Spector T D, Perry L A, Jubb R W
Department of Environmental and Preventive Medicine, St Bartholomew's Hospital, London, UK.
Clin Rheumatol. 1991 Sep;10(3):316-9. doi: 10.1007/BF02208698.
Epidemiologic and clinical observations have suggested a relationship between generalised osteoarthritis (GOA) and hormonal and menopausal factors in women. We explored the hypothesis that postmenopausal women with GOA have altered sex hormone status compared with control women. We studied 112 women (mean age 64) with GOA. Controls were 151 women (mean age 54) from the general population without clinical evidence of hand or knee OA. All women were postmenopausal. Serum was assayed by RIA for testosterone, oestradiol, sex hormone binding globulin (SHBG), and dyhydroepiandrosterone sulphate (DHEAS). Because of the differences in mean ages, the results were compared according to equal age groups divided on the basis of tertiles. SHBG was lower in the GOA group, reaching significance in the middle group 53-61 years (58.0 vs 67.9 nmol/l p less than 0.05). Testosterone was slightly higher in GOA women aged under 53. No consistent differences were seen in the older age group or for the other sex steroids. These preliminary data suggest that middle-aged women with GOA have lower circulating SHBG levels. This implies that higher circulating free oestrogens and androgens are present suggesting a role in the aetiopathogenesis of GOA.
流行病学和临床观察表明,女性的全身性骨关节炎(GOA)与激素及绝经因素之间存在关联。我们探讨了这样一个假设:与对照女性相比,患有GOA的绝经后女性性激素状态有所改变。我们研究了112名患有GOA的女性(平均年龄64岁)。对照组为151名来自普通人群的女性(平均年龄54岁),她们没有手部或膝部骨关节炎的临床证据。所有女性均已绝经。采用放射免疫分析法测定血清中的睾酮、雌二醇、性激素结合球蛋白(SHBG)和硫酸脱氢表雄酮(DHEAS)。由于平均年龄存在差异,根据基于三分位数划分的同年龄组对结果进行比较。GOA组的SHBG较低,在53 - 61岁的中间组达到显著水平(58.0对67.9 nmol/l,p < 0.05)。53岁以下的GOA女性睾酮略高。在老年组或其他性类固醇方面未观察到一致的差异。这些初步数据表明,患有GOA的中年女性循环SHBG水平较低。这意味着存在较高水平的循环游离雌激素和雄激素,提示其在GOA病因发病机制中起作用。