Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, B-9000 Ghent, Belgium.
J Clin Endocrinol Metab. 2009 Nov;94(11):4300-8. doi: 10.1210/jc.2009-0568. Epub 2009 Sep 22.
Pathophysiology of deficient bone mass acquisition in male idiopathic osteoporosis (IO) remains poorly understood.
Our objective was to investigate volumetric and geometric parameters of the appendicular skeleton, biochemical markers, and anthropometrics in men with IO.
DESIGN, SETTING, AND PARTICIPANTS: Our cross-sectional study included 107 men diagnosed with idiopathic low bone mass, 23 of their adult sons, and 130 age-matched controls.
Body composition and areal bone parameters (dual-energy x-ray absorptiometry) and volumetric and geometric parameters of radius and tibia (peripheral quantitative computed tomography) were assessed. Serum levels of testosterone, estradiol (E(2)), and SHBG, and bone turnover markers were measured using immunoassays. Free hormone fractions were calculated.
Men with idiopathic low bone mass had lower weight (-9.6%), truncal height (-3.3%), and upper/lower body segment ratio (-2.7%; all P < 0.001) and presented at the radius and tibia lower trabecular (-19.0 and -23.6%, respectively; both P < 0.001) and cortical volumetric bone mineral density (vBMD) (-2.4 and -1.7%; both P < 0.001) and smaller cortical areas (-9.7 and -13.6%; both P < 0.001) and thicknesses (-13.5 and -14.5%, both P < 0.001) due to larger endosteal circumferences (+11.8 and +7.4%, both P < 0.001) than controls. Furthermore, (free) E(2) was lower and SHBG higher (both P < 0.01). Their sons had lower trabecular vBMD (-10.3%, P = 0.036) and a thinner cortex (-8.3%, P = 0.024) at the radius.
Bone mass deficits in men with idiopathic low bone mass involve trabecular and cortical bone, resulting from lower vBMD and smaller cortical bone cross-sectional areas and thicknesses. A similar bone phenotype is present in at least part of their sons. The lower E(2), together with characteristics as lower upper/lower body segment ratio, larger endosteal circumferences and lower vBMD, may indicate an estrogen-related factor in the pathogenesis of male IO.
男性特发性骨质疏松症（IO）中骨量获取不足的病理生理学仍知之甚少。
我们的目的是研究 IO 男性的四肢骨骼体积和几何参数、生化标志物和人体测量学。
设计、地点和参与者：我们的横断面研究包括 107 名被诊断为特发性低骨量的男性、他们的 23 名成年儿子和 130 名年龄匹配的对照者。
使用双能 X 射线吸收法评估身体成分和面积骨参数，以及使用外周定量计算机断层扫描评估桡骨和胫骨的体积和几何参数。使用免疫分析法测量血清睾酮、雌二醇（E2）和 SHBG 以及骨转换标志物的水平。计算游离激素分数。
特发性低骨量男性的体重（-9.6%）、躯干高度（-3.3%）和上下身比例（-2.7%；均 P < 0.001）较低，桡骨和胫骨的小梁骨体积骨密度（vBMD）（-19.0 和-23.6%；均 P < 0.001）和皮质 vBMD（-2.4 和-1.7%；均 P < 0.001）以及皮质面积（-9.7 和-13.6%；均 P < 0.001）和厚度（-13.5 和-14.5%；均 P < 0.001）较小，这是由于骨内表面周长增加（+11.8 和+7.4%；均 P < 0.001）所致。此外，（游离）E2 较低，SHBG 较高（均 P < 0.01）。他们的儿子桡骨的小梁骨 vBMD 较低（-10.3%，P = 0.036），皮质较薄（-8.3%，P = 0.024）。
特发性低骨量男性的骨量不足涉及到小梁骨和皮质骨，其原因是 vBMD 较低，皮质骨的横截面积和厚度较小。他们的至少部分儿子存在类似的骨骼表型。较低的 E2 以及上半身与下半身比例较小、骨内表面周长较大和 vBMD 较低等特征，可能表明雌激素相关因素在男性 IO 的发病机制中起作用。
