Endogenous sex hormones, sex hormone-binding globulin, and the risk of incident vertebral fractures in elderly men and women: The Rotterdam Study
Endogenous sex hormones, sex hormone-binding globulin, and the risk of incident vertebral fractures in elderly men and women: The Rotterdam Study
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DOI：
10.1210/jc.2002-022041
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发表时间：
2004-07-01
影响因子：
5.8
通讯作者：
Pols, HAP
中科院分区：
文献类型：
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作者：
Goderie-Plomp, HW;van der Klift, M;Pols, HAP
在一项年龄匹配的病例对照研究中，我们调查了内源性性类固醇激素与老年男性和女性（67.7 +/- 6.8岁）椎体骨折发生率之间的关系。来自鹿特丹研究的参与者需要基线和随访时的腰椎x线片（平均随访时间为6.5年）和基线时的冷冻血液样本。其中男性178人（5例），女性454人（115例）。测定血清雌二醇、SHBG、睾酮和胰岛素，以及脊柱和髋关节的骨密度。血清雌二醇含量最低（小于或等于15.5 pmol/l）的女性发生椎体骨折的风险增加2.1倍（95%可信区间，1.3-3.5），与任何部位测量的骨密度无关。最低两组的SHBG水平与椎体骨折风险降低50%相关。经年龄和体重调整后，同时存在低雌二醇和高SHBG的女性发生椎体骨折的风险高出7.8倍（95%可信区间，2.7-22.5;P < 0.001）。当使用非shbg结合的雌二醇代替总雌二醇时，这种增加的风险没有改变。对于男性来说，没有发现明显的联系，可能是由于权力不足。在男性和女性中，睾酮和椎体骨折之间没有明显的联系。
In an age-matched, case-control study, we investigated the association between endogenous sex steroid hormones and incident vertebral fractures in both elderly men and women (aged 67.7 +/- 6.8 yr). Drawn from the Rotterdam Study, participants required radiographs of the lumbar spine at both baseline and follow-up (average time of follow-up, 6.5 yr) and frozen blood samples, taken at baseline. One hundred and seventy-eight men ( 5 cases) and 454 women (115 cases) were thus selected. Serum estradiol, SHBG, testosterone, and insulin were measured, along with bone mineral density at both spine and hip. Women in the lowest tertile of serum estradiol (less than or equal to15.5 pmol/liter) had a 2.1 times increased risk (95% confidence interval, 1.3-3.5) of incident vertebral fractures, independently of bone mineral density measured at either site. SHBG levels in the lowest two tertiles were associated with a 50% reduction in incident vertebral fracture risk. Women with a combination of both low estradiol and high SHBG had a 7.8 times higher risk of an incident vertebral fracture ( 95% confidence interval, 2.7-22.5; P < 0.001), adjusted for age and weight. This increased risk did not change when non-SHBG bound estradiol was used instead of total estradiol. For men, no clear association was found, possibly due to insufficient power. No clear association between testosterone and incident vertebral fractures was observed in either men or women.