女性年龄相关的性激素与骨密度减少率的关系  

Relationship of age-related levels of serum sex hormones with bone mineral density decreasing rate in women

作　　者：王丹丹[1] 伍西羽[1] 廖二元[1] 谢辉[1] 张红[1] 罗湘杭[1] 盛志峰[1] 彭依群[1] 姚小红[1] 伍贤平[1] 

机构地区：[1]中南大学代谢内分泌研究所湘雅二医院内分泌科,长沙410011

出　　处：《中华医学杂志》2013年第30期2359-2363,共5页National Medical Journal of China

摘　　要：目的探讨女性雌激素、卯泡刺激素（FSH）和黄体生成素（LH）与骨密度减少率（BDR）的关系，以及它们对BDR的影响。方法2004年4月至2008年9月，中南大学湘雅二医院内分泌科测定694名20～80岁成年健康女性的血清雌激素、FSH和LH，采用双能X线吸收法骨密度仪测量腰椎、髋部和前臂远端的BDR行前瞻性研究。结果各骨骼部位BDR与FSH（r=-0．597～-0．479，均P〈0．01）和LH（r=-0．452～-0．283，均P〈0．01）呈显著负相关，雌激素与髋部和前臂远端BDR呈轻度正相关（r=0．077～0．122，均P〈0．05）。经年龄和体质指数调整后，FSH与BDR的偏相关系数、LH与腰椎和髋部及雌激素与前臂远端BDR的偏相关系数差异均有统计学意义。多元线性回归分析显示，FSH对BDR是负性决定因素，可解释BDR变异的20％～32％。雌激素对BDR是正性决定因素，可解释BDR变异的2．5％-5．4％。LH对腰椎BDR的影响为0．6％～0．8％。FSH对BDR的影响约是雌激素的3．8—12．8倍。结论女性BDR与循环中FSH变化有关，其主要决定因素可能是FSH增加，雌激素水平下降可能起次要作用。Objective To explore the relationship between the changes of estrogen, follicle- stimulating hormone （FSH） and luteinizing hormone （LH） levels and bone mineral density （BMD） decreasing rate （BDR） at different skeletal regions and examine the effects of hormones levels on BDR. Methods An age cross-sectional study was conducted in 694 healthy adult women excluded from diseases and drugs affecting bone metabolism. Their age range was 20 - 80 years. The serum concentrations of FSH, LH and estradiol （E2 ） were measured with radioimmunoassay. And BDR was measured with a DXA fan- beam bone densitometer at various skeletal regions including lumbar spine, left hip and left forearm. Results The serum levels of FSH （ r = - 0. 597 to - 0. 479, all P 〈 0. 01 ） and LH r = - 0. 452 to - 0. 283, all P 〈 0. 01 ） were significantly negatively correlated with BDR at various skeletal regions. Meanwhile, the serum level of E2 only had slightly positive correlation with hip and distal forearm （r = 0. 077 to 0. 122, all P 〈 0. 05 ）. After adjusting age and body mass index （ BMI）, serum FSH still had markedly negative correlation with BDR at various skeletal regions. However, the correlation coefficients became weak. Multiple line regression stepwise analysis revealed that serum FSH was a negative determinant factor of BDR at various skeletal regions ： 20% - 32% changes in BDR of various skeletal regions were determined by FSH, while LH only produced very small negative effects （0. 6% -0. 8% ） on BDR of lumbar spine. Serum E2 seemed to be a positive determinant factor of skeletal regions and 2. 5% -5.4% changes in BDR were determined by E2. The effects of serum FSH on BDR were approximately 3.8 - 12. 8 folds than those of serum E2. Conclusions BDR is correlated with increased FSH in women. The most critical factor for aging-related BDR is FSH in women while a decreased level of estrogen may be secondary.

关 键 词：性腺激素类 骨密度 女(雌)性 年龄因素 

分 类 号：R580[医药卫生—内分泌]