Dennison E, Hindmarsh P, Fall C, Kellingray S, Barker D, Phillips D, Cooper C
Medical Research Council Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, United Kingdom.
J Clin Endocrinol Metab. 1999 Sep;84(9):3058-63. doi: 10.1210/jcem.84.9.5964.
Exogenous glucocorticoids are known to increase the risk of osteoporosis. However, the contribution made by endogenous circulating cortisol concentrations to adult skeletal status remains unknown. We examined this issue in a sample of 34 healthy men, aged 61-72 yr. Venous blood samples were obtained under standard conditions every 20 min over a 24-h period. Measurements were made of serum cortisol and cortisol-binding globulin. Bone mineral density was measured at the lumbar spine and proximal femur using dual energy x-ray absorptiometry. Measurements were made at baseline and 4 yr later. There was a weak negative association between integrated cortisol concentration and lumbar spine bone density (r = -0.37; P < 0.05); similar relationships (P < 0.05) existed at three of five proximal femoral sites. There were also statistically significant positive associations between the trough cortisol concentration and bone loss rate at the lumbar spine (r = 0.38; P < 0.05), femoral neck (r = 0.47; P < 0.001), and the trochanteric region (r = 0.41; P = 0.02) over the 4-yr follow-up period. The cross-sectional relationships between cortisol concentration and bone density were removed by adjustment for body mass index, but the influence on bone loss rate remained significant after adjusting for adiposity, cigarette smoking, alcohol consumption, dietary calcium intake, physical activity, and serum testosterone and estradiol levels. These observations suggest that the endogenous cortisol profile of healthy elderly men is a determinant of their bone mineral density and their rate of involutional bone loss.
已知外源性糖皮质激素会增加骨质疏松症的风险。然而，内源性循环皮质醇浓度对成年人骨骼状态的影响仍不清楚。我们在34名年龄在61 - 72岁的健康男性样本中研究了这个问题。在24小时内，每隔20分钟在标准条件下采集静脉血样。测量血清皮质醇和皮质醇结合球蛋白。使用双能X线吸收法测量腰椎和股骨近端的骨密度。在基线和4年后进行测量。皮质醇综合浓度与腰椎骨密度之间存在微弱的负相关(r = -0.37;P < 0.05);在五个股骨近端部位中的三个部位也存在类似关系(P < 0.05)。在4年的随访期内，皮质醇谷浓度与腰椎(r = 0.38;P < 0.05)、股骨颈(r = 0.47;P < 0.001)和转子区(r = 0.41;P = 0.02)的骨丢失率之间也存在统计学上的显著正相关。通过调整体重指数消除了皮质醇浓度与骨密度之间的横断面关系，但在调整了肥胖、吸烟、饮酒、饮食钙摄入量、身体活动以及血清睾酮和雌二醇水平后，对骨丢失率的影响仍然显著。这些观察结果表明，健康老年男性的内源性皮质醇水平是其骨密度和 involutional 骨质流失率的一个决定因素。 （注：involutional 可能是 involutional osteoporosis 中的 involutional，可译为“绝经后骨质疏松症相关的”，这里根据语境暂保留英文，因为不确定原文准确意思）
