围绝经期妇女性激素水平与骨质疏松症的相关性研究  

Correlation between sex hormone levels and osteoporosis in perimenopausal women

作　　者：赵春锋[1] 杨焕民[1] ZHAO Chunfeng;YANG Huanmin(Department of Gynecology,Jinan Hospital,Jinan 250014,Shandong,China)

机构地区：[1]济南医院妇科,济南250014

出　　处：《中国性科学》2020年第11期88-91,共4页Chinese Journal of Human Sexuality

摘　　要：目的分析围绝经期妇女性激素水平与骨质疏松症的相关性。方法选取2017年1月至2019年7月济南医院诊治的286例围绝经期妇女作为研究对象。根据是否伴发骨质疏松症分为病例组(n=82)和对照组(n=204),比较两组患者血清性激素[促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)]水平、骨代谢指标[I型胶原羧基末端肽(CTX)、Ⅰ型前胶原N端前肽(PINP)、N端中段骨钙素(NMID-OT)]水平及骨密度(BMD),分析性激素与骨质疏松症各指标的相关性,以受试者操作特征(ROC)曲线下面积(AUC)量化性激素预测骨质疏松症的效能。结果病例组患者血清E2水平明显低于对照组,FSH水平明显高于对照组,差异均具有统计学意义(P<0.05);病例组患者血清CTX、PINP、N-MID-OT水平均明显高于对照组,差异均具有统计学意义(均P<0.05);病例组患者腰椎、股骨颈及髋部BMD均明显低于对照组,差异均具有统计学意义(均P<0.05)。围绝经期妇女血清E2水平与CTX、PINP、N-MID-OT水平均呈负相关,与腰椎、股骨颈及髋部BMD均呈正相关,FSH水平与CTX、PINP、N-MID-OT水平均呈正相关,与腰椎、股骨颈及髋部BMD均呈负相关,差异均具有统计学意义(均P<0.05)。经ROC曲线分析,围绝经期妇女血清E2联合FSH预测骨质疏松症的AUC为0.915,明显大于单一指标E2的0.695和FSH的0.675,差异均具有统计学意义(均P<0.05)。结论围绝经期妇女血清E2、FSH水平与骨质疏松症风险密切相关,低水平E2和高水平FSH均可能是导致骨代谢异常、减小BMD的主要危险因素,两者联合预测骨质疏松症的效能较好,值得临床研究应用。Objective To analyze the relationship between sex hormone levels and osteoporosis in perimenopausal women.Methods A total of 286 perimenopausal women,who were treated in Jinan Hospital from January 2017 to July 2019,were selected as the research subjects.According to whether they were associated with osteoporosis,they were divided into the case group(n=82)and the control group(n=204),to compare the levels of serum sex hormones[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)],bone metabolism indicators[type I collagen carboxy-terminal peptide(CTX),procollagen type I N-terminal propeptid(PINP),N-MID osteocalcin(N-MID-OT)]levels and bone mineral density(BMD),analyze the correlation between sex hormones and various indicators of osteoporosis,quantifies the efficacy of sex hormones in predicting osteoporosis on the basis of the area under the ROC curve(AUC).Results Serum E2 level and FSH level in the case group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The serum levels of CTX,PINP and N-MID-OT in the case group were significantly higher than those in the control group,and the differences were statistically significant(all P<0.05).The BMD of lumbar spine,femoral neck and hip in the case group was significantly lower than that in the control group,with statistically significant differences(all P<0.05).Serum E2 levels of perimenopausal women were negatively correlated with CTX,PINP,and N-MID-OT levels,and positively correlated with BMD of lumbar spine,femoral neck,and hip;FSH levels were positively correlated with CTX,PINP,and N-MID-OT levels,and negatively correlated with BMD of lumbar spine,femoral neck,and hip,with statistically significant differences(all P<0.05).According to ROC curve analysis,the AUC of serum E2 combined with FSH in perimenopausal women in predicting osteoporosis was 0.915,which was significantly higher than that of E2(0.695)and FSH(0.675)respectively,with statistically significant differences(all P<0.05).Conc

关 键 词：围绝经期 骨质疏松症 促卵泡激素 雌二醇 骨密度 

分 类 号：R711[医药卫生—妇产科学]