Effects of age and estrogen status on serum parathyroid hormone levels and biochemical markers of bone turnover in women: A population-based study
Effects of age and estrogen status on serum parathyroid hormone levels and biochemical markers of bone turnover in women: A population-based study
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DOI：
10.1210/jc.82.5.1522
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发表时间：
1997-05-01
影响因子：
5.8
通讯作者：
Riggs, BL
中科院分区：
文献类型：
--
作者：
Khosla, S;Atkinson, EJ;Riggs, BL
虽然雌激素缺乏是导致绝经后早期妇女骨转换增加的原因，但年龄相关因素，如血清PTH水平的进行性增加，被认为是导致老年妇女骨转换增加的原因。雌激素缺乏是否继续直接或间接地在老年妇女骨转换增加的发病机制中发挥作用仍不清楚。因此，我们测量了351名妇女的血清甲状旁腺素、激素转换标志物和血清性类固醇水平年龄范围21-94岁，其中包括47名绝经后妇女，仅接受长期雌激素替代治疗，当绝经前妇女和雌激素缺乏的绝经后妇女一起分析时，血清PTH作为年龄的函数增加（r = 0.35; P < 0.001）。与此相反，这种与年龄相关的血清PTH升高在接受长期雌激素治疗的绝经后妇女中被消除，这也导致了绝经后早期（小于或等于20岁）和晚期（>20岁）妇女中骨形成和骨吸收标志物的类似抑制。通过多变量分析，血清25-羟基维生素D水平高度预测血清PTH水平，无论绝经状态，而血清雌酮水平预测绝经后妇女骨吸收的标志物。我们的结论是，雌激素缺乏可能是负责不仅在绝经后早期妇女的骨转换增加，但也间接为继发性甲状旁腺功能亢进和骨转换增加发现在绝经后晚期妇女。残余血清雌激素水平是绝经后妇女骨吸收的重要决定因素。
Although estrogen deficiency is responsible far the increase in bone turnover in early postmenopausal women, age-related factors, such as the progressive increase in serum PTH levels, are believed to be responsible for the increase in bone turnover in elderly women. Whether estrogen deficiency continues to play a role, either directly or indirectly, in the pathogenesis of the increased bone turnover in elderly women remains unclear. Thus, we measured serum PTH, markers of bane turnover, and serum sex steroid levels in a population-based sample of 351 women (age range, 21-94 yr), which included 47 postmenopausal women who mere receiving long term estrogen replacement therapy.Serum PTH increased as a function of age when the premenopausal women and the estrogen-deficient postmenopausal women were analyzed together (r = 0.35; P < 0.001). By contrast, this age-related increase in serum PTH was eliminated in the postmenopausal women receiving long term estrogen therapy, which also resulted in a similar suppression of markers of bone formation and resorption in bath the early (less than or equal to 20 yr) and late (>20 yr) postmenopausal women. By multivariate analysis, serum 25-hydroxyvitamin D levels were highly predictive of serum PTH levels regardless of menopausal status, whereas serum estrone levels were predictive of markers of bone resorption in the postmenopausal women. We conclude that estrogen deficiency may be responsible not only for the increase in bone turnover in early postmenopausal women, but also indirectly for the secondary hyperparathyroidism and increase in bone turnover found in late postmenopausal women. Residual serum estrogen levels are important determinants of bone resorption in postmenopausal women.