Maïmoun L, Lumbroso S, Paris F, Couret I, Peruchon E, Rouays-Mabit E, Rossi M, Leroux J L, Sultan C
Groupe de Recherche Interdisciplinaire Sur le Métabolisme Osseux (GRISMO), Montpellier, France.
Spinal Cord. 2006 Dec;44(12):791-7. doi: 10.1038/sj.sc.3101922. Epub 2006 Mar 28.
This cross-sectional study compared the androgen and growth factor profiles and the bone turnover of patients with spinal cord injury (SCI) versus able-bodied controls (AB).
Determine whether androgens, GH, or either IGF-I or IGFBP-3, are implicated in bone turnover alteration in patients with recent SCI.
Propara Center, Montpellier, France.
In all, 16 men (31.3 years) with complete SCI, seven paraplegics and nine tetraplegics, who had sustained injury an average of 3 months earlier, and 12 AB who served as controls (27.5 years) participated. Androgens, growth hormone and its mediators were investigated. The bone resorption process was evaluated by urinary and plasma type I collagen C-telopeptide (CTXu, CTXp), while bone formation was evaluated by osteocalcin (OC) and bone alkaline phosphatase.
Total testosterone (TT) and the free androgen index (FAI) were significantly lower in the SCI patients, whereas FSH was significantly higher (P<0.05). These hormonal variations were not related to the level of neurological lesion. There was no significant difference in GH, IGF-I, or IGFBP-3 levels. CTXu and CTXp indicated high bone resorption activity in the SCI patients (P<0.05). Regarding bone formation markers, only OC was affected by neurological lesion (P<0.05). Basal hormone levels did not correlate with markers of bone turnover.
The high bone resorption process observed in SCI patients did not seem directly related to testicular endocrine abnormalities or an altered growth factor profile. Nevertheless, the reduced TT and FAI levels could be aggravating factors in the development of acute bone loss.
本横断面研究比较了脊髓损伤（SCI）患者与健全对照者（AB）的雄激素和生长因子谱以及骨转换情况。
确定雄激素、生长激素（GH）或胰岛素样生长因子-I（IGF-I）及胰岛素样生长因子结合蛋白-3（IGFBP-3）是否与近期脊髓损伤患者的骨转换改变有关。
法国蒙彼利埃的普罗帕拉中心。
共有16名男性（31.3岁）完全性脊髓损伤患者参与研究，其中7名截瘫患者和9名四肢瘫患者，平均受伤时间为3个月前，另有12名健全对照者（27.5岁）参与。对雄激素、生长激素及其介质进行了研究。通过尿和血浆I型胶原C末端肽（CTXu、CTXp）评估骨吸收过程，通过骨钙素（OC）和骨碱性磷酸酶评估骨形成。
脊髓损伤患者的总睾酮（TT）和游离雄激素指数（FAI）显著降低，而促卵泡生成素（FSH）显著升高（P<0.05）。这些激素变化与神经损伤水平无关。GH、IGF-I或IGFBP-3水平无显著差异。CTXu和CTXp表明脊髓损伤患者的骨吸收活性较高（P<0.05）。关于骨形成标志物，只有OC受神经损伤影响（P<0.05）。基础激素水平与骨转换标志物无相关性。
脊髓损伤患者中观察到的高骨吸收过程似乎与睾丸内分泌异常或生长因子谱改变无直接关系。然而，TT和FAI水平降低可能是急性骨质流失发展的加重因素。
