Sex Steroid Hormones in Older Men: Longitudinal Associations with 4.5-Year Change in Hip Bone Mineral Density-The Osteoporotic Fractures in Men Study
Sex Steroid Hormones in Older Men: Longitudinal Associations with 4.5-Year Change in Hip Bone Mineral Density-The Osteoporotic Fractures in Men Study
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DOI：
10.1210/jc.2009-2635
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发表时间：
2010-09-01
影响因子：
5.8
通讯作者：
Orwoll, Eric S.
中科院分区：
文献类型：
--
作者：
Cauley, Jane A.;Ewing, Susan K.;Orwoll, Eric S.
内容：关于性激素和老年男性骨丢失之间的关系的信息有限。目的：我们的目的是确定性类固醇激素和骨矿物质密度（BMD）之间的纵向关系。设计和设置：我们对美国6个临床中心的5995名年龄至少65岁的男性进行了前瞻性研究。参与者：对1602名男性随机抽样进行性类固醇激素测定。排除后，1238名男性被纳入横断面分析，969名被纳入纵向分析。使用液相色谱-质谱法测量基线性激素。根据质量作用方程计算生物可利用（Bio）雌二醇（BioE 2）和睾酮（毕奥）。SHBG测量使用荧光substrate.Main结果measurements：BMD的全髋关节，测量在基线和一次或两次后超过4.6 year的follow-up，evaluated.Results：髋关节BMD的年百分比变化增加，降低BioE 2（P趋势= 0.03）。BioE 2最低（= 66.0 pmol/L）的男性BMD丢失速度快38%（P < 0.05）。毕奥和髋部BMD丢失之间没有关联。BioE 2最低、毕奥最低和SHBG最高的男性与BioE 2水平较高的男性相比，BMD损失率快3倍（P = 0.02）。观察到SHBG的阈值效应; SHBG为49-60 nM.Conclusions：低BioE 2和高SHBG水平与较低的BMD和更快的髋部BMD损失相关。低BioE 2、低毕奥和高SHBG的组合与BMD损失的显著更快速率相关。（临床内分泌代谢杂志95：4314-4323，2010）
Context: There is limited information on the association between sex hormones and bone loss in older men.Objective: Our objective was to determine the longitudinal association between sex steroid hormones and bone mineral density (BMD).Design and Setting: We conducted a prospective study of 5995 men aged at least 65 yr old at six U.S. clinical centers.Participants: Sex steroid hormones were measured in a random sample of 1602 men. After exclusions, 1238 men were included in cross-sectional analyses and 969 in longitudinal analyses. Baseline sex hormones were measured using liquid chromatography-mass spectrometry. Bioavailable (Bio) estradiol (BioE2) and testosterone (BioT) were calculated from mass action equations. SHBG was measured using chemiluminescent substrate.Main Outcome Measures: BMD of the total hip, measured at baseline and once or twice afterward over 4.6 yr of follow-up, was evaluated.Results: The annualized percent change in hip BMD increased with decreasing BioE2 (P trend = 0.03). Men with the lowest BioE2 (= 66.0 pmol/liter) experienced 38% faster rate of BMD loss (P < 0.05). There was no association between BioT and hip BMD loss. Men with lowest BioE2, lowest BioT, and highest SHBG experienced a 3-fold faster rate of BMD loss compared with men with higher levels (P = 0.02). A threshold effect of SHBG was observed; the rate of hip BMD loss increased in men with SHBG of 49-60 nM.Conclusions: Low BioE2 and high SHBG levels were associated with lower BMD and faster hip BMD loss. The combination of low BioE2, low BioT, and high SHBG was associated with significantly faster rates of BMD loss. (J Clin Endocrinol Metab 95: 4314-4323, 2010)