Dunajska Katarzyna, Milewicz Andrzej, Jóźków Paweł, Jedrzejuk Diana, Kuliczkowski Wiktor, Lwow Felicja
Department of Health Promotion, University School of Physical Education, Wroclaw, Poland.
Maturitas. 2006 Sep 20;55(2):142-9. doi: 10.1016/j.maturitas.2006.01.007. Epub 2006 Feb 24.
Although suspected, relationships between sex steroids and bone mineral density (BMD) are not fully defined in male population. According to recent data there may also exist an association between low BMD and atherosclerosis.
Our aim was to investigate relationships between serum sex steroids and BMD, and between BMD and atherosclerosis in men with coronary artery disease (CAD).
We recruited for the study 55 men aged 40-60 years with angiographically confirmed CAD and 30 healthy, age-matched controls. In each of the examined subjects serum levels of total testosterone (T), estradiol (E(2)), estrone and DHEA-S, as well as femoral neck, lumbar spine and total skeleton BMD were measured.
We found that the prevalence of osteopenia/osteoporosis recognized on spine and/or femoral BMD (T-score below -1.0) did not differ between men with CAD and healthy controls (respectively 47% versus 47%; p=0.8 in chi(2) Yates test). The mean BMD value at different regions did not differ between both groups either. Hormonal status of men with CAD and normal BMD was similar to men with CAD and osteopenia/osteoporosis except for the level of testosterone. After adjustment for age and BMI, men with lower BMD had lower testosterone and lower T/E(2) ratio than men with normal BMD (geometric means for testosterone were respectively: 16.1+/-8.3 versus 16.2+/-4.2; p<0.05 in ANCOVA with BMI and age as covariates; for T/E(2) ratio it was: 202.1+/-94.7 versus 222.8+/-83.9; p=0.05). However, we did not find any correlation between sex hormones concentrations and bone mineral density. There was a relationship between the advance of atherosclerosis (ranged by number of stenotic arteries) and BMD: men with the most advanced form of the disease (three-vessels) had the lowest femoral neck BMD. The groups did not differ in lumbar spine BMD.
Our data suggest that in middle-aged men with CAD: (1) lower serum testosterone and lower T/E(2) ratio are associated with lower BMD; (2) advance of coronary atherosclerosis is inversely related to femoral neck BMD, however this relationship is weak and requires further investigation.
尽管存在怀疑，但在男性群体中，性类固醇与骨矿物质密度（BMD）之间的关系尚未完全明确。根据最近的数据，低骨密度与动脉粥样硬化之间可能也存在关联。
我们的目的是研究冠心病（CAD）男性患者血清性类固醇与骨密度之间的关系，以及骨密度与动脉粥样硬化之间的关系。
我们招募了55名年龄在40 - 60岁之间、经血管造影证实患有冠心病的男性患者以及30名年龄匹配的健康对照者。对每位受试者测量血清总睾酮（T）、雌二醇（E₂）、雌酮和硫酸脱氢表雄酮（DHEA - S）水平，以及股骨颈、腰椎和全身骨骼的骨密度。
我们发现，通过脊柱和/或股骨骨密度（T值低于 - 1.0）诊断出的骨质减少/骨质疏松症患病率在冠心病男性患者和健康对照者之间没有差异（分别为47%对47%；卡方耶茨检验中p = 0.8）。两组在不同区域的平均骨密度值也没有差异。除睾酮水平外，骨密度正常的冠心病男性患者的激素状态与患有骨质减少/骨质疏松症的冠心病男性患者相似。在调整年龄和体重指数（BMI）后，骨密度较低的男性患者的睾酮水平和T/E₂比值低于骨密度正常的男性患者（睾酮的几何平均值分别为：16.1±8.3对16.2±4.2；以BMI和年龄作为协变量的协方差分析中p < 0.05；T/E₂比值为：202.1±94.7对222.8±83.9；p = 0.05）。然而，我们未发现性激素浓度与骨矿物质密度之间存在任何相关性。动脉粥样硬化的进展（按狭窄动脉数量划分）与骨密度之间存在关系：疾病最严重形式（三支血管病变）的男性患者股骨颈骨密度最低。两组在腰椎骨密度方面没有差异。
我们的数据表明，在患有冠心病的中年男性中：（1）较低的血清睾酮水平和较低的T/E₂比值与较低的骨密度相关；（2）冠状动脉粥样硬化的进展与股骨颈骨密度呈负相关，然而这种关系较弱，需要进一步研究。
