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卵巢切除术对血清性类固醇水平和骨代谢的影响以及通过定量计算机断层扫描(QCT)-C值评估腰椎小梁骨的骨密度

Influence of oophorectomy on serum levels of sex steroids and bone metabolism and assessment of bone mineral density in lumbar trabecular bone by QCT-C value.

作者信息

Ohta H, Makita K, Suda Y, Ikeda T, Masuzawa T, Nozawa S

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan.

出版信息

J Bone Miner Res. 1992 Jun;7(6):659-65. doi: 10.1002/jbmr.5650070610.

Abstract

The present cross-sectional study was carried out to determine the influence of oophorectomy (OPX) on serum levels of sex steroids and bone metabolism, as well as bone mineral density (BMD), in OPX subjects in comparison with age- and body size-matched controls. Quantitative computed tomography (QCT) and dual-photon absorptiometry (DPA) demonstrated a remarkable reduction in BMD in OPX subjects. In particular, the QCT of the centrum of vertebral bone (QCT-C) in these subjects was no more than 69.33 +/- 3.40% (X +/- SEM) of the control value, and this parameter was much lower than the QCT integral (QCT-I) value of total lumbar vertebrae. This means that BMD decreases specifically in spongy portions after OPX. The serum level of estrone (E1) was significantly lower in OPX subjects than in controls. The hormonal action of E1 on target organs has been thought to be only one-third of that of estradiol (E2), but the marked reduction in serum E1 level seemed to be a significant cause of the reduction in BMD. The serum level of androstenedione (delta 4) significantly decreased in OPX subjects and appeared to affect bone metabolism negatively. Both bone formation and bone resorption were found to be stimulated following OPX, but the rate of bone resorption was found to be higher than that of bone formation: there was an imbalance between bone formation and bone resorption in OPX subjects. However, it was not possible to prove a relationship between Ca regulating hormone and this phenomenon. In conclusion, the QCT-C value reflects the changes in spongy vertebral BMD more sensitively than the QCT-I value or DPA.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本横断面研究旨在确定卵巢切除术(OPX)对OPX受试者血清性类固醇水平、骨代谢以及骨密度(BMD)的影响,并与年龄和体型匹配的对照组进行比较。定量计算机断层扫描(QCT)和双能光子吸收法(DPA)显示OPX受试者的BMD显著降低。特别是,这些受试者椎骨中心的QCT(QCT-C)不超过对照值的69.33±3.40%(X±SEM),且该参数远低于腰椎的QCT积分(QCT-I)值。这意味着OPX后骨密度在松质骨部分特异性降低。OPX受试者的血清雌酮(E1)水平显著低于对照组。E1对靶器官的激素作用被认为仅为雌二醇(E2)的三分之一,但血清E1水平的显著降低似乎是BMD降低的一个重要原因。OPX受试者的血清雄烯二酮(δ4)水平显著降低,似乎对骨代谢有负面影响。OPX后发现骨形成和骨吸收均受到刺激,但骨吸收速率高于骨形成速率:OPX受试者骨形成和骨吸收之间存在失衡。然而,无法证明钙调节激素与这种现象之间的关系。总之,QCT-C值比QCT-I值或DPA更能敏感地反映松质骨椎骨BMD的变化。(摘要截断于250字)

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