胰岛素样生长因子-I和睾酮水平作为健康社区居住男性骨密度的预测指标。

IGF-I and testosterone levels as predictors of bone mineral density in healthy, community-dwelling men.

作者信息

Rucker Diana, Ezzat Shereen, Diamandi Anastasia, Khosravi Javad, Hanley David A

机构信息

Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

出版信息

Clin Endocrinol (Oxf). 2004 Apr;60(4):491-9. doi: 10.1111/j.1365-2265.2004.02006.x.

DOI:10.1111/j.1365-2265.2004.02006.x

PMID:15049965

Abstract

OBJECTIVE

Age-related decline in IGF-I and gonadal hormones have been postulated to play an important role in the pathogenesis of age-related bone loss in men. In this cross-sectional study, the relation between serum IGF-I and gonadal hormones with bone mineral density (BMD) was examined in community-dwelling men.

DESIGN AND SUBJECTS

Serum IGF-I, testosterone and BMD were examined in 61 community-dwelling men over the age of 27, who were randomly selected from the Calgary cohort of 1000 subjects in the Canadian Multicentre Osteoporosis Study. In the present study, IGF-I, serum testosterone, SHBG, free androgen index (FAI), parathyroid hormone (PTH), 25-hydroxy-vitamin D [25(OH)D] and other markers of bone turnover were measured. BMD was measured at the spine and hip (HOLOGIC 4500). Simple linear regression was used to assess the linear relation between IGF-I, testosterone, BMD and other biochemical markers of bone metabolism and potential confounding variables and subsequent multivariate regression models were constructed separately for each BMD measurement to assess the importance of IGF-I and testosterone in the presence of potential confounding variables.

RESULTS

Serum IGF-I, FAI and SHBG significantly decreased as a function of age, whereas serum levels of PTH increased. Only 25(OH)D, total testosterone and FAI were positively associated with serum IGF-I after adjusting for age and BMI. Multiple linear regression models revealed that IGF-I was a significant predictor of BMD at the total hip, femoral neck and femoral trochanter neck (P < or = 0.001). In contrast, the FAI was a significant predictor of BMD at the lumbar spine and wards area (P < or = 0.011), and SHBG was a significant predictor at the total hip and femoral trochanter (P < or = 0.045).

CONCLUSION

These data support the hypothesis that the age-related decline in bone mass in men is associated with declining levels of IGF-I and testosterone.

摘要

目的

胰岛素样生长因子-I（IGF-I）和性腺激素随年龄增长而下降，这被认为在男性年龄相关性骨质流失的发病机制中起重要作用。在这项横断面研究中，对社区居住男性血清IGF-I和性腺激素与骨密度（BMD）之间的关系进行了研究。

设计与研究对象

对61名年龄超过27岁的社区居住男性进行了血清IGF-I、睾酮和骨密度检测，这些男性是从加拿大多中心骨质疏松研究中卡尔加里队列的1000名受试者中随机选取的。在本研究中，测量了IGF-I、血清睾酮、性激素结合球蛋白（SHBG）、游离雄激素指数（FAI）、甲状旁腺激素（PTH）、25-羟维生素D [25(OH)D]以及其他骨转换标志物。在脊柱和髋部（HOLOGIC 4500）测量骨密度。采用简单线性回归评估IGF-I、睾酮、骨密度与其他骨代谢生化标志物及潜在混杂变量之间的线性关系，并针对每次骨密度测量分别构建多元回归模型，以评估在存在潜在混杂变量的情况下IGF-I和睾酮的重要性。

结果

血清IGF-I、FAI和SHBG随年龄增长显著下降，而血清PTH水平升高。在调整年龄和体重指数（BMI）后，只有25(OH)D、总睾酮和FAI与血清IGF-I呈正相关。多元线性回归模型显示，IGF-I是全髋、股骨颈和股骨转子颈骨密度的显著预测因子（P≤0.001）。相比之下，FAI是腰椎和沃德区骨密度的显著预测因子（P≤0.011），SHBG是全髋和股骨转子骨密度的显著预测因子（P≤0.045）。