Keleş Işik, Aydin Gülümser, Başar M Murad, Hayran Mutlu, Atalar Ebru, Orkun Sevim, Batislam Ertan
Physical Medicine and Rehabilitation Department, Faculty of Medicine, Kirikkale University, Turkey.
Joint Bone Spine. 2006 Jan;73(1):80-5. doi: 10.1016/j.jbspin.2005.04.003. Epub 2005 Jul 1.
To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men.
Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking.
The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured.
Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD.
评估内源性性激素对健康土耳其男性骨密度（BMD）的作用。
对240名年龄在22 - 76岁的志愿者中的174名健康男性测定血清总睾酮（TT）、游离睾酮（FT）、硫酸脱氢表雄酮和雌二醇水平。采用双能X线吸收法测量腰椎、股骨颈以及非优势侧近端和远端桡尺骨部位的骨密度（g/cm²）。以每个骨密度测量部位作为因变量，每种性激素作为自变量进行线性回归分析。针对每个骨部位和性激素运行四个模型；分别为粗模型、年龄校正模型、年龄和体重指数（BMI）校正模型以及年龄、BMI和吸烟校正模型。
纳入研究的男性的平均年龄和BMI分别为47.7 ± 13.7岁和26.9 ± 3.6 kg/m²。在分析粗效应和校正效应的所有模型中，FT的对数与远端前臂的骨密度显著相关。在对年龄（岁）校正、BMI校正和吸烟校正后，硫酸脱氢表雄酮对近端前臂骨密度的影响接近统计学显著水平。未发现雌二醇和TT水平与所测量的任何部位的骨密度相关。
在男性内源性性激素中，主要是FT似乎是骨密度的决定因素之一。因此，老年男性或继发性原因导致的血清睾酮水平下降可能会对骨密度产生负面影响。
