老年男性骨代谢相关性激素与年龄和骨密度的相关性  

Relationships of bone metabolism-correlating sex hormones with age and bone mineral density in men

作　　者：王田琪[1] 刘幼硕[1] 黄武[1] 龙利民[1] 王艳娇[1] 王翼[1] 廖二元[2] 

机构地区：[1]中南大学湘雅二医院老年病科,长沙市410011 [2]中南大学湘雅二医院代谢内分泌研究所,长沙市410011

出　　处：《中华老年医学杂志》2007年第5期341-344,共4页Chinese Journal of Geriatrics

基　　金：中央保健委员会专项科研基金（2002湘B026）

摘　　要：目的探讨老年男性的性激素水平,包括血清睾酮（TTT）、雌二醇（E2）、脱氢表雄酮硫酸酯（DHEAS）随年龄的变化及与多部位骨密度（BMD）之间的关系。方法采用化学发光法测定108例55～92岁男性血清TTT、E2,ELISA法测定血清DHEAS、DEXA测定腰椎正位、股骨颈、大转子、大转子内侧、髋部和Ward＇s三角（Ward＇s）的BMD。根据年龄和BMD诊断标准技血清E2水平的四分位间距分组,年龄分组按每10岁年龄段分为5组,按BMI分为正常组、超重组和肥胖组3组,按T值＞-1．0 s、-2．5 s～-1．0s及≤-2．5 s分为正常骨量组、低骨量组及骨质疏松组,比较各组性激素的差异和BMD的关系。结果（1）各年龄组血清DHEAS水平随增龄而降低（P＜0．05）,与年龄呈负相关（r=-0．596,P＜0．01）,血清E2!、TTT水平与增龄无相关性。（2）正常骨量组、低骨量组、骨质疏松组血清E_1水平逐渐降低（P＜0．05）;股骨上端和腰椎BMD与E2呈正相关（r分别为0．247～0．366,P＜0．05）,与血清TTT和DHEAS水平无相关性,经校正年龄。体质量和BMI后,偏相关分析仍示与血清E1水平相关（r=0．256～0．322,P＜20．05）。各部位的BMD在E2的第1和第2分位间距差异有统计学意义（P＜0．05）,第3和第4分位间距差异无统计学意义。结论（1）老年男性血清DHEAS水平与年龄呈负相关,随增龄而降低;（2）血清E2水平是影响老年男性骨量的一个独立危险因素,动态监测可用于预测老年男性的骨量丢失。Objective To investigate the relationships of serum estradiol（E~ ）, testosterone （TTT）, dehydroepiandrosterone sulfate （DHEAS） levels with aging and bone mineral density（BMD） of multiple skeletal sites in elderly men. Methods One hundred and eight healthy elderly men aged 50-92 years were enrolled in the study. The BMD of the anteroposterior spine（AP） , upper of hip were measured by dual energy X-ray absorptiometry （DEXA）. Serum TTT, E2 , DHEAS levels were detected. All the cases were divided into 5 groups at every 10 years, and into 3 groups according to BMI （normal, overweight, obesity）, and 3 groups according tot value （≤-2.5 s, -2.5～-1.0 s, 〉-1.0 s）.The differences of sex steroids among different groups were compared, and their relationship with BMD were analyzed. Results （1）Serum DHEAS level had significant differences among age groups and was negatively correlated with aging（r =-0.596, P〈0.01）, but serum TTT, E2 levels were not correlated with aging. （2） Serum E2 levels differed significantly among different BMD groups （P〈0.05）, but TTT, DHEAS had no significant difference among those groups. Linear regression analysis showed that serum E： level was positively correlated with BMD at multiple sites （r =0.247-0.366,all P〈0.05）. After adjusted by age, weight and BMI, partial regression analysis showed that E2 was still correlated with BMD at multiple sites （r=0. 256-0. 322, all P〈0.05）. Significant differences of BMD were found in the lower two quartiles levels of serum E2 level （P〈0.05）, but not in the higher two quartiles. Conclusions （1）Serum DHEAS level is negatively correlated with aging and decreased in the elderly. （2） The decreased serum E2 level is a risk factor for BMD in elderly healthy man. Dynamic monitoring of serum E2 level can predict the BMD decrease in elderly men.

关 键 词：骨质疏松 骨密度 性腺甾类激素 硫酸脱氢表雄酮 

分 类 号：R686[医药卫生—骨科学]