Bischoff-Ferrari H A, Orav E J, Dawson-Hughes B
Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich, Gloriastrasse, 258091, Zurich, Switzerland.
Osteoporos Int. 2008 Sep;19(9):1307-14. doi: 10.1007/s00198-008-0573-7. Epub 2008 Mar 20.
Higher physiologic testosterone levels among community dwelling older men and women may protect against falls, and this benefit may be further increased among those taking additional vitamin D plus calcium.
The aim of this study is to investigate sex hormone levels and fall risk in older men and women.
One hundred and ninety-nine men and 246 women age 65+ living at home were followed for 3 years after baseline assessment of sex hormones. Analyses controlled for several covariates, including baseline 25-hydroxyvitamin D, sex hormone binding globulin, and vitamin D plus calcium treatment (vitD+cal).
Compared to the lowest quartile, men and women in the highest quartile of total testosterone had a decreased odds of falling (men: OR = 0.22; 95% CI [0.07,0.72]/ women: OR = 0.34; 95% CI [0.14,0.83]); if those individuals also took vitD+cal, the fall reduction was enhanced (men: OR = 0.16; 95% CI [0.03,0.90] / women: OR = 0.15; 95% CI [0.04,0.57]). Similarly, women in the top quartile of dihydroepiandrosterone sulfate (DHEA-S) had a lower risk of falling (OR = 0.39; 95% CI [0.16,0.93]). Other sex hormones and SHBG did not predict falling in men or women.
Higher testosterone levels in both genders and higher DHEA-S levels in women predicted a more than 60% lower risk of falling. With vitD+cal, the anti-fall benefit of higher physiologic testosterone levels is enhanced from 78% to 84% among men and from 66% to 85% among women.
社区居住的老年男性和女性体内较高的生理性睾酮水平可能预防跌倒,而对于那些额外补充维生素D加钙的人来说,这种益处可能会进一步增加。
本研究的目的是调查老年男性和女性的性激素水平及跌倒风险。
对199名65岁及以上居家男性和246名65岁及以上居家女性在进行性激素基线评估后随访3年。分析控制了几个协变量,包括基线25-羟基维生素D、性激素结合球蛋白以及维生素D加钙治疗(维生素D+钙)。
与最低四分位数相比,总睾酮水平处于最高四分位数的男性和女性跌倒几率降低(男性:OR = 0.22;95%CI[0.07,0.72]/女性:OR = 0.34;95%CI[0.14,0.83]);如果这些个体同时服用维生素D+钙,跌倒减少情况会增强(男性:OR = 0.16;95%CI[0.03,0.90]/女性:OR = 0.15;95%CI[0.04,0.57])。同样,硫酸脱氢表雄酮(DHEA-S)处于最高四分位数的女性跌倒风险较低(OR = 0.39;95%CI[0.16,0.93])。其他性激素和性激素结合球蛋白不能预测男性或女性的跌倒情况。
两性中较高的睾酮水平以及女性中较高的DHEA-S水平预示跌倒风险降低超过60%。补充维生素D+钙后,较高生理性睾酮水平的防跌倒益处,男性从78%提高到84%,女性从66%提高到85%。