm2 和 0.97
g/cm2，比高加索人种的数据参考值分别低 10% 和 5%。西亚的沙特人群峰值骨量值[6]与西方国家近
似，明显高于东亚的中国和日本，且统计学差异明显。
1.3 Mongoloid
Mongoloid is the yellow race who lived in the most area of Asia and America. There is a research item
at Singapore. Local residents’ PBM values of lumbar and femoral neck appeared at 20-24 years old. The
PBM values were 1.006 g/cm2 and 0.97 g/cm2. These values were lower 10% and 5% than that of Caucasian.
The peoples in Saudi Arabia have the almost same values to the west countries. The values are higher than
that of people in China and Japan significantly.
2. 峰值骨量出现的年龄差异
峰值骨量的出现时间根据不同的研究方法和年龄分组可以有不同的结果。一般认为，在多数部
位，亚洲人种要比其他人种更早地达到平台期。Bachrach 等人[3]的研究表明，亚洲人群（包括男性及
女性）和黑人女性比其他种族的人群更早到达平台期。由于平台期出现较晚，黑色人种及白色人种可
以有更多的时间维持骨量的快速增长，从而在到达平台期前积累更多的骨量。
2. The age’s difference of PBM values appearance
Different research methods and different age specific got the different PBM value ages. In general, at
the most body parts, Asian showed the PBM values earlier than that of other races. Bachrach etc. (3)
research showed that Asian male and female persons and Negro female persons showed the PBM platform
earlier than that of other races. So, Caucasian and Negroes have more time to keep the rapid bone mass
growing and build up more bone mass before reaching at the platform.
研究发现[1]，许多因素可以影响个体的峰值骨量，这些影响因素有外因和内因。外因包括环境、
生活习惯（饮酒、吸烟等）
、运动、营养（包括钙、维生素 D、蛋白等）
、药物等；内因包括遗传因素、
种族、性别、激素水平（性激素、肾上腺皮质激素、胰岛素样生长因子等）、疾病等。越来越多的研
究发现，遗传因素对峰值骨量有显著的影响。Jones 等[7]研究了澳大利亚 291 对母子的骨密度，发现
17
在有骨量减少的母亲的子女中，所有部位的骨量显著低于对照人群；Ettinger[8]发现即使在骨架结构、
身体组分、饮食、体力活动、内分泌因素得到矫正后，种族之间峰值骨量的差异也不能排除。说明遗
传的基因差异是种族骨量差异不可忽视的原因。另外，汉族[9]和朝鲜人群[10]同属蒙古人种，研究结果
均未发现妇女峰值骨量与 ER-α基因 Pvu II 和 Xba I 多态性有相关，而白种人妇女峰值骨量与上述
基因的多态性有相关[11]。
Some research found (1) that many factors could affect one’s PBM value. These factors have
exopathic and internal causes. The exopathic factors include environment, living habits
(Drinking, smoking etc.), movement, nutrition ( calcium, Vit D, Protein etc.) and drugs.
The internal causes include genetic factor, race, gender, hormone level ( sex hormone, adrenal
cortex hormone, insulin-like growth factor etc.) and disease. More and more researches showed that genetic
factor affects PBM value greatly. Johns etc. (7) research showed 291 couples BMD values of Australia
mothers and sons. When mothers bone mass were osteopenia, their children’ bone mass would be lower than
that of comparison others. Ettinger[8] found that even corrected the factors of bone structures, body elements,
diet, movements and endocrine, they could not remove the differences in races. Moreover, Han People[9] in
China and Koreans both belongs to Mongoloid. Some researches found their women’ PBM values were
not related with polymorphism of ER-αgene Pvu Pvu Iiand Xba I. However, Caucasian women’ PBM
values were related with polymorphism of them. [11]
3．中国各民族之间的骨量差异
中国少数民族在地域分布、饮食习惯、生活条件等诸多环境因素与汉族人群存在某些差异，可能
对骨密度产生一定影响。
中国女性少数民族人群的峰值骨量的差异明显，几乎每两个种族的数值比较都有显著差异；而男
性人群几乎没有显著性差异。中国国内尚未见中国少数民族与汉族人群在某些影响骨代谢激素受体
（维生素 D 受体基因、雌激素受体基因、降钙素受体基因等）基因型和多态性存在差异性的报道，
推测民族之间骨量差异可能与少数民族地域分布、生活方式、饮食习惯有关。
3. The Difference of bone mass among each nation in China
China minority ethnic groups have some differences with Han People in geographical distributions,
eating habits and living conditions. These factors will affect BMD.
China minority women’ PBM values varied greatly. Nearly each nation has significant differences with
other nations. But China minority men’ PBM values almost have not significant differences. Till now in
China, there are not reports about the differences of bone metabolism hormone receptors’ genotype and
polymorphism between minority and Han People. These bone metabolism hormone receptors’ genes include
Vit D receptor gene, estrogen receptor gene, calcitonin receptor gene etc.. So it is estimated that the bone
mass differences are related to geographical distributions, eating habits and life style.
4. 小结：
峰值骨量直接影响骨密度正常标准参考值的设立，因此研究不同地区，不同种族的正常人群骨密
度值对准确诊断骨质疏松防止漏诊具有重要意义[12]。我们测量峰值骨量主要是三个部位，股骨颈、
前臂远端和腰椎 L-2-4，不用大转子、小转子、Ward’s 区、侧位腰椎测量的数据。由于测量条件、测
量仪器的不同，中国各民族具体峰值骨量的数值的缺失，还不能完善地比较中国各民族之间峰值骨量
的差异。但作为骨质疏松诊断和疗效评估的重要前提，建立不同民族、地区的骨密度正常参考值是一
项重要、必须的基础工作。
使用同一种品牌型号的骨密度仪测量的 PBM 数据才可以相互对比 [13.14.15]。
18
4. Conclusion
PBM values affect the establishment of normal BMD standard reference values directly. So in order to
prevent missed diagnosis, it is important to investigate the differences of normal peoples’ BMD values of
different races，countries and regions[12]. To get PBM values depends on three parts of body: Femoral neck,
Distal of forearm and Lumbar 2-4. It is not suggested to measure femoral trochanters, Ward’s region and
lateral lumbar. Because of different measurement conditions, instruments, and decades of China minority’s
PBM values, we can nor show the real differences of PBM values of each nations in China. However, as an
important precondition of osteoporotic diagnosis and curative effects evaluation, it is an important and
imperative basic work to set up normal BMD reference values of different nations and regions.
In order to compare to each other, it should be used the same type and brand BMD instrument to
measure PBM values. [13.14.15]
19
New Standard of Osteoporosis Care
Avery Basil Ince
The first bisphosphonate registered in the US for PMO that became available was
alendronate in 1995, and the more wide-spread use of the weekly formulations of these two
aminobisphosphonates has been since the year 2000 and 2002.
Alendronate therapy for osteoporosis has been studied in clinical trials involving more than
20,000 patients with up to lo years of continuous treatment. The standard treatment dose of
10 mg / day reduces biochemical markers of bone turnover to within the premenopausal
range within 3-6 months. This dose also produced an increase of approximately 8% in bone
mineral density ( BMD ) at the spine and 7 % at the hip within 3 years. Systematic reviews
and meta analyses have demonstrated that alendronate reduces the risk of all types of
fractures ( including hip fractures) by approximately 50 %.
Long term follow up of patients in Phase III studies of alendronate showed that spinal BMD
progressively increased throughout 10 years of continuous treatment. Biochemical markers
of bone turnover were reduced to premenopausal levels within months and remained stable
for up to 10 years , with no evidence of progressive decline. Weekly dosing with
alendronateat 70 mg has shown therapeutic equivalence to 10mg / day, as assessed by bone
turnover and BMD changes during l- 2 years of follow up. Alendronate has also
demonstrated a significant effect on bone density in clinical trials in men with low bone mass.
Recently, a once weekly tablet combining alendronate 70 mg and cholecalciferol ( vitamin
D3 ) 2800 IU has become available. Vitamin D plays a critical role in mineral homeostasis
and also appears to be important for neuromuscular function , which may prevent falls
( another risk factor for fractures ). Thus , Vitamin D is considered an essential component in
managing osteoporosis . However vitamin D is rare in foods and many osteoporotic
patients do not take the recommended amounts of vitamin D containing supplements. The
combination tablet ensures that patients receive vitamin D supplements together with the
proven effective dose of alendronate for reducing fracture risk.
20
Treatment of GIOP: Who? When? What?
Nancy E. Lane
Many randomized controlled trials (RCTs) have investigated drug treatment for women at high risk of
fracture, with a reduction in fracture risk as their end point. There has also been progress in identifying
women at the highest risk of fractures. The most important clinical determinant contributing to the clinical
decision of initiating and choosing drug therapy for fracture prevention is a woman’s fracture risk, which, in
RCTs, was determined by menopausal state, age, bone mineral density, fracture history, fall risks and
glucocorticoid use. Women with secondary osteoporosis were excluded, except in studies of glucocorticoid
use. A second determinant of drug therapy is the evidence for fracture prevention in terms of spectrum
(vertebral, nonvertebral and/or hip fractures), size and speed of effect. In the absence of head-to-head RCTs
with fracture risk as the end point, however, the efficacy of antifracture drugs cannot be directly compared.
Other determinants include the potential extraskeletal benefits and safety concerns of the drug, patient
preferences and reimbursement issues.
During the past two decades, many randomized controlled trials (RCTs) have investigated the use of drug
treatment to reduce fracture risk in women with postmenopausal osteoporosis, who are at high risk of
fractures. The results of these RCTs guide therapy for postmenopausal osteoporosis and, to a lesser degree of
evidence, for glucocorticoid-induced osteoporosis (GIOP).
Meanwhile, the process of identifying those women with the highest risk of fractures has progressed,
initially from the measurement of bone mineral density (BMD) alone to the development of algorithms that
are based on an integrated approach combining BMD, BMD-independent clinical risk factors (e.g. age,
personal and family fracture history, low body weight, smoking, excessive alcohol intake, rheumatoid
arthritis and glucocorticoid use) and BMD-independent, fall-related risk factors.
The aim of this Review is to identify patient-and drug-related determinants that contribute to the clinical
decision about choosing and initiating drug therapy for the prevention of fractures. Cost-effectiveness is an
issue of increasing interest, but is not the focus of this article. References to RCTs published before 2006 are
available elsewhere in general reviews on postmenopausal osteoporosis and GIOP.
There is strong evidence in support of the initiation of effective antifracture medications in women that have
either postmenopausal osteoporosis or GIOP and a high risk of fracture. The selection of the drugs can be
based on answers to questions about patient characteristics (menopausal state, age, BMD, fracture history,
risk of vertebral, nonvertebral and hip fracture, time of fracture [recent or old], GIOP, need for an
extraskeletal benefit, previous nonpersistence or noncompliance, and preferences of the patient) and drug
characteristics (mechanisms of action, antifracture effects, safety, and route and frequency of administration);
however, more work is needed to link drug characteristics with the underlying causes of fracture risk in
individual patients and to find new medications with both antifracture and extraskeletal effects so as to
increase patient acceptance and efficacy of therapy. The perspective of fracture prevention by sequential
21
treatment, which first restores the lost bone and then maintains the newly formed bone, combined with fall
prevention strategies, provides a window of opportunity for the prevention of further fractures.




There is strong evidence that supports the initiation of effective antifracture medications in women with
postmenopausal osteoporosis or glucocorticoid-induced osteoporosis who have a high risk of fracture
The selection of a specific drug treatment can be based on characteristics of the patient and of the drug,
and should include adequate calcium and vitamin D supplementation
More work is needed to match drug treatment with the underlying causes of fracture risk in an
individual patient
Sequential treatment with anabolic and antiresorptive agents, combined with fall prevention strategies,
provides a window of opportunity for the prevention of further fractures
22
Title
The Risk of Refracture Associated With the Compliance with Bisphosphonates Therapy in Taiwan.
Yung-Kuei Soong1, Keh-Sung Tsai2, Hong-Yuan Huang1, Yang Rong-Sen3, Jung-Fu Chen4, Paulo
Chih-Hsing Wu5, Ko-En Huang6
1.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
2.
Department of Laboratory Medicine, National Taiwan University Hospital
3.
Department of Orthopaedic Surgery, National Taiwan University Hospital
4.
Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Kaohsiung
5.
Department of Family Medicine, Obesity and Body Composition Research Center, National Cheng Kung University Hospital
6.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Kaohsiung and Chang Gung University, Taiwan.
Background
Osteoporosis is a common condition that affects about one in four women. It is associated with an increased
risk of fractures. Vertebral fractures are the most common and account for about 40% of all osteoporotic
fractures.4 Hip fractures are associated with 20% mortality 1 year after fracture. Unfortunately, most patients
3
with osteoporosis, including those presenting with fragility fractures, are not diagnosed, evaluated, or
treated.5
Bisphosphonates have been used for the treatment of postmenopausal osteoporosis since the early 1990s,
they are potent inhibitors of osteoclast activity that reduce bone turnover and re-establish the balance
between bone resorption and formation. Caro et al. showed that patients who were compliant with their
osteoporosis medication, including bisphosphonates, estrogens and calcitonin, experienced a 16% lower
fracture rate compared to non-compliant users.8 However, in line with Taiwan reimbursed guideline, the
patients experienced osteoporosis-related fractures were eligible for bisphosphonates treatment. The
objective of this study was to investigate the risk of refracture associated with the compliance with
bisphosphonates therapy in Taiwan.
Objectives
To elucidate the relation of the risk of refractures to compliance with bisphosphonates therapy in Taiwan
Methods:
The data used for this study were obtained from the National Health Insurance Research Database (NHIRD)
of Taiwan. The data included all records of hospitalizations, physician services, and medication prescriptions
dispensed between 1 January 2003 and 31 December 2006. The study cohort included all new users of
bisphosphonates．Compliance was calculated using the Medication Possession Ratio (MPR). MPR was
defined as the sum of days supply of osteoporosis medications dispensing during osteoporosis medication
therapy.
Results and conclusion:
The refracture rates of these osteoporosis patients is high and increasing with time. The refracture rate is
5.15%, 7.36% and 8.49% at the 1st , 2nd and 3rd year. And the refracture rate of patients with over 80%
compliance is lower than whom compliance below 80% (p<0.05). The study reported that near half of the
patients were noncompliant with therapy (MPR<80%) at as early as 3 month and only near 30% of the
patients are adherent at 1 year. And the result also shows that the risk of refracture is increasing for that
23
patients with MPR<80%, older patients or patients with comobility such as diabetes mellitus or dementia.
From the study, the compliance of Taiwan patients is poor. And the study demonstrated that the risk of
refracture is associated with the compliance with bisphosphonates therapy in Taiwan from the fact world.
The compliance issue for osteoporosis treatment should be paid much more attention.
24
The Diagnosis and Treatment Gap in Post-fracture Osteoporosis Care in Taiwan
Lin RM1, Hsu WW2, Jiang CC3, Yang RS3, Chen WJ4, Gau YL5, Soong YK4, Tsai KS3, Chen JF5, Wu CH1,
Huang HY4
1
National Cheng Kung University hospital, 2Chiayi Chang Gung Memorial Hospital, 3National Taiwan University Hospital,
4
Medical College, Chang Gung University, Taiwan; 5Kaohsiung Chang Gung Memorial Hospital
Objectives: In order to characterize the diagnosis and treatment of osteoporosis in post-menopausal women
before and after fragility hip fracture, an international fracture gap survey was initiated in 2008. Taiwan is 1 of
the 7 countries participating in this survey.
Methods: This retrospective observational survey, involving 5 medical centers across Taiwan, enrolled
female patients hospitalized because of low trauma, non-pathological fragility fractures of the hip between
July 2006 and June 2007. Patients were retrospectively identified from hospital discharge records of
participating medical centers. Study data were collected by telephone interview. Patients were asked about
their history of diagnosis with osteoporosis, their treatment history, life style management strategies for
future fracture prevention, and anti-osteoporosis drug use during the 6-months following recent
hospitalization. Demographic and co-morbidity data, as well as information regarding the patients'
knowledge and beliefs about osteoporosis treatment were also collected during the interview. Medical charts
were reviewed for supplemental data regarding medical treatment, BMD screening, and prescription history.
Results: Between July 2006 and June 2007, 210 female patients with a mean age of 72.8 ±11.3 years were
admitted to hospitals for post-fracture management and were enrolled in this study. 44 patients (20.9%)
reported having fallen during the 12 months prior to index fracture hospitalization, and 32 patients (15.2%)
had history of fragility fractures.
125 patients (60%) reported having been diagnosed with osteoporosis before or after the index fracture,
however, only 40.5% (n=85) of them continued to receive osteoporosis treatment after hospital discharge.
Among patients who continued to receive osteoporosis treatment, 45 patients (52.9%) were prescribed with
alendronate, 23 (27.1%) were prescribed raloxifene and 9 (10.6%) were prescribed calcitonin according to
medical records up to six months post-hospitalization. 35 patients (41.2%) were prescribed calcium
supplements and none reported the concomitant use of vitamin D supplements.
Conclusion: Based on this survey, the proportion of fracture patients who received a diagnosis of osteoporosis
is high (60%) in Taiwan, while the proportion of those being treated with a prescription therapy for
osteoporosis is low (40.5%) in this high risk group. Given that osteoporosis treatment is critical in preventing
repeat fracture, there is an urgent need to improve disease education for patients and to urge more aggressive
management of osteoporosis by physicians. The international survey is ongoing and additional data continue
to be gathered throughout the Asia Pacific region.
25
履歷表
基本資料
姓名
林子閎
性別
男
出生日期
69 年 4 月 24 日
出生地
台北縣
現在住址
104 台北市中山區中吉里吉林路 119
巷 4 號 5F
永久住址
114 台北市內湖區內湖路三段一百號
3F
手機
0928-646-038
教育程度
就讀學校
電話
(02)23123456-88319
主修科目
台灣大學
藥理學科研究所
成功大學
生物系
就讀期間
自 91 年 9 月至今
自 87 年 9 月至 91 年 6 月
研究領域
目前就讀於台灣大學藥理所博士班，指導老師是藥理所符文美教授以及骨科楊榮
森教授。主要領域是藥理學以及骨質疏鬆症相關的研究。專長於動物實驗，細胞
分化實驗以及分生實驗的研究。
研究主題有三個大方向：
1. PPARγ 相關訊息在骨質疏鬆症扮演的角色以及機轉。
2. Heme-oxygenase-1 調控成骨細胞與破骨細胞分化的機轉研究
3. 15d-PGJ2 對於骨關節炎調控機轉的研究。
26
Curriculum Vitae
黃國淵
Kuo-Yuan Huang, MD
台大骨科住院醫師
台大骨科總醫師
成大醫院骨科部專任主治醫師
成大醫學院臨床助理教授
27
Curriculum Vitae
Name: Chen, Jung-Fu 陳榮福
Sex: male
Birth Date: July. 22 1959
Citizenship: Taiwan, Republic of China
Office Address & Tel No:
123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung County, Taiwan, R.O.C.
Chinese Permanent Registration No.: E120***011
Language: Mandarin, Taiwanese and English
Education:M.D., Graduated June 1984, Taipei Medical College, Taipei, Taiwan, R.O.C.
Employment Record:
July 1990 - Now: Attending Physician, Division of Endocrinology and Metabolism, Chang
Gung Memorial Hospital
July 1998: Clinical lecturer of Chang Gung Memorial Hospital
May 1999: Chief of department of Health Examination of Chang Gung Memorial Hospital at
Kaohsiung
August 2007: Chief of department of General Medicine of Chang Gung Memorial Hospital at
Kaohsiung
Society:
Jan 1999: Certified Clinical Densitometrist (CCD) of International Society of Clinical
Densitometry (ISCD).
July 1999: Member of trustee board of Taiwan Osteoporosis Foundation & vice chairperson of
Publications Committee
Mar. 2004: Member of trustee board of Diabetes Association of the Republic of China
28
TAI,
Tel: (02) 2302-1133ext.5000
Fax: (02) 2302-0851
E-mail: tytai@tjci .org.tw
TONG-YUAN
PERSONAL
Birthplace: Pingtong, Taiwan
DOB: 1939/04/27
Marital Status: Married
INFORMATION
EDUCATION
CURRENT
POSITIONS
1. M.D., College of Medicine, National Taiwan University (NTUCM), 1965
2. Research Fellow, Endocrinology and Metabolism, University of Michigan,
Medical Center, 1973~1974
3. Doctor of Medical Science, Niigata University, Japan, 1980
Teaching & Clinical Research
1.Director General,Taipei Jen Chi Relief Institution,20052.Adjunct Professor, Internal Medical, NTUCM, 2003~
3.Physician Advisor, Department of Internal Medicine, National Taiwan
University Hospital (NTUH), 2005~
Professional Affiliation of Borad
4. Director, The Formosan Medical Association, 1995~
5. Supervisor, Diabetes Association of R.O.C., 2000~
6.Standing Supervisor, Taiwan Association of Gerontology and Geriatrics,2009~
7.Supervisor,Taiwan Association of senior citizen Institution,20098..President, Formosan Diabetes Care Foundation, 1997~
9..Adjunct investigator,NHRI,2005-
PREVIOUS
EXPERIENCES
Teaching & Clinical Research
1. Professor, Department of Internal Medicine, NTUCM, 1982-2003.
2. Deputy Superintendent, Taiwan Provincial Tao-Yuan General Hospital,1982~1984
3.. Deputy Executive Secretary, Preparatory Office, Medical Center of
National Chung Kung University, 1984~1988
4..
5..
6..
Superintendent, National Chung Kung University Hospital, 1988~1989
Deputy Superintendent, National Taiwan University Hospital, 1991~1992
Superintendent, National Taiwan University Hospital, 1992~1998
Professional Affiliation
7. President, Chinese Taipei Association of Family Medicine, 1990~1994
8.. Honorary President, Chinese Taipei Association of Family Medicine, 1994~1997
9.. President, Diabetes Association of R.O.C., 1995~2001
10.President,Taiwan Association of Gerontology and Geriatrics.
HONORS &
AWARDS
1.
3.
4.
5.
6.
7.
Dr. Taro Takemi Outstanding Paper Award, 1976/09.
2. Outstanding Paper Award, Endocrinology Society & Diabetes
Association of R.O.C., 1993/03.
Distinguished Research Award, Endocrinology Society & Diabetes
Association of R.O.C., 1995/03.
Gold-Jade Chair Professor, National Taiwan University, 1999/07.
Medal of Diplomacy, Ministry of Foreign Affairs, 1999/10.
Health Medal of the First Order, Department of Health, 2000/03.
Award for Outstanding Academic & Research Publication, Taiwanese
Association of Diabetes Educators, 2001/06.
29
8.
10.
11.
12.
13.
Excellent Article Award, Gerontology Society of Taiwan, 2001/06.
9. Award for Distinguished Contribution, Endocrinology Society &
Diabetes Association of R.O.C., 2002/09.
Chair Professor, Cross-Century Foundation, 2004~
Professor Emeritus, National Taiwan University, Feb. 2004~
Professional Lecturer, I-Shou University, Feb. 2004~
The award for the best oral presentation: Taiwan Association of
Gerontology and Geriatrics.Jun,2009
30
劉華昌
教授 (Prof. Hwa-Chang Liu)
學歷
1969
1977
國立台灣大學醫科畢業
日本東京大學臨床醫學研究所博士
主要經歷
1970~1974
1978~1981
1981
台大醫院住院及總住院醫師
台大醫學院外科講師
中沙醫療團霍夫醫院骨科主治醫師
1981~1987
1987~1988
1988.6~
1988.8~
1992.8~1999.7
1999.3~2002.7
1999.3~
台大醫學院外科副教授
台大醫學院外科教授(台大醫學院院務會議及台大校務會議通過)
台大醫學院外科教授(教育部通過年資起算年月)
台大醫學院骨科教授(骨科部從外科部獨立分出)
台大醫院門診部主任
台大醫學工程研究所首任所長
台大醫學工程研究所教授
現任職務
1.
2.
台大醫學院骨科退休榮譽教授
台安醫院骨科主治醫師
專書
1. 基本骨科學-劉華昌編譯 (1988)
2. Arthroplasty 2000
P.165~170 (2001) 劉華昌著
3. 骨科自我診斷-名醫window (2004) 劉華昌著
4. 中高齡身心健康寶鑑-生命的輪軸繼續轉動葉英堃、王子哲主編
合記書局
N. Matsui, Y. Taneda, Y.
Yoshida (Eds.)- Springer
華成圖書出版股份有限公司
健康文化事業股份有限公司出
P.93~P.104 (2005) – 劉華昌著
版
專長
骨外科－膝關節及髖關節的醫療手術
風濕免疫
醫學工程
辦公室住址:100北市中山南路一段七號台大醫院臨床大樓骨科11-20室
e-mail:hcliu@ntuh.gov.tw
31
簡
歷
姓名：黃國恩
地址：高雄縣鳥松鄉(833)大埤路 123 號
高雄長庚醫院 院長室
E-mail: khuang@adm.cgmh.org.tw
學歷：國立台灣大學醫學院醫科畢業 1959
日本國立千葉大學醫學部研究院 1970-1971
現任：長庚醫院名譽院長
長庚大學婦產科教授
長庚醫院更年期醫學暨生殖醫學研究中心主任
美國羅徹斯特大學婦產科客座教授
台灣更年期醫學會常務理事、名譽理事長
中華民國骨質疏鬆症醫學會常務理事、名譽理事長
美國婦產科學院院士
國際更年期醫學會執行理事 2008曾任：國立成功大學醫學院附設醫院院長 1992-1998
國立成功大學醫學院婦產科教授 1992-1998
國立成功大學醫學院代院長 1995-1996
台灣更年期醫學會創會理事長 1995-1999
中華民國骨質疏鬆症醫學會創會理事長 1997-1999
國立台灣大學醫學院婦產科講師、副教授 1972-1977
美國羅徹斯特大學婦產科講師、助理教授、副教授 1977-1987
美國羅徹斯特生殖醫學及不妊症研究所所長 1987-1992
參加學會：台灣醫學會
台灣婦產科醫學會
台灣更年期醫學會
中華民國骨質疏鬆症醫學會
台灣生殖醫學會
美國內分泌學會
美國生殖醫學學會
北美更年期醫學會
國際更年期醫學會
榮譽暨獎項：日本武田醫學獎學金 1970
美國國家衛生研究院研究獎 1978
美國國家衛生研究院荷爾蒙及腦下垂體研究獎 1980
美國羅徹斯特大學最佳教師獎 1982
美國紐約州立大學授與醫學博士 1988
美國科達公司研究顧問 1991-1992
美國羅徹斯特醫學會最佳論文獎 1991
台灣省立嘉義中學傑出校友 1994
台灣醫學會地方醫學會會長 1995
台灣醫學會春季學術研討會會長 1997
國際更年期醫學會雜誌編輯委員會 1997 至 2007
國際更年期醫學會諮議委員(台灣代表) 1997 至今
亞太骨鬆症基金會諮議委員(台灣代表) 1999 至今
亞太更年期聯會副理事長 2001 至 2004
亞太更年期聯會理事長 2004 至 2007
國際更年期醫學會執行理事 2008 至 2011
32
個 人 資 料 表
一、基本資料
身
分
證
號
中 文 姓 名
碼
填表日期：
A101575614
林 瑞 模
英 文 名 字
/
/
RUEY-MO LIN
(Last Name)(First Name)(Mekkle Name)
國
籍 中華民國
聯 絡 / 住 宅
性
別
■男
□女 出 生 日 期 1954年04月03日
□□□□□ 台南市勝利路138號
聯
絡
電
話
(公) 06-2766689
傳
真
號
碼
06-2766189
(宅) 06-2087281
E-MAIL
linrm@mail.ncku.edu.tw
二、主要學歷請填學士及以上之學歷或其他最高學歷均可，若仍在學者，請在學位欄填『肄業』
畢 / 肄 業 學 校 國
別 主 修 學 門 系 所
學
位
起
訖
年
國 立 台 灣 大 學 中
華
民
國 醫學系
學
士
1973 / 09 至1980 / 06
國 立 成 功 大 學 中
華
民
國 醫學工程研究所
碩
士
1988 / 09 至1990 / 06
月
三、現職及專長相關之經歷指與研究之專任職務，請依任職之時間先後順序由最近者往前追溯
服
務
機
關
服 務 部 門 / 系 所 職
稱
起訖年月
現職：國立成功大學
醫學院骨科學科
教授
1999/08~
國立成功大學醫學院附設醫院
門診部
主任
2007/08~
院長
2008/08~
主任
2003/08~2007/07
中華民國骨質疏鬆症學會
理事長
2005/09~2007/08
台灣脊椎外科醫學會
理事長
2002/05～2004/04
國立成功大學醫學院附設醫院斗
六分院
經歷：
國立成功大學附設醫院
骨科部
國立成功大學醫學院
復健學科
代理系主任
1997/08 ~2003/07
國立成功大學
醫學院骨科
副教授
1993/08~1999/07
33
國立成功大學附設醫院
骨科部
主治醫師
1987/08 ~
國立成功大學附設醫院
脊椎外科
脊椎外科主任
1998/06~
國立成功大學醫學院
物理治療學系
代理系主任
1997/08 ~ 1998/07
耶魯大學醫學院
骨科部生物力學研究室
研究員
1990/08至1991/07
國立台灣大學附設醫院
骨科部
主治醫師
1987/08至1988/07
四、 專長請自行填寫與研究方向有關之專長學門
1.脊椎骨科
2.一般骨科
3.醫學工程
34
4.
刘忠厚，研究员，男，1938 年 6 月生，汉族，籍贯吉林省。
通信地址：100102，北京市 9910 信箱
TEL: 8610-64706214
FAX: 8610-64743744
E-mail: liuzhonghou@china-osteofound.org
Website:www.china-osteofound.org
教育经历：
1965 年
1974-1975 年
1979 年
1987-1988 年
毕业于吉林医科大学（长春市）
在北京 301 医院学习临床病理学；
在北京医学院学习英语；
作为访问学者在日本金泽医科大学研究骨质疏松；
工作经历及职务：
1965-1984 年
在卫生部工业卫生实验所从事放射标准与防护的研究工作；
1984-1997 年
在中日友好医院临床研究所从事骨矿测量及骨质疏松诊断标准的研究工作；
1985-1990 年
主持我国第一个骨质疏松的“七•五”攻关课题；
1990-2011 年
1994 年
1995-2011 年
1995 年
1996-1998 年
1998 年
中国老年学学会骨质疏松委员会第一、二、三、四届主任委员；
中国老年学学会第二届、第三届、第四届副秘书长，理事；
<<中国骨质疏松杂志>>第一、二、三、四、五届编委会主编；
<<日本骨矿代谢杂志>>顾问；
国际骨病学会联合会科学家委员会执委
北京医科大学口腔医学院博士研究生副导师
1998 年
为 IOF 国家学会委员会的成员；
1999 年
在香港成立的亚太骨质疏松基金会中被选为常务理事、荣誉财务总监；
任第一至十三届全国骨质疏松年会组委会主席(1991 北京、1993 南宁、1994 西安、1996 洛阳、1997
黄山、1998 大连、2000 杭州、2002 九江、2003 成都、2004 张家界、2005 黄山、2007 北京、2008
珠海)；
任第一届至十届全国钙剂研究年会组委会主席（1996 山西太原、1997 黄山、1998 大连、2000 杭州、
2002 九江、2003 成都、2004 张家界、2005 黄山、2007 北京、2008 珠海）；
任第一至九届在中国召开的国际骨质疏松研讨会组委会执行主席(1992 北京、1995 北京、1999 西
安、2004 桂林、2005 西安、2006 昆明、2007 乌鲁木齐、2008 呼和浩特、2009 上海)；
2001-2009 年
第一、二、三、四、五、六、七届国际骨矿研究学术会议组委会执行主席（2001
北京、2004 桂林、2005 西安、2006 昆明、2007 乌鲁木齐、2008 呼和浩特、2009 上海）；
2005-2008 年
广州中医药大学客座教授
2006 年
内蒙古医学院名誉教授
2007 年
中国核动力研究设计院兼职博士生导师
2007 年
中国老年学学会骨质疏松诊疗与研究长春基地、密云基地、广东基地、新疆基地、
北京基地首席研究员
2007 年
西安交大医学部地病所兼职教授
著书及科技成果：
35
1965-1984 年
在卫生部工业卫生实验所工作期间，发表文章 40 余篇，著书 3 部，获部级成果 3
项；
1984-1997 年在中日友好医院临床研究所工作期间，发表文章 50 余篇、著书 4 部，获省部级、局
级成果 9 项；
1992 年
1995 年
1998 年
2006 年
工具书。
主编<<骨质疏松症>>(100 万字)；
获民政部科技进步一等奖，题目为“骨质疏松诊断与防治的研究”
主编<<骨质疏松学>>(120 万字)；
主编<<骨矿与临床>>(210 万字)，与<<骨质疏松学>>一起成为国内骨质疏松领域的
在刘忠厚教授领导下，中国老年学学会骨质疏松委员会和中国骨质疏松杂志社是中国在骨质疏松和骨
矿研究领域里起步早、组织活动多、与国外友好学术组织和杂志合作最活跃的学术团体，为推动中国
的骨质疏松和骨矿研究事业做出了卓越的贡献。
36
陳博光 教授 (Po-Quang Chen, MD)
Professor Emeritus, National Taiwan University
Past Professor and Chief, Section of Spinal Surgery
Department of Orthopedic Surgery,
National Taiwan University Hospital
College of Medicine, National Taiwan University
7, Chung-Shan South Road. Taipei 10002, Taiwan, Republic of China.
Tel: 02-23123456 ext. 65271 Fax: +8862 2322 5110
E-mail: pqchen@ntu.edu.tw
chen.poquang@gmail.com
Address:
1. Home; 12-B Floor, 5, section 1, Chinan Rd, Taipei 100, Taiwan
2. Office; 7, Chung-Shan S Road, Department of Orthopedic Surgery,
National Taiwan University Hospital (NTUH), Taipei, Taiwan ROC
and Min-Sheng General Hospital. 168, Gin-Kuo Rd, Taoyuan city, Taoyuan county,
Taiwan
Date of Birth: December 23, 1942
Citizen: Taiwan, Republic of China
Education:
1.
Hsin-Chu middle School,(1954-57)
2.
Hsin-Chu High School (1957-59)
3.
National Taiwan University, College of Medicine (1961-68)
4.
Internship (1967-1868) National Taiwan University Hospital
5.
Residency: (1968-1972)
First year at Taipei Veteran General Hospital, second year on to Chief residency at
National Taiwan University Hospital
6.
Orthopedic Fellowship (1982-1983)
Department of Orthopedic Surgery, Rush-Presbyterian St. Luke Medical Center, Chicago,
U.S.A. Studied with both Professor Jorge Galante and Professor Ronald L. DeWald.
Academic Degree:
1.
Bachelor of Medicine, College of Medicine, National Taiwan University 1968
2.
Research fellow: Rush-Presbyterian- St. Luke Medical Center. Chicago, USA, 1982-83
37
3.
Doctor of Medical Science. Tokyo Medical College, Tokyo, 1993.
Academic Position:
1.
Associate Professor in Orthopedic Surgery (1983-1991)
2.
Professor: 1991, Aug - 2008, Feb. (retired from NTU)
4.
Chief of Spinal Surgery, Department of Orthopedic surgery, NTUH: Aug.1995- Feb, 2008
5.
Director, Biomedical Department, NTUH 1997-2000
6.
台灣大學名譽教授 Emeritus professor, National Taiwan University. 2008
7.
成功大學榮譽教授 Honorable Professor, National Cheng Kung University, 2008 April
8.
Visiting Professor, 上海交通大學 2007
9.
Visiting Professor, 山東大學 2007
10.
Visiting Professor, 泰安醫學院 2008
38
CURRICULUM VITAE
BASIL AVERY INCE MD PhD
I.
PERSONAL
A. Home Address:
30 West Street, Unit 7F
New York, NY 10006
(646) 781-9739
B. Marital Status: Married with two children
II. EDUCATION
School Date
Fellowship Training –Endocrinology 2001 - 2004
Massachusetts General Hospital
Harvard Medical School
Boston, Massachusetts
Residency Training –Internal Medicine 1998 –2001
Massachusetts General Hospital
Harvard Medical School
Boston, Massachusetts
M.D., College of Medicine 1993 - 1997
University of Illinois
Urbana, Illinois
Ph.D. in Cell & Structural Biology 1989 - 1994
University of Illinois
Urbana, Illinois
B.A. in Biomedical Engineering 1983 - 1987
Brown University
Providence, Rhodes Island
III. MERCK EMPLOYMENT HISTORY
Title Date
Medical Director, MSD Taiwan 11/08 - present
AP Regional Director Medical Affairs, MS Franchise 11/08 Director 12/06 – 11/08
present
Clinical Research, Endocrine-Bone
–Clinical Monitor, Cathepsin K Phase III FractureTrial in Osteoporotic Women
- Clinical Monitor, Cathepsin K Phase III Imaging study in Women with Low Bone Density
–Clinical Monitor, Cathepsin K Phase IIb Trial in Postmenopausal Osteoporotic Women
–Unblinded Clinical Monitor, Integrin Inhibitor Phase I Trial in Metastatic Bone Disease Pts
–Chair, Integrin Inhibitor Working Group
–Chair, Cathepsin K Inhibitior Safety Sub-team
–Member, Cathepsin K Inhibitor PDT
–Member, Cathepsin K Inhibitor Outcomes Research Subteam
39
–MRL Lead Representative, CATK JPT
–Member, Endocrinology Licensing Committee
Associate Director 8/04 –11/06
Clinical Research, Endocrine/Bone (as above)
IV. NON-MERCK EMPLOYMENT HISTORY
Title Date
Clinical and Research Fellow in Endocrinology 7/01 - present
Massachusetts General Hospital
Harvard Medical School
Harvard University
Boston, Massachusetts
Resident in Medicine
Massachusetts General Hospital 7/98 - 6/01
Harvard Medical School
Harvard University
Boston, Massachusetts
Clinical and Research Fellow in Medicine
Massachusetts General Hospital
Harvard Medical School
Harvard University
Boston, Massachusetts
Research Fellow in Medicine 9/97 - 3/98
Harvard Medical School
3/98 - 6/98
Harvard University
Boston, Massachusetts
Research Assistant 8/91 - 7/97
Department of Cell & Structural Biology
University of Illinois
Urbana, Illinois
Graduate Research Fellow 6/90 - 7/91
Department of Cell & Structural Biology
University of Illinois
V.
Urbana, Illinois
Research Technician
2/88 - 6/89
Department of Physiology
Mt. Sinai Medical Center
New York, New York
ACADEMIC EXPERIENCE
Title
Clinical & Research Fellow in Endocrinology
Massachusetts General Hospital
2001 - present
40
Harvard Medical School
Harvard University
Boston, Massachusetts
41
史都渥．西瓦曼醫師
Stuart L. Silverman, MD, FACP, FACR
個人簡介：
史都渥．西瓦曼醫師出生於西元1947年9月4日，美國伊利諾州芝加哥人，現為臨床風濕病專科
醫師，並擔任多項學術單位之研究或教學職務，主要研究領域為骨質疏鬆症之治療與預防、婦女醫學、
退化性類風濕性關節炎、健康與生活品質、纖維肌痛等。曾任許多醫學雜誌，如Journal of Bone and
Mineral Research、Future Rheumatology、Current Rheumatology Reports、Therapeutic Advances
in Muskuloskeletal Disease等之編審委員。迄今已參與數百篇的研究論文及評論之發表，並經常受邀
巡迴各地進行專題演講。
學


歷：
約翰．霍普金斯大學醫學院(1973)
普林斯頓大學(1969)
現




職：
加州大學洛杉磯分校醫學院臨床醫學教授
骨質疏鬆症醫學研究中心主任 (該中心為加州一非營利性組織)
美國ASBMR (American Society for Bone and Mineral Resources) ONJ 研究小組成員(2006 –
迄今)
美國US ICUROS (International Costs and Utilities Related to Osteoporosis


Fractures Study)成員
Cedars Sinai醫學中心纖維肌痛復健計劃主持人
專業職務：
 美國內科醫學會理事
 美國風濕病醫學會理事
 美國過敏免疫醫學會理事
專業證號：California C39893
42
BIOGRAPHICAL SKETCH
Provide the following information for the key personnel in the order listed on Form Page 2.
Photocopy this page or follow this format for each person.
NAME
Serge L. Ferrari, MD
POSITION TITLE
Associate Professor of Medicine and Osteoporosis
Genetics
Born June 15, 1963
Div. of Bone Diseases
Dept. of Rehabilitation and Geriatrics
Geneva University Hospital and Faculty of Medicine,
1211 GE 14, Switzerland
Married, 1 child
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as
nursing, and include postdoctoral training.)
DEGREE
INSTITUTION AND LOCATION
(if applicable)
YEAR(s)
FIELD OF STUDY
College of Geneva, Switzerland
A.B.
1978 - 1982
Latin Literature
Faculty of Sciences, Geneva University, Switzerland
M.Sc.
1988
Mol. & Cell Biology
Faculty of Medicine, Geneva University, Switzerland
M.D.
1982 - 1989
Medicine
Faculty of Medicine, Geneva University, Switzerland
Doctorate
1991
Medicine
FMH (Board
1997
Internal Medicine
Swiss Medical Association
certification)
Swiss National Science Foundation
Professorship
2001
Medicine
Faculty of Medicine, Geneva University, Switzerland
Privat Docent
2004
Genetics of Osteoporosis
43
Nancy E. Lane, M.D.
-Associate Professor of Medicine
p: 415-206-4777
e: NLane@itsa.ucsf.edu
Division of Rheumatology
San Francisco General Hospital, UCSF
P.O. Box 0868
San Francisco, CA 94143
Dr. Lane received her M.S. (Biochemistry, 1976) from the University of California at Davis and M.D.
(1980) from the University of California at San Francisco. She did her Rheumatology Subspecialty
training at Stanford University Medical Center (1983-1985). In 1990, she joined the faculty of the
Division of Rheumatology at SFGH/UCSF. Her major academic activities include directing her
musculoskeletal research group that is both laboratory and clinical research based, and performing
clinical duties at San Francisco General Hospital.
Research Interests
Dr. Lane has focused her research efforts in two broad areas that include osteoarthritis and
osteoporosis, the most common degenerative diseases of the elderly.
Dr. Lane began her research in osteoarthritis many years ago when she assessed the risk of
weight-bearing exercise, specifically running, on the development of osteoarthritis of the knee in
middle-aged runners and controls. The initial finding had a high public health message in that
individuals with normal joints could run without increasing their risk of developing osteoarthritis.
However, important risk factors for the development of osteoarthritis in these runners included age,
weight and pace per mile. Fast runners, probably expose their joints to high impact loads that
accelerate the degenerative process. This work has lead to Dr. Lane studying and reporting on risk
factors for the development and progression of hip osteoarthritis. Some interesting findings of risk
factors that accelerate the development and worsening of hip OA include low levels of vitamin D, no
estrogen replacement, taking nitrate and statin medications, and a high bone mass. Dr. Lane's
research group is now exploring the genetic risk factors for the development and progression of hip
OA in elderly Caucasian women. In addition, Dr. Lane's research group has participated in an NIH
funded multicenter study to determine if the sugars glucosamine and chondroitin alter the
progression of knee OA. This study, with initial results expected by October of 2004 should help
patients decide if these sugars are effective in the treatment of pain in knee OA. Lastly, in
collaboration with investigators at Stanford University, Dr. Lane has developed a clinical study to
determine if a special shoe that alters the forces of an individual's gait can slow the progression of
knee OA. This research group is hopeful that by understanding the risk factors for the development
of lower-extremity joint OA, followed by either medical or mechanical alteration with a special shoe
we can begin to make a difference in this disease.
The second major area of research is in osteoporosis. Osteoporosis is a disease that results from
both low bone mass and changes in the bone architecture such that with very little force a bone
44
breaks. Osteoclasts, cells that breakdown bone, tend to be overly activated in most forms of adult
osteoporosis. However, one form on osteoporosis, secondary to glucocorticoids (potent
anti-inflammatory agents) results from both an increase in cells that breakdown bone (osteoclasts)
and a reduction in the cells that form bone (osteoblasts). Dr. Lane's laboratory investigates the
activation of osteoclast cells that breakdown bone, and her clinical studies are focused on
interventions to reverse glucocorticoid-induced osteoporosis (an unfortunate complication of
long-term glucocorticoid use in rheumatic disease patients). Initial work from Dr. Lane's research
group determined that PTH, a bone building agent, could reverse the bone loss induced by
glucocorticoid use in rheumatic diseased patients by increasing osteoblast activity and possibly
lifespan. Dr. Lane's group is now evaluating in the laboratory how glucocorticoids alter bone cell
lifespan and bone strength (by nanoidentation methods), and in the clinic studies are underway to
determine how to maintain the new bone formed by PTH in patients on glucocorticoids.
Recent Publications
Lane NE, Nevitt M, Williams E, Hochberg M. Progression of symptomatic and asymptomatic hip OA
in a community sample of elderly women. (in press Arthritis and Rheumatism 7/03)
Lane NE, Williams E, Yung-Yi Hung, Hochberg MC, Cummings SR, Nevitt MC. Association of nitrate
use with risk of new radiographic features of hip osteoarthritis in elderly white women. (in press to
Arthritis Care & Research, 4/15/02)Lane NE, Nevitt MC. Osteoarthritis, bone loss and fractures: How
do these conditions relate to eachother. Arthritis and Rheumatism, 46 (9): 1-4, 2002
Lane NE, Nevitt MC, Gore LR, Cummings SR. Serum levels of vitamin D and the incidence and
progression of hip osteoarthritis in elderly women. Arthritis and Rheumatism 42(5):854-860, 1999
Lane NE, Sanchez S, Modin G, Genant HK, Pierini E, Arnaud CD. Parathyroid hormone treatment can
reverse steroid osteoporosis: results of a randomized clinical trial. Journal of Clinical Investigation
102(8):1627-1633, 1998.
Bone mass continues to increase after parathyroid hormone treatment is stopped in osteoporotic
women on low dose corticosteroids and hormone replacement. Journal of Bone and Mineral Research
15(5):944-951,2000
Kinney JH, Haupt DL, Witkin D, Ladd AJC, Ryaby JT, Lane NE. Three-Dimensional Morphometry of
the L-6 Vertebrae in the Ovariectomized Rat Model of Osteoporosis: Biomechanical Implications. The
Journal of Bone and Mineral Research, 15(10):1981-1991, 2000
Rehman Q, Lang T, Modin G, Lane NE. Quantitative Computed Tomography (QCT), of the lumbar
spine, not dual energy x-ray absorptiometry (DXA) is an independent predictor prevalent vertebral
fractures in osteopenic postmenopausal women on chronic glucocorticoid and hormone replacement
therapy. Arthritis and Rheumatism 46(5):1292-1297, 2002
Lane, NE, Yao W, Kinney JH, Modin G, Baloosh M, Wronski T. Both hPTH (1-34) and bFGF increase
trabecular bone mass in osteopenic rats, however they have different effects on trabecular bone
architecture. Journal of Bone and Mineral Research, 18(12):2105-2115. 2003
Rehman Q, Lang T, Modin GW, Genant HK, Lane NE. Does parathyroid hormone (hPTH 1-34)
treatment increase vertebral size in postmenopausal women with glucocorticoid-induced
osteoporosis. Osteoporosis International;14(1):77-81, 2003
45
Curriculum Vitae
1. Basic Information
Name in
Chinese
吳至行
Name in WU CHIH-HSING (Paulo)
E n glish (Last Name) (First Name) (Middle Name)
Nationality
Taiwan, R.O.C.
S
Coresspondance Address
138 Sheng Li road, Department of Family Medicine, National Cheng Kung
University, College of Medicine, Tainan, 70428, Taiwan.
Official Address
138 Sheng Li road, Department of Family Medicine, National Cheng Kung
University, College of Medicine, Tainan, 70428, Taiwan.
Te l e p h o n e
(0) +886 6 2353535-5210
(H) +886 6 2364383
Hand Phone
+ 886 922 198 288
B.P. Call 800-8109(o)
Fascimile
(F) +886 6 2754243
E - M A I L paulo@mail.ncku.edu.tw
e
x
■M □F Date of Birth 30th DEC 1964
2. Academic Records
Name of Schools
Country
Major
Medical College, Chinese Medical
College, Taiwan
Taiwan,
R.O.C.
Medicine
Country
Taiwan,
R.O.C.
Taiwan,
Obesity Board Examination
R.O.C.
Taiwan,
Geriatrics Board Examination
R.O.C.
National Board Examination for
Taiwan,
Medical Doctors
R.O.C.
Medical College, Chinese Medical Taiwan,
College, Taiwan
R.O.C.
Major Examinations
Family Medicine Board
Examination
Dates
M. D.
Deg
From: September 1982
To: June 1988
Dec 1992
ree Dates
Result Deg
s
Passed
Family
Physician
Passed
Bariatics
Dec 2002
Passed
Gariatitian
ree
Dec 2002
Passed
General
July 1988
Practitioner
Passed
M. D.
June 1988
3. Jobs
Authority
Department
Position
Dates
Present:
National Cheng Kung University
Hospital
Family Medicine Dept.
Associate
Professor
Aug. 2002 till present
Previous:
National Cheng Kung University
Hospital
Family Medicine Dept. Lecturer
Aug. 1996 to July
2002
National Cheng Kung University
Hospital
Family Medicine Dept. Visiting Staff
Aug. 1992 till present
46
National Cheng Kung University
Hospital
National Cheng Kung University
Hospital
Family Medicine Dept. Chief Resident
Aug. 1991 to July
1992
Family Medicine Dept. Resident
Aug. 1988to July 1991
4. Specialty:
Osteoporosis
Obesity
Family and
Community Medicine
47
Geriatrics
CURRICULUM VITAE
Rev. January 2009
NAME:
Soong, Yung-Kuei
SEX:
Male
BIRTH DATE:
March 15, 1945
BIRTH PLACE: Kaohsiung, Taiwan
CITIZENSHIP:
Taiwanese
OFFICE ADDRESS AND PHONE NUMBER:
Dept. Obstetric & Gynecology
Chang Gung Memorial Hospital
5, FU-HSING St,
KWEISHAN 333, Taiwan, R. O. C.
EDUCATION:
1965-1970
Bachelor of Medicine, (equivalent to M.D. in the U.S.A.)
The College of Medicine,
The National Taiwan University, Taipei,
Taiwan, R.O.C.
1980-1982
Master of Philosophy in Endocrinology
University of London
POST-GRADUATE EDUCATION:
1970 - 1971 Intern, National Taiwan University Hospital,
Taipei, Taiwan, R.O.C.
1971 - 1972 Military Surgeon, China Air Forces.
1972 - 1976 Residency and Chief Residency,
Dept. of OBS/GYN, National Taiwan University Hospital.
Sept. 1977
Diagnostic Ultrasound (UCLA, U.S.A.)
1980 - 1982 Fellowship and Student of Institute of OBS/GYN
University of London.
April 1981
Reproductive Endocrinology (London)
May 1982
Infertility (London)
Sept. 1984
Ultrasound in Obstetrics (AIUM, U.S.A.)
48
Nov. 1984
Sept. 1985
In Vitro Fertilization (Australia)
Tenth Asian & Oceanic Congress of Obstetrics and Gynaecology
Srilanka)
Sept. 1985
XIth World Congress of Gynecology and Obstetrics
Rio de Janeiro, Brazil
Nov. 1989
Symposium on neuroendocrine regulation of reproduction
(Lapa California, S SC Yen)
Oct. 1990 Third International Symposium of Osteoporosis
Copenhagen, Denmark
49
(Colombo
一、基本資料：
身分證號碼 F 1 2 3 2 2 7 5 6 9
中文姓名
張尹凡
英文姓名
國籍
中華民國
聯絡電話
別 男
性
聯絡地址
Chang Yin-Fan
□女 出生日期
1972 年05 月28 日
臺南市 704 北區勝利路 138 號
(公)06-2353535 ext5212
傳真號碼
06-2754243
(宅 /手機)0953953870
E-mail
yinfan@mail.ncku.edu.tw
二、主要學歷
學校名稱
私立中國醫藥學院
三、現職及與專長相關之經歷
服務機構
國別
主修學門系所
中華民國
醫學系
服務部門／系所
學位
起訖年月(西元年/月)
醫學士 自 1991/09 至 1998/06
職稱
起訖年月(西元年/月)
現職：
國立成功大學
附設醫院/家庭醫學部 主治醫師
自 2003/10 迄今
經歷：
行政院衛生署嘉義醫院 家庭醫學科
主治醫師兼
代理主任
自 2002/08 至 2003/09
國立成功大學
附設醫院/家庭醫學部 總住院醫師 自 2000/08 至 2002/07
國立成功大學
附設醫院/家庭醫學部 住院醫師
四、專長
家庭醫學
骨質疏鬆症
肥胖醫學
50
自 1998/08 至 2000/07