总雌二醇而非睾酮水平可预测老年男性的骨质疏松症。
Total estradiol, rather than testosterone levels, predicts osteoporosis in aging men.
作者信息
Clapauch Ruth, Mattos Tatiana Martins, Silva Patrícia, Marinheiro Lizanka Paola, Buksman Salo, Schrank Yolanda
机构信息
Divisão de Endocrinologia Feminina e Andrologia, Setor de Endocrinologia, Hospital da Lagoa, Rio de Janeiro, RJ, Brasil.
出版信息
Arq Bras Endocrinol Metabol. 2009 Nov;53(8):1020-5. doi: 10.1590/s0004-27302009000800017.
OBJECTIVE
To study and establish sex hormone cutoff levels for osteoporosis risk in men over 50 years old.
METHODS
Case-control study of 216 men > 50 years, 110 with osteoporosis (O) and 106 with normal bone density (C). We measured estradiol (E2), sex hormone binding globulin (SHBG), total testosterone (TT) and albumin. Free testosterone (FT) and bioavailable testosterone (BT) were calculated through Vermeulen's formula.
RESULTS
There was no difference in TT between groups. Relative risks of osteoporosis were 1.89 for E2 < 37 pg/mL (p = 0.02); 1.91 for SHBG > 55 nmol/L (p = 0.019); 2.5 for FT < 7 ng/dL (p = 0.015); 2.7 for BT < 180 ng/dL (p = 0.0003).
CONCLUSIONS
In men over 50 years old, TT was not indicative of osteoporosis risk while E2 < 37 ng/mL was. SHBG > 55 nmol/L, FT < 7 ng/dL and BT < 180 ng/dL can represent additional indications for osteoporosis screening in men over 50 years old.
目的
研究并确定50岁以上男性骨质疏松风险的性激素临界值水平。
方法
对216名50岁以上男性进行病例对照研究，其中110人患有骨质疏松症（O组），106人骨密度正常（C组）。我们测量了雌二醇（E2）、性激素结合球蛋白（SHBG）、总睾酮（TT）和白蛋白。游离睾酮（FT）和生物可利用睾酮（BT）通过Vermeulen公式计算得出。
结果
两组之间的TT无差异。当E2<37 pg/mL时，骨质疏松的相对风险为1.89（p = 0.02）；当SHBG>55 nmol/L时，相对风险为1.91（p = 0.019）；当FT<7 ng/dL时，相对风险为2.5（p = 0.015）；当BT<180 ng/dL时，相对风险为2.7（p = 0.0003）。
结论
在50岁以上男性中，TT不能指示骨质疏松风险，而E2<37 ng/mL可以。SHBG>55 nmol/L、FT<7 ng/dL和BT<180 ng/dL可作为50岁以上男性骨质疏松筛查的额外指标。
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