Clarke B L, Ebeling P R, Jones J D, Wahner H W, O'Fallon W M, Riggs B L, Fitzpatrick L A
Division of Endocrinology and Endocrine Research Unit, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Calcif Tissue Int. 2002 Mar;70(3):137-45. doi: 10.1007/s00223-001-1072-4. Epub 2002 Jan 31.
Factors contributing to the pathogenesis of osteoporosis in women are well defined. However, changes in bone mineral metabolism in aging men and the role of various factors in the pathogenesis of age-related bone loss in men are less well understood. To further clarify these changes, serum and urine biochemical parameters, and lumbar spine, hip, and total body bone mineral density (BMD) were evaluated in a small sample of 45 healthy men aged 20-80 years, and multiple regression models were developed to predict age-related bone loss. Serum calcium, phosphate, albumin, creatinine clearance, osteocalcin, C-terminal propeptide of type I procollagen, log-free androgen index, dehydroepiandrosterone sulfate (DHEA-S), and androstenedione decreased with age, and serum sex hormone binding globulin and urine total and free pyridinoline increased with age. Femoral neck BMD decreased with age, but remained stable at the other sites measured. Multiple regression analysis indicated that serum phosphate, DHEA-S, and intact parathyroid hormone (PTH) predicted lumbar spine BMD. Age, serum phosphate, and PTH predicted femoral neck BMD. Urine-free deoxypyridinoline alone predicted femoral greater trochanter BMD. Weight, serum creatinine, and urine-free deoxypyridinoline predicted total body BMD. We conclude that predictor variables of bone density vary by skeletal site in healthy men. Alterations in adrenal androgens, phosphate, and PTH may be important in the pathogenesis of bone loss with aging in men.
导致女性骨质疏松症发病的因素已明确。然而，老年男性骨矿物质代谢的变化以及各种因素在男性年龄相关性骨质流失发病机制中的作用尚不清楚。为进一步阐明这些变化，对45名年龄在20 - 80岁的健康男性小样本进行了血清和尿液生化参数以及腰椎、髋部和全身骨密度（BMD）评估，并建立了多元回归模型来预测年龄相关性骨质流失。血清钙、磷、白蛋白、肌酐清除率、骨钙素、I型前胶原C端前肽、无对数雄激素指数、硫酸脱氢表雄酮（DHEA - S）和雄烯二酮随年龄降低，血清性激素结合球蛋白以及尿液总吡啶啉和游离吡啶啉随年龄增加。股骨颈骨密度随年龄降低，但在其他测量部位保持稳定。多元回归分析表明，血清磷、DHEA - S和完整甲状旁腺激素（PTH）可预测腰椎骨密度。年龄、血清磷和PTH可预测股骨颈骨密度。仅尿游离脱氧吡啶啉可预测股骨大转子骨密度。体重、血清肌酐和尿游离脱氧吡啶啉可预测全身骨密度。我们得出结论，健康男性中骨密度的预测变量因骨骼部位而异。肾上腺雄激素、磷和PTH的改变可能在男性衰老相关骨质流失的发病机制中起重要作用。
