Normal volumetric bone mineral density and bone turnover in young men with histories of constitutional delay of puberty
Normal volumetric bone mineral density and bone turnover in young men with histories of constitutional delay of puberty
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DOI：
10.1210/jc.83.12.4280
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发表时间：
1998-12-01
影响因子：
5.8
通讯作者：
Saggese, G
中科院分区：
文献类型：
--
作者：
Bertelloni, S;Baroncelli, GI;Saggese, G
有人认为，青春期的适当时机是必要的正常骨矿物质密度（BMD）的收购，这可能是无法实现的儿童体质性青春期延迟（CDP）。为了评估青春期延迟对BMD的影响，我用双能X线吸收法（DEXA）测量了一组CDP患者（n = 21;平均年龄，21.8 ± 1.7岁）和健康对照组（n = 12;平均年龄，19.3 ± 1.3岁）腰椎的面积BMD（aBMD）。7名患者（A组）的子集未接受治疗，而6名受试者（B组）接受了im睾酮贮库（100 mg/月，6-12个月）和8名男孩（C组）口服氧雄龙（1.25-2.5 mg/日，6-28个月），他们的青春期延迟。根据DEXA测量值计算体积BMD（vBMD）。CDP患者的aBMD降低（1.101 +/- 0.134 g/cm（2）），与对照组相比（1.222 ± 0.091 g/cm（2）; P < 0.009）;各组间无显著差异（a组，1.089 ± 0.133 g/cm（2）; B组，1.111 ± 0.118 g/cm（2）; c组，1.103 ± 0.160 g/cm（2））。CDP患者的vBMD无显著差异（0.327 +/- 0.021 g/cm（3））和对照组（0.337 +/- 0.017 g/cm（3）; P =不显著）;各组间无显著差异（a组，0.326 ± 0.016 g/cm（3）; B组，0.332 ± 0.022 g/cm（3）; c组，0.330 ± 0.021 g/cm（3））。CDP患者与对照组的骨矿物质代谢和骨标志物无显著差异，骨折发生率无明显增加，提示CDP患者vBMD正常，aBMD降低可能是生长方式改变者不加鉴别地使用DEXA测量的结果，而骨折发生率无明显增加。在青春期给予雄激素不能改善有CDP病史的年轻男性的BMD。
It has been suggested that an appropriate timing of puberty is necessary for normal bone mineral density (BMD) acquisition, which may not be achievable in children with constitutional delay of puberty (CDP). To assess the effect of pubertal delay on BMD, me measured areal BMD (aBMD) at lumbar spine, by dual-energy x-ray absorptiometry (DEXA), in a group of patients with CDP (n = 21; mean age, 21.8 +/- 1.7 yr) at final height and in healthy controls (n = 12; mean age, 19.3 +/- 1.3 yr). A subset of seven patients (group a) were untreated, whereas six subjects (group b) had received im testosterone depot (100 mg/month, for 6-12 months) and 8 boys (group c) oral oxandrolone (1.25-2.5 mg/daily, for 6-28 months) for their pubertal delay. Volumetric BMD (vBMD) was calculated from DEXA measurements. aBMD was reduced in patients with CDP (1.101 +/- 0.134 g/cm(2)), in comparison with controls (1.222 +/- 0.091 g/cm(2); P < 0.009); no significant differences were found among the groups (group a, 1.089 +/- 0.133 g/cm(2); group b, 1.111 +/- 0.118 g/cm(2); group c, 1.103 +/- 0.160 g/cm(2)). vBMD was not significantly different in patients with CDP (0.327 +/- 0.021 g/cm(3)) and in controls (0.337 +/- 0.017 g/cm(3); P = not significant); no significant differences were found among the groups (group a, 0.326 +/- 0.016 g/cm(3); group b, 0.332 +/- 0.022 g/cm(3); group c, 0.330 +/- 0.021 g/cm(3)). No differences were found in mineral metabolism and in bone markers between patients and controls; patients did not report an increased fracture rate, compared with controls.Our data indicate that: 1) men with CDP have normal vBMD; 2) the reduced aBMD may he the result of uncritical use of DEXA measurements in subjects with altered growth pattern; and 3) androgen administration during pubertal years did not improve BMD in young men with a history of CDP.