Hormone predictors of bone mineral density changes during the menopausal transition
Hormone predictors of bone mineral density changes during the menopausal transition
复制标题
DOI：
10.1210/jc.2005-1836
复制
发表时间：
2006-04-01
影响因子：
5.8
通讯作者：
Ettinger, B
中科院分区：
文献类型：
--
作者：
Sowers, MR;Jannausch, M;Ettinger, B
目的和背景：我们的目的是检查绝经过渡期间生殖激素浓度对骨矿物质密度 (BMD) 损失的可预测性。设计：我们进行了一项纵向（五次年度检查）、多地点 (n = 5) 队列研究，即全国妇女健康研究 (SWAN)。参与者：参与者包括基线时的 2311 名绝经前或早期绝经者 围绝经期非裔美国人、白种人、中国人和日本女性。主要结果指标：我们评估了年度双能 X 射线骨密度测量腰椎和全髋骨密度测量值，以及内源性雌二醇 (E2)、FSH、雄激素和自我报告的月经出血模式。结果：在 4 年期间，腰椎 自然绝经后的 BMD 损失为 5.6%，手术绝经后的 BMD 损失为 3.9%，围绝经后期的 BMD 损失为 3.2%。基线 FSH 浓度、随后的 FSH 水平及其相互作用预测了 4 年 BMD 损失。如果基线 FSH 低于 25 mIU/ml，则较高的后续 FSH (>70 mIU/ml) 预测 4 年脊柱 BMD 损失为 -0.05 g/cm(2)。如果基线 FSH 值超过 35-45 mIU/ml，则较低的后续 FSH（即 40-50 mIU/ml）预测 4 年脊柱 BMD 损失为 -0.05 g/cm(2)。图表显示随着时间的推移，结合基线 FSH 值和 FSH 水平预测的 BMD 损失量。 E2 浓度低于 35 pg/ml 与较低的 BMD 相关，但年度 E2 测量和变化并不能预测 BMD 损失。睾酮、游离雄激素指数和硫酸脱氢表雄酮浓度与 BMD 损失没有显着相关。结论：绝经过渡期间脊柱和髋部 BMD 损失与初始 FSH 水平和纵向 FSH 变化之间的相互作用密切相关，而不是与 E2 或雄激素水平或变化相关。
Objective and Context: Our objective was to examine predictability of reproductive hormone concentrations for bone mineral density (BMD) loss during the menopausal transition.Design: We conducted a longitudinal (five annual examinations), multiple-site (n = 5) cohort study, the Study of Women's Health Across the Nation (SWAN).Participants: Participants included, at baseline, 2311 premenopausal or early perimenopausal African-American, Caucasian, Chinese, and Japanese women.Main Outcome Measures: We assessed annual dual-energy x-ray absorptiometry lumbar spine and total hip BMD measures, with endogenous estradiol (E2), FSH, androgens, and self-reported menstrual bleeding patterns.Results: Over the 4-yr period, lumbar spine BMD loss was 5.6% in natural postmenopause, 3.9% in surgical postmenopause, or 3.2% in late perimenopause. Baseline FSH concentrations, subsequent FSH levels, and their interaction predicted 4-yr BMD loss. If baseline FSH was less than 25 mIU/ml, higher follow-up FSH (>70 mIU/ml) predicted a 4-yr spine BMD loss of -0.05 g/cm(2). If baseline FSH values were more than 35-45 mIU/ml, lower follow-up FSH (i.e. 40-50 mIU/ml) predicted a -0.05 g/cm(2) 4-yr spine BMD loss. Charts show amounts of predicted BMD losses with combinations of baseline FSH values and FSH levels over time. E2 concentrations less than 35 pg/ml were associated with lower BMD, but annual E2 measures and changes did not predict BMD loss. Testosterone, free androgen index, and dehydroepiandrosterone sulfate concentrations were not significantly associated with BMD loss.Conclusions: Spine and hip BMD losses during the menopause transition were most strongly related to the interaction between initial FSH levels and longitudinal FSH changes and not to E2 or androgen levels or changes.