Endogenous sex steroids, weight change and rates of hip bone loss in older men: the MrOS study
Endogenous sex steroids, weight change and rates of hip bone loss in older men: the MrOS study
复制标题
DOI：
10.1007/s00198-006-0088-z
复制
发表时间：
2006-09-01
影响因子：
4
通讯作者：
Orwoll, E.
中科院分区：
文献类型：
--
作者：
Ensrud, K. E.;Lewis, C. E.;Orwoll, E.
导读：内源性性类固醇水平降低或这些激素水平下降可能导致体重减轻的老年人骨质流失率增加。我们假设，在体重减轻的老年男性中，基线生物利用性类固醇水平较低或这些激素水平下降幅度较大的男性，臀部骨质流失率较高。方法：为了验证这一假设，在基线和平均1.8年后进行的第二次检查中，对1267名参加男性骨质疏松性骨折（MrOS）研究的老年男性进行了体重、髋部骨密度（BMD）（双能x线吸收仪）和内源性性类固醇配对血清样本进行了敏感免疫测定。结果：在基线性类固醇水平的每四分位数内，体重减轻的男性髋骨丢失率高于体重稳定或体重增加的男性[体重变化类别趋势测试的p值在生物利用雌二醇和睾酮的每四分位数内< 0.010，在性激素结合球蛋白（SHBG）的每四分位数内< 0.060]。在分析中，当用性类固醇的变化代替基线性类固醇时，结果相似。在体重减轻的男性中，随着基线生物有效雌二醇的降低（p值< 0.040）、基线SHBG的增加（p值< 0.030）和生物有效睾酮较基线的更大幅度下降（p值< 0.001），髋关节总骨密度下降的幅度逐步增加。结论：这些发现支持了一个假设，即老年男性体重减轻对髋骨丢失率的影响可能会因性类固醇不足而增加。
Introduction: Lower levels of endogenous sex steroids or declines in these hormones may contribute to the increased rates of bone loss observed in older adults experiencing weight loss. We hypothesized that among older men with weight loss, higher rates of bone loss at the hip would be observed in men with lower baseline bioavailable sex steroids or those with greater declines in these hormones. Methods: To test this hypothesis, body weight, hip bone mineral density (BMD) using dual energy x-ray absorptiometry and endogenous sex steroids in paired serum samples by sensitive immunoassays were measured at a baseline and at a second examination that was held an average of 1.8 years later in 1267 older men enrolled in the Osteoporotic Fractures in Men (MrOS) study.\ Results: Men experiencing weight loss had higher rates of hip bone loss than those with stable weight or weight gain within each quartile of baseline sex steroid level [p values for test of trend across weight change categories < 0.010 within each quartile of bioavailable estradiol and testosterone and < 0.060 within each quartile of sex hormone-binding globulin (SHBG)]. Results were similar when a change in sex steroids was substituted for baseline sex steroids in the analyses. Among men with weight loss, the rate of decline in total hip BMD showed a stepwise increase in magnitude with decreasing baseline bioavailable estradiol (p value for trend < 0.040), with increasing baseline SHBG (p value for trend < 0.030) and with greater decreases in bioavailable testosterone from baseline (p value for trend < 0.001). Conclusions: These findings support the hypothesis that the impact of weight loss in older men on rates of hip bone loss may be increased by the presence of a sex steroid insufficiency.