Adrenarche and bone modeling and remodeling at the proximal radius: Weak androgens make stronger cortical bone in healthy children
Adrenarche and bone modeling and remodeling at the proximal radius: Weak androgens make stronger cortical bone in healthy children
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DOI：
10.1359/jbmr.2003.18.8.1539
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发表时间：
2003-08-01
影响因子：
6.2
通讯作者：
Wudy, SA
中科院分区：
文献类型：
--
作者：
Remer, T;Boye, KR;Wudy, SA
肾上腺，肾上腺雄激素分泌的生理性增加，可能有助于更好的骨骼状态。对205例健康儿童青少年的桡骨近端骨密度和24小时尿类固醇激素进行了横断面分析。观察到对放射状骨干骨的正性肾上腺作用。显然，肾上腺是儿童骨矿状态的决定因素之一。简介：据报道，在生长过程中肾上腺雄激素分泌过快的几种情况下，骨量增加。然而，没有关于正常儿童的数据。因此，我们的目的是为了探讨生理范围内的肾上腺雄激素是否参与了生长过程中骨干骨的强化。方法：采用外周定量CT(PQCT)测量健康儿童和青少年骨干近端骨膜周长(PC)、皮质骨密度、皮质面积、骨矿含量、骨强度应变指数(SSI)和前臂横断肌面积。所有6-18岁的受试者在进行pQCT分析时采集了24小时尿样(男孩100人，女孩105人)，采用气相色谱-质谱仪对尿糖皮质激素(C21)和雄激素(C19)代谢物进行了定量。结果和结论：在耻骨前毛发出现之前，肌肉发达对骨膜造型(PC)有显著影响，而激素对PC影响不大。类似地，皮质醇总分泌量(C21)对其他骨骼变量没有影响。然而，在调整了肌肉强度或年龄后，在耻骨前儿童中，观察到C19对皮质密度(p<；0.01)、皮质面积(p<；0.001)、骨矿含量(p<；0.001)和SSI(p<；0.001)的积极影响--至少部分反映了皮质内重塑的减少。对于所有皮质变量(PC除外)，当替代C19和C21时，这种早期肾上腺对近端骨干骨强度的贡献得到进一步证实。将特定的脱氢表雄酮代谢物作为自变量纳入多元回归模型。在阴毛(耻骨)的发育过程中，肌肉发达和青春期似乎比肾上腺激素更能影响骨量。我们的研究表明，尤其是耻骨前肾上腺雄激素分泌的增加在健康儿童近端骨干骨强度的增加中起着独立的作用。
Adrenarche, the physiological increase in adrenal androgen secretion, may contribute to better bone status. Proximal radial bone and 24-h urinary steroid hormones were analyzed cross-sectionally in 205 healthy children and adolescents. Positive adrenarchal effects on radial diaphyseal bone were observed. Obviously, adrenarche is one determinant of bone mineral status in children.Introduction: Increased bone mass has been reported in several conditions with supraphysiological adrenal androgen secretion during growth. However, no data are available for normal children. Therefore, our aim was to examine whether adrenal androgens within their physiological ranges may be involved in the strengthening of diaphyseal bone during growth.Methods: Periosteal circumference (PC), cortical density, cortical area, bone mineral content, bone strength strain index (SSI), and forearm cross-sectional muscle area were determined with peripheral quantitative computed tomography (pQCT) at the proximal radial diaphysis in healthy children and adolescents. All subjects, aged 6-18 years, who collected a 24-h urine sample around the time of their pQCT analysis (100 boys, 105 girls), were included in the present study, and major urinary glucocorticoid (C21) and androgen (C19) metabolites were quantified using gas chromatography-mass spectrometry.Results and Conclusions: We found a significant influence of muscularity, but not of hormones, on periosteal modeling (PC) before the appearance of pubic hair (prepubarche). Similarly, no influence of total cortisol secretion (C21) was seen on the other bone variables. However, positive effects of C 19 on cortical density (p < 0.01), cortical area (p < 0.001), bone mineral content (p < 0.001), and SSI (p < 0.001)-reflecting, at least in part, reduction in intracortical remodeling-were observed in prepubarchal children after muscularity or age had been adjusted for. This early adrenarchal contribution to proximal radial diaphyseal bone strength was further confirmed for all cortical variables (except PC) when, instead of C 19 and C21. specific dehydroepiandrosterone metabolites were included as independent variables in the multiple regression model. During development of pubic hair (pubarche), muscularity and pubertal stage rather than adrenarchal hormones seemed to influence bone variables. Our study shows that especially the prepubarchal increase in adrenal androgen secretion plays an independent role in the accretion of proximal radial diaphyseal bone strength in healthy children.