镉、卵泡刺激素与 42-60 岁女性骨的关系：NHANES III 研究
Cadmium, follicle-stimulating hormone, and effects on bone in women age 42-60 years, NHANES III.
机构信息
PhD Program in Population Health and Clinical Outcomes Research, Stony Brook University, Health Sciences Center L3-R071, Stony Brook, New York 11794-8338, USA.
出版信息
Environ Res. 2010 Jan;110(1):105-11. doi: 10.1016/j.envres.2009.09.012.
BACKGROUND
Increased body burden of environmental cadmium has been associated with greater risk of decreased bone mineral density (BMD) and osteoporosis in middle-aged and older women, and an inverse relationship has been reported between follicle-stimulating hormone (FSH) and BMD in middle-aged women; however, the relationships between cadmium and FSH are uncertain, and the associations of each with bone loss have not been analyzed in a single population.
OBJECTIVES
The objective of this study was to evaluate the associations between creatinine-adjusted urinary cadmium (UCd) and FSH levels, and the associations between UCd and FSH with BMD and osteoporosis, in postmenopausal and perimenopausal women aged 42-60 years.
METHODS
Data were obtained from the Third National Health Examination and Nutrition Survey, 1988-1994 (NHANES III). Outcomes evaluated were serum FSH levels, femoral bone mineral density measured by dual energy X-ray absorptiometry, and osteoporosis indicated by femoral BMD cutoffs based on the international standard. Urinary cadmium levels were analyzed for association with these outcomes, and FSH levels analyzed for association with bone effects, using multiple regression. Subset analysis was conducted by a dichotomous measure of body mass index (BMI) to proxy higher and lower adipose-synthesized estrogen effects.
RESULTS
UCd was associated with increased serum FSH in perimenopausal women with high BMI (n=642; beta=0.45; p< or =0.05; R(2)=0.35) and low BMI (n=408; beta=0.61; p< or =0.01; R(2)=0.34). Among perimenopausal women with high BMI, BMD was inversely related to UCd (beta=-0.04; p< or =0.05) and FSH (beta=-0.03; p< or =0.05). In postmenopausal women with low BMI, an incremental increase in FSH was associated with 2.78 greater odds for osteoporosis (109 with and 706 without) (OR=2.78; 95% CI=1.43, 5.42; p< or =0.01).
CONCLUSION
Long-term cadmium exposure at environmental levels is associated with increased serum FSH, and both FSH and UCd are associated with bone loss, in US women aged 42-60 years.
背景
环境镉的体内负荷增加与中年和老年女性骨矿物质密度（BMD）降低和骨质疏松症的风险增加有关，并且中年女性的卵泡刺激素（FSH）与 BMD 之间呈负相关；然而，镉与 FSH 之间的关系尚不确定，并且尚未在单一人群中分析每种物质与骨丢失的关联。
目的
本研究旨在评估 42-60 岁绝经后和围绝经期妇女的尿肌酐校正镉（UCd）和 FSH 水平之间的关系，以及 UCd 和 FSH 与 BMD 和骨质疏松症之间的关系。
方法
数据来自 1988-1994 年第三次国家健康检查和营养调查（NHANES III）。评估的结果是血清 FSH 水平、双能 X 射线吸收法测量的股骨骨矿物质密度以及基于国际标准的股骨 BMD 截定点表示的骨质疏松症。使用多元回归分析来分析尿镉水平与这些结果之间的关系，并分析 FSH 水平与骨效应之间的关系。通过身体质量指数（BMI）的二分法测量进行亚组分析，以代理更高和更低的脂肪合成雌激素效应。
结果
在 BMI 较高的围绝经期妇女（n=642；β=0.45；p<0.05；R(2)=0.35）和 BMI 较低的妇女（n=408；β=0.61；p<0.01；R(2)=0.34）中，UCd 与血清 FSH 升高相关。在 BMI 较高的围绝经期妇女中，BMD 与 UCd（β=-0.04；p<0.05）和 FSH（β=-0.03；p<0.05）呈负相关。在 BMI 较低的绝经后妇女中，FSH 的递增与骨质疏松症的风险增加 2.78 倍（109 例伴发和 706 例不伴发）（OR=2.78；95%CI=1.43, 5.42；p<0.01）。
结论
在美国 42-60 岁的女性中，环境水平的长期镉暴露与血清 FSH 升高有关，FSH 和 UCd 均与骨丢失有关。
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