血清睾酮水平与老年男性骨质疏松性髋部骨折的相关性  

Correlation between serum testosterone and fragile hip fracture in elderly men

作　　者：黄佳涌 郑博 胡良聪 刘晓银 屈波 张秀莉 蒋涛[1] HUANG Jia-yong;ZHENG Bo;HU Liang-cong;LIU Xiao-yin;QU Bo;ZHANG Xiu-li;JIANG Tao(Department of Orthopaedics,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Department of Orthopaedics,Tongji Hospital,Huazhong University of Science and Technology,Wuhan 430000,China;Department of Neurosurgery,Special Medical Center,Chinese People's Armed Police Force,Tianjin Medical University,Tianjin 300000,China)

机构地区：[1]成都医学院第一附属医院骨科,成都610500 [2]华中科技大学附属同济医院骨科,武汉430000 [3]天津医科大学附属中国人民武装警察部队特色医学中心神经外科,天津300000

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2019年第4期362-368,共7页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：四川省教育厅自然科学基金(15AZ0265)

摘　　要：目的 探究血清睾酮、雌二醇、碱性磷酸酶及骨密度与老年男性骨质疏松性髋部骨折的相关性。方法 选取2015年9月1日至2018年11月30日4家三甲医院65~85岁男性髋部脆性骨折住院患者220例为试验组,选取同时期65~85岁无脆性骨折男性300例为对照组。检测两组受试者空腹血清睾酮、雌二醇、碱性磷酸酶水平,并进行腰椎、股骨颈、股骨大粗隆骨密度测定。结果 试验组股骨大粗隆、股骨颈、腰椎骨密度低于对照组,差异有统计学意义[股骨大粗隆:(0.834±1.872)g/cm^2 vs.(0.892±0.931)g/cm^2, P <0.01;股骨颈:(0.677±2.014)g/cm^2 vs.(0.728±3.120)g/cm^2, P <0.01;腰椎:(0.530±0.034)g/cm^2 vs.(0.634±1.592)g/cm^2, P <0.01 ]。试验组血清睾酮水平低于对照组,差异有统计学意义[7.1(4.8, 9.1)nmol/L vs. 12.3(7.9, 16.7)nmol/L , P <0.05];两组血清碱性磷酸酶、雌二醇水平差异无统计学意义( P >0.05)。Logistic回归分析校正三处骨密度值后发现,睾酮是脆性髋部骨折的危险因素( OR =2.140,95% CI :1.387~3.302, P =0.001)。结论 血清睾酮水平降低可能是老年男性髋部骨折的危险因素之一,睾酮水平检测对老年男性骨质疏松性髋部骨折具有预测作用。Objective To study the correlation between serum testosterone, estradiol, alkaline phosphatase and bone mineral density(BMD) and osteoporotic hip fractures in elderly men. Methods The inpatients with fragile fractures of the hips aged 65-85 years in the four Third Class A hospitals from September 1, 2015 to November 30, 2018 were selected as experimental group (220 cases) and men with 65-85 years old non-fragile fractures were selected as the control group (300 cases). Fasting serum testosterone, estradiol, alkaline phosphatase, and BMD at spine, femoral neck, and femur trochanter were measured and compared. Results The BMD of femoral trochanter, femoral neck and lumbar vertebrae in the experimental group were lower than the control group[femoral large trochanter:(0.834±1.872)g/cm^2 vs.(0.892±0.931)g/cm^2, P < 0.01;femoral neck:(0.677±2.014)g/cm^2 vs.(0.728±3.120)g/cm^2, P <0.01;lumbar vertebrae:(0.530±0.034)g/cm 2 vs.(0.634±1.592)g/cm^2, P <0.05]. The experimental group s serum testosterone level was lower than the control group[ 7.1(4.8, 9.1)nmol/L vs. 12.3(7.9,16.7)nmol/L, P <0.05). Serum alkaline phosphatase and serum estradiol in the experimental group were similar to control group( P >0.05). Logistic regression analysis was used to calibrate the three bone mineral density values, and testosterone was a risk factor for fragile hip fracture ( OR =2.140, 95% CI :1.387-3.302, P =0.001). Conclusion Low serum testosterone may be one of the risk factors for hip fracture in elderly men aged 65-85 years. Detection of serum testosterone maybe has a predictive effect on osteoporotic hip fracture in elderly men.

关 键 词：骨质疏松 脆性骨折 睾酮 老年人 男性 

分 类 号：R681[医药卫生—骨科学] R683[医药卫生—外科学]