School of Public Health and Preventive Medicine, Monash University-Central and Eastern Clinical School, Alfred Hospital, Melbourne, Victoria, Australia.
Maturitas. 2011 Jun;69(2):141-56. doi: 10.1016/j.maturitas.2011.03.019. Epub 2011 Apr 9.
To systematically review the evidence for a relationship between sex hormones and structural changes in osteoarthritis (OA).
Electronic searches of MEDLINE were performed in November-December 2010 and in February 2011 for studies of sex hormones and OA that met a predefined set of criteria. Both controlled trials and observational studies were eligible for inclusion. Two independent reviewers extracted the data and assessed the methodological quality of the included studies. Due to the heterogeneity of the studies, we were unable to perform a best evidence synthesis. However we have provided summaries for each section.
Twenty-seven studies were included in this review, of which 11 were considered high quality. The evidence suggests an association between endogenous oestrogen and cartilage turnover and radiographic OA, and between testosterone and cartilage volume. There is also evidence for an association between exogenous oestrogen and cartilage and bone turnover, although its effects on radiographic and MRI structure as well as joint replacement are unclear. The evidence also supports an association between oestrogen receptor α and β gene polymorphisms and OA.
Although the heterogeneity of the studies means that there is insufficient evidence to form strong conclusions, the available evidence supports an effect of endogenous and exogenous oestrogen as well as oestrogen receptor polymorphisms on joint health.
系统回顾性激素与骨关节炎（OA）结构变化之间关系的证据。
2010 年 11 月至 12 月和 2011 年 2 月对 MEDLINE 进行了电子检索，以查找符合预定标准的性激素与 OA 的研究。符合条件的研究包括对照试验和观察性研究。两名独立的评审员提取数据并评估了纳入研究的方法学质量。由于研究的异质性，我们无法进行最佳证据综合。但是，我们为每个部分提供了摘要。
本综述共纳入 27 项研究，其中 11 项被认为是高质量的。证据表明内源性雌激素与软骨代谢和放射学 OA 之间以及睾丸激素与软骨体积之间存在相关性。也有证据表明外源性雌激素与软骨和骨代谢之间存在相关性，尽管其对放射学和 MRI 结构以及关节置换的影响尚不清楚。证据还支持雌激素受体α和β基因多态性与 OA 之间的相关性。
尽管研究的异质性意味着没有足够的证据得出强有力的结论，但现有证据支持内源性和外源性雌激素以及雌激素受体多态性对关节健康的影响。
