Zhu Kun, Henley David, Pennell Craig, Herbison Carly E, Mountain Jenny, Lye Stephen, Walsh John P
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia.
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia; School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia.
Bone. 2016 Apr;85:37-44. doi: 10.1016/j.bone.2016.01.016. Epub 2016 Jan 21.
In older adults, high-normal circulating cortisol levels are associated with lower bone mass, but relationships between hypothalamic-pituitary-adrenal axis function and peak bone mass in young adults have not been examined. We studied 411 male and 390 female participants in the Western Australia Pregnancy Cohort (Raine) Study. At 18years of age, participants underwent a Trier Social Stress Test (TSST) with measurement of plasma and salivary cortisol at baseline and at multiple time points after stress. Cortisol responses were classified as anticipatory responder (significant fall in cortisol during the test), reactive responder (significant increase) or non-responder. At 20years, total body bone mineral content (BMC) and density (BMD) were measured by DXA. In males, after adjustment for weight, height (for BMC and bone area only), alcohol and smoking, there was a significant inverse relationship between both plasma and salivary cortisol measured at baseline in the TSST and each of BMC and BMD, such that each additional 10% of salivary cortisol was associated with reductions of 6.9g (95% CI -11.7, -2.2) in BMC, and 1.8mg/cm(2) (95% CI -3.3, -0.4) in BMD. Males classified as anticipatory responders in the TSST had 3.2% lower BMC (adjusted mean±SE: 3131±28 vs. 3233±18g, P=0.006) and 2.5% lower BMD (1108±9 vs. 1136±6mg/cm(2), P=0.022) than reactive responders. In females, there were no significant relationships between baseline cortisol or TSST responses and BMC or BMD in covariate-adjusted analyses. We conclude that in young males (but not females), higher circulating cortisol at the baseline of the stress test and an anticipatory responder pattern on the TSST are associated with lower total body bone mass.
在老年人中，循环皮质醇水平处于高正常范围与较低的骨量相关，但下丘脑 - 垂体 - 肾上腺轴功能与年轻人峰值骨量之间的关系尚未得到研究。我们对西澳大利亚妊娠队列（Raine）研究中的411名男性和390名女性参与者进行了研究。在18岁时，参与者接受了特里尔社会应激测试（TSST），并在基线和应激后的多个时间点测量血浆和唾液皮质醇。皮质醇反应被分类为预期反应者（测试期间皮质醇显著下降）、反应性反应者（显著增加）或无反应者。在20岁时，通过双能X线吸收法（DXA）测量全身骨矿物质含量（BMC）和骨密度（BMD）。在男性中，在调整体重、身高（仅针对BMC和骨面积）、酒精和吸烟因素后，TSST基线时测量的血浆和唾液皮质醇与BMC和BMD中的每一项之间均存在显著的负相关关系，即唾液皮质醇每增加10%，BMC降低6.9克（95%可信区间 -11.7，-2.2），BMD降低1.8毫克/平方厘米（95%可信区间 -3.3，-0.4）。在TSST中被分类为预期反应者的男性，其BMC比反应性反应者低3.2%（调整后均值±标准误：3131±28 vs. 3233±18克，P = 0.006），BMD低2.5%（1108±9 vs. 1136±6毫克/平方厘米，P = 0.022）。在女性中，在协变量调整分析中，基线皮质醇或TSST反应与BMC或BMD之间无显著关系。我们得出结论，在年轻男性（而非女性）中，应激测试基线时较高的循环皮质醇水平以及TSST上的预期反应者模式与较低的全身骨量相关。
