Hypergonadotropic amenorrhea and bone density: new approach to an old problem
Hypergonadotropic amenorrhea and bone density: new approach to an old problem
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DOI：
10.1007/s00774-004-0495-1
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发表时间：
2004-07-01
影响因子：
3.3
通讯作者：
Senada, S
中科院分区：
文献类型：
--
作者：
Devleta, B;Adem, B;Senada, S
闭经会导致骨质流失，但并非该过程中的所有机制都是已知的。闭经女性骨质流失的程度是由闭经的原因决定的。本研究的目的是探讨继发性闭经对骨密度的影响，并比较促性腺激素分泌不足的闭经女性和促性腺激素亢进的闭经女性的骨密度。本研究涉及 22 名 40 岁以下的闭经女性和 12 名正常月经女性。每名女性都接受了腰椎和股骨颈骨密度、体重指数 (BMI) 以及卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇、黄体酮和催乳素血清水平的测量。根据FSH水平，我们将闭经女性分为两组：高促性腺激素（n = 7；FSH，>40 IU/l）和低促性腺激素（n = 15；FSH，小于或等于40 IU/l）闭经女性。闭经女性的腰椎骨密度低于正常月经对照（P = 0.002）。高促性腺激素性闭经女性的腰椎骨密度低于低促性腺激素性闭经女性（P = 0.026）。在促性腺激素亢进组中，只有 FSH 水平与腰椎骨密度存在相关性（负相关）（P = 0.05），但在促性腺激素低下组中，激素水平、BMI、年龄或闭经持续时间之间没有相关性。闭经女性BMI与腰椎骨密度呈正相关（P<0.025）。闭经女性的骨密度低于正常月经女性，但高促性腺激素的闭经女性的骨密度低于促性腺激素低下的女性。高促性腺激素性闭经组骨质流失较多可能是由于 FSH 对骨代谢的潜在直接影响所致。
Amenorrhea can cause bone loss, but not all mechanisms in this process are known. The degree of bone loss in amenorrheic women is determined by the cause of the amenorrhea. The aim of this study was to investigate the influence of secondary amenorrhea on bone density and to compare the bone density between hypogonadotropic amenorrheic women and hypergonadotropic amenorrheic women. Twenty-two amenorrheic and 12 eumenorrheic women under the age of 40 were involved in this study. Every woman underwent measurements of lumbar spine and femoral neck bone density, body mass index (BMI), and serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and prolactin. According to FSH levels, we divided the women with amenorrhea into two groups: hypergonadotropic (n = 7; FSH, >40 IU/l) and hypogonadotropic (n = 15; FSH, less than or equal to40 IU/l) amenorrheic women. Amenorrheic women had a lower lumbar spine bone density than eumenorrheic controls (P = 0.002). Hypergonadotropic amenorrheic women had lower lumbar spine bone density (P = 0.026) than hypogonadotropic ameneorrheic women. In the hypergonadotropic group, only FSH level had a correlation (negative) with lumbar spine bone density (P = 0.05), but in the hypogonadotropic group, there was no correlation between hormonal levels, BMI, age, or duration of amenorrhea. BMI was positively correlated with lumbar spine bone density in amenorrheic women (P < 0.025). Amenorrheic women had lower bone density than eumenorrheic women, but hypergonadotropic amenorrheic women had lower bone density than hypogonadotropic women. The greater bone loss in the hypergonadotropic amenorrheic group could have been caused by a potential direct effect of FSH on bone metabolism.