Välimäki Ville-Valtteri, Alfthan Henrik, Ivaska Kaisa K, Löyttyniemi Eliisa, Pettersson Kim, Stenman Ulf-Håkan, Välimäki Matti J
Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
J Clin Endocrinol Metab. 2004 Aug;89(8):3785-9. doi: 10.1210/jc.2003-032187.
To study the role of serum testosterone (T), estradiol (E(2)), and SHBG as regulators of peak bone mass and bone turnover rate in males, a cross-sectional study with data on lifestyle factors collected retrospectively was performed in 204 young Finnish men, 18.3-20.6 yr old. One hundred fifty-four men were recruits of the Finnish Army, and 50 were men of similar age who had postponed their military service for reasons not related to health. Bone mineral content, density, and scan area were measured in lumbar spine and upper femur by dual-energy x-ray absorptiometry. Blood was sampled for determination of serum total and free T, total and free E(2), SHBG, type I procollagen aminoterminal propeptide (PINP), total osteocalcin (TOC) and carboxylated osteocalcin (COC), and tartrate-resistant acid phosphatase 5b (TRACP5b); and urine was collected for determination of type I collagen aminoterminal telopeptide (NTX). Serum sex steroid concentrations did not associate with bone mineral content, scan area, or bone mineral density, adjusted for anthropometric and lifestyle factors at any measurement site. Instead, serum total (r = 0.23; P = 0.008) and free (r = 0.15; P = 0.023) T were positive predictors of serum TOC, whereas serum free E(2) correlated inversely with serum PINP (r = -0.20; P = 0.0039), TOC (r = -0.12; P = 0.086), COC (r = -0.14; P = 0.036), and urinary NTX (r = -0.15; P = 0.041). Interestingly, serum SHBG correlated positively with all the bone markers studied, the correlation coefficients being 0.18 for serum PINP (P = 0.012), 0.24 for TOC (P = 0.0006), 0.24 for COC (P = 0.0005), 0.27 for serum TRACP5b (P < 0.0001), and 0.21 for urine NTX (P = 0.0031). Serum SHBG was also a positive predictor of serum 25-hydroxyvitamin-D level (r = 0.20; P = 0.0036). The correlations of SHBG persisted after adjusting for weight, free E(2), and free T. We conclude that single measurements of serum E(2) and T were not determinants of peak bone mass in this population of young men. However, E(2) and T contributed to bone turnover rate, with serum T increasing bone formation, and serum E(2) suppressing both bone formation and resorption. Moreover, serum SHBG appeared to be an independent positive predictor of bone turnover rate, which also positively associated with serum 25-hydroxyvitamin-D levels.
为研究血清睾酮(T)、雌二醇(E₂)和性激素结合球蛋白(SHBG)作为男性峰值骨量和骨转换率调节因子的作用,我们对204名年龄在18.3 - 20.6岁的芬兰年轻男性进行了一项横断面研究,回顾性收集了生活方式因素的数据。其中154名男性为芬兰军队新兵,50名是因与健康无关的原因推迟服兵役的同龄男性。采用双能X线吸收法测量腰椎和股骨上段的骨矿物质含量、密度及扫描面积。采集血液样本测定血清总睾酮和游离睾酮、总雌二醇和游离雌二醇、SHBG、I型前胶原氨基端前肽(PINP)、总骨钙素(TOC)和羧化骨钙素(COC)以及抗酒石酸酸性磷酸酶5b(TRACP5b);收集尿液样本测定I型胶原氨基端肽(NTX)。在对任何测量部位的人体测量和生活方式因素进行校正后,血清性激素浓度与骨矿物质含量、扫描面积或骨矿物质密度均无关联。相反,血清总睾酮(r = 0.23;P = 0.008)和游离睾酮(r = 0.15;P = 0.023)是血清TOC的阳性预测因子,而血清游离E₂与血清PINP(r = -0.20;P = 0.0039)、TOC(r = -0.12;P = 0.086)、COC(r = -0.14;P = 0.036)和尿NTX(r = -0.15;P = 0.041)呈负相关。有趣的是,血清SHBG与所有研究的骨标志物均呈正相关,血清PINP的相关系数为0.18(P = 0.012),TOC为0.24(P = 0.0006),COC为0.24(P = 0.0005),血清TRACP5b为0.27(P < 0.0001),尿NTX为0.21(P = 0.0031)。血清SHBG也是血清25 - 羟基维生素D水平的阳性预测因子(r = 0.20;P = 0.0036)。在校正体重、游离E₂和游离睾酮后,SHBG的相关性依然存在。我们得出结论,在这群年轻男性中,单次测量血清E₂和T并非峰值骨量的决定因素。然而,E₂和T对骨转换率有影响,血清T增加骨形成,血清E₂抑制骨形成和骨吸收。此外,血清SHBG似乎是骨转换率的独立阳性预测因子,且与血清25 - 羟基维生素D水平也呈正相关。