Szathmári Miklós, Vásárhelyi Barna, Treszl András, Tulassay Tivadar, Tulassay Zsolt
First Department of Medicine, Semmelweis University, Budapest, Hungary.
Int J Colorectal Dis. 2002 Mar;17(2):63-6. doi: 10.1007/s003840100334.
We investigated the coexistence of dehydroepiandrosterone sulfate (DHEAS) and testosterone deficiency in men with inflammatory bowel disease (IBD) and their relationship with bone homeostasis.
In 45 men with IBD (25 with ulcerative colitis, 20 with Crohn's disease) the testosterone and DHEAS levels were examined in relationship to bone mineral density, osteocalcin levels, and urinary deoxypyridinoline excretions.
We detected osteoporosis in 10 and osteopenia in 22 patients at the lumbar spine and/or femoral neck. Lower testosterone levels were measured in 20. Lower DHEAS levels were present in 23 patients; these had higher deoxypyridinoline excretion and lower lumbar spine and femoral neck BMD T scores than patients with normal DHEAS. DHEAS and BMD were correlated at the lumbar spine and the femoral neck. Associations remained significant after adjustment for age, weight, steroid use, and inflammatory activity. No independent effect of testosterone deficiency was detected on bone parameters.
DHEAS deficiency may contribute to the bone loss of men with IBD. This putative action of DHEAS on bone turnover is contrary to the common effect of testosterone deficiency and steroid therapy.
我们研究了炎症性肠病（IBD）男性患者中硫酸脱氢表雄酮（DHEAS）与睾酮缺乏的共存情况及其与骨稳态的关系。
在45例IBD男性患者（25例溃疡性结肠炎，20例克罗恩病）中，检测睾酮和DHEAS水平，并分析其与骨矿物质密度、骨钙素水平及尿脱氧吡啶啉排泄量的关系。
我们在10例患者的腰椎和/或股骨颈检测到骨质疏松，22例患者检测到骨量减少。20例患者睾酮水平较低。23例患者DHEAS水平较低；与DHEAS正常的患者相比，这些患者的脱氧吡啶啉排泄量更高，腰椎和股骨颈骨密度T值更低。腰椎和股骨颈处DHEAS与骨密度相关。在对年龄、体重、类固醇使用和炎症活动进行校正后，这种相关性仍然显著。未检测到睾酮缺乏对骨参数有独立影响。
DHEAS缺乏可能导致IBD男性患者骨质流失。DHEAS对骨转换的这种假定作用与睾酮缺乏和类固醇治疗的常见作用相反。
