The association of concurrent vitamin D and sex hormone deficiency with bone loss and fracture risk in older men: the osteoporotic fractures in men (MrOS) study.
The association of concurrent vitamin D and sex hormone deficiency with bone loss and fracture risk in older men: the osteoporotic fractures in men (MrOS) study.
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同时性维生素D和性激素缺乏症与老年男性骨质流失和骨折风险的关联：男性骨质疏松性骨折（MROS）研究。
DOI：
10.1002/jbmr.1697
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发表时间：
2012-11
影响因子：
6.2
通讯作者：
Orwoll, Eric S.
中科院分区：
文献类型：
--
作者：
Barrett-Connor, Elizabeth;Laughlin, Gail A.;Li, Hong;Nielson, Carrie M.;Wang, P. Ying;Dam, Tien T.;Cauley, Jane A.;Ensrud, Kristine E.;Stefanick, Marcia L.;Lau, Edith;Hoffman, Andrew R.;Orwoll, Eric S.
低25-羟基维生素D（VitD），低性激素（SH）和高性激素结合球蛋白（SHBG）水平在老年男性中很常见。我们检验了低VitD、低SH和高SHBG组合对老年男性骨密度（BMD）、骨丢失和骨折风险具有协同作用的假设。参与者是来自男性骨质疏松性骨折研究（MrOS）的1468名男性（平均年龄74岁）的随机子样本，加上278名在病例队列设计中研究的非脊柱骨折的MrOS男性。“异常”定义为维生素D（<20 ng/ml）、生物可利用睾酮（BioT，<163 ng/dl）和生物可利用雌二醇（BioE，<11 pg/ml）的最低四分位数;以及SHBG（>59 nM）的最高四分位数。总的来说，10%有孤立的VitD缺乏症; 40%只有低SH或高SHBG; 15%有SH/SHBG和VitD异常，35%没有异常。与所有正常水平的男性相比，SH/SHBG和VitD异常的男性往往年龄更大，更肥胖，并且报告较少的体力活动。孤立的维生素D缺乏症，和低毕奥或不低维生素D，是没有显着相关的骨骼措施。VitD缺乏与低BioE和/或高SHBG的组合与显著较低的基线BMD和较高的髋部骨丢失的年发生率比单独SH异常或无异常相关。与所有正常水平的男性相比，在4.6年的中位随访期间，低VitD组发生非脊柱骨折的多变量校正风险比（95%CI）为1.2（0.8-1.8）;低BioE和/或高SHBG组为1.3（0.9-1.9）;低BioE/高SHBG+低VitD组为1.6（1.1-2.5）。总之，低水平性类固醇对骨骼的不良影响在VitD水平低的老年男性中最为明显。在低BioE/高SHBG的存在下，低VitD的存在可能会导致骨骼健康状况不佳。
Low 25-hydroxyvitamin D (VitD), low sex hormones (SH), and high sex hormone binding globulin (SHBG) levels are common in older men. We tested the hypothesis that combinations of low VitD, low SH, and high SHBG would have a synergistic effect on bone mineral density (BMD), bone loss, and fracture risk in older men. Participants were a random subsample of 1468 men (mean age 74) from the Osteoporotic Fractures in Men Study (MrOS) plus 278 MrOS men with incident non-spine fractures studied in a case-cohort design. “Abnormal” was defined as lowest quartile for VitD (<20 ng/ml), bioavailable testosterone (BioT, <163 ng/dl), and bioavailable estradiol (BioE, <11 pg/ml); and highest quartile for SHBG (>59 nM). Overall, 10% had isolated VitD deficiency; 40% had only low SH or high SHBG; 15% had both SH/SHBG and VitD abnormality, and 35% had no abnormality. Compared to men with all normal levels, those with both SH/SHBG and VitD abnormality tended to be older, more obese, and to report less physical activity. Isolated VitD deficiency, and low BioT with or without low VitD, was not significantly related to skeletal measures. The combination of VitD deficiency with low BioE and/or high SHBG was associated with significantly lower baseline BMD and higher annualized rates of hip bone loss than SH abnormalities alone or no abnormality. Compared to men with all normal levels, the multivariate-adjusted hazard ratio (95% CI) for incident non-spine fracture during 4.6 yr median follow-up was 1.2 (0.8–1.8) for low VitD alone; 1.3 (0.9–1.9) for low BioE and/or high SHBG alone; and 1.6 (1.1–2.5) for low BioE/high SHBG plus low VitD. In summary, adverse skeletal effects of low sex steroid levels were most pronounced in older men with low VitD levels. The presence of low VitD in the presence of low BioE/high SHBG may contribute substantially to poor skeletal health.
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影响因子：
5.8
作者：
Barrett-Connor, E;Mueller, JE;Sartoris, DJ
通讯作者：
Sartoris, DJ
影响因子：
5.8
作者：
Goderie-Plomp, HW;van der Klift, M;Pols, HAP
通讯作者：
Pols, HAP
影响因子：
5.8
作者：
LeBlanc, Erin S.;Nielson, Carrie M.;Orwoll, Eric S.
通讯作者：
Orwoll, Eric S.
影响因子：
5.8
作者：
Cauley, Jane A.;Ewing, Susan K.;Orwoll, Eric S.
通讯作者：
Orwoll, Eric S.
影响因子：
4
作者：
Ensrud, K. E.;Lewis, C. E.;Orwoll, E.
通讯作者：
Orwoll, E.