50岁及以上韩国男性体内睾酮、性激素结合球蛋白和胰岛素样生长因子-1与骨参数的关联
The association of testosterone, sex hormone-binding globulin, and insulin-like growth factor-1 with bone parameters in Korean men aged 50 years or older.
作者信息
Kim Hye-Jung, Koo Hyung Suk, Kim Young-Sang, Kim Moon Jong, Kim Kwang-Min, Joo Nam-Seok, Haam Ji-Hee
机构信息
Department of Family Medicine, Green-cross I-MED, 06647, Seoul, South Korea.
Department of Family Medicine, Dongguk University Bundang Oriental Hospital, 13601, Seongnam, South Korea.
出版信息
J Bone Miner Metab. 2017 Nov;35(6):659-665. doi: 10.1007/s00774-016-0803-6. Epub 2016 Nov 21.
Testosterone and insulin-like growth factor-1 (IGF-1) are essential factors for the maintenance of bone health in men. However, the results for the association of testosterone and IGF-1 with bone parameters were not consistent in prior studies. We evaluated the relationship of testosterone, sex hormone-binding globulin (SHBG), and IGF-1 with bone mineral density (BMD) and bone turnover markers (BTMs) in Korean men. We enrolled 1227 men aged ≥50 years in this cross-sectional study. Serum levels of total testosterone (TT), SHBG, IGF-1, osteocalcin, and C-terminal cross-linking telopeptide of type I collagen (CTX) were measured. Free testosterone (FT) was calculated using Vermeulen's method. BMD was measured by dual-energy X-ray absorptiometry. TT level was not related to BMD or BTMs in the unadjusted model; however, after adjusting for SHBG and IGF-1, the association between TT and BTMs was significant (β = -0.139 for osteocalcin and β = -0.204 for CTX). SHBG levels were negatively associated with lumbar BMD, and positively associated with BTMs in all models. As SHBG level increased, the prevalence of osteopenia or osteoporosis defined by BMD significantly increased (OR of 1SD change, 1.24). IGF-1 levels were significantly related with BMD, but not with BTMs. Meanwhile, FT levels were positively associated with BMD and negatively associated with BTMs. In conclusion, SHBG levels were independently related with bone parameters and osteopenia in men aged ≥50 years. IGF-1 levels were positively associated with BMD, but not with BTMs. SHBG may play a role in regulating age-related bone loss in men after middle-age.
睾酮和胰岛素样生长因子-1(IGF-1)是维持男性骨骼健康的重要因素。然而,在先前的研究中,睾酮和IGF-1与骨参数之间关联的结果并不一致。我们评估了韩国男性中睾酮、性激素结合球蛋白(SHBG)和IGF-1与骨密度(BMD)及骨转换标志物(BTMs)之间的关系。在这项横断面研究中,我们纳入了1227名年龄≥50岁的男性。测量了血清总睾酮(TT)、SHBG、IGF-1、骨钙素和I型胶原C端交联末端肽(CTX)的水平。游离睾酮(FT)采用韦尔梅伦方法计算。通过双能X线吸收法测量骨密度。在未校正模型中,TT水平与骨密度或骨转换标志物无关;然而,在校正SHBG和IGF-1后,TT与骨转换标志物之间的关联具有显著性(骨钙素的β=-0.139,CTX的β=-0.204)。在所有模型中,SHBG水平与腰椎骨密度呈负相关,与骨转换标志物呈正相关。随着SHBG水平升高,由骨密度定义的骨质减少或骨质疏松的患病率显著增加(1标准差变化的OR为1.24)。IGF-1水平与骨密度显著相关,但与骨转换标志物无关。同时,FT水平与骨密度呈正相关,与骨转换标志物呈负相关。总之,SHBG水平与≥50岁男性的骨参数和骨质减少独立相关。IGF-1水平与骨密度呈正相关,但与骨转换标志物无关。SHBG可能在调节中年后男性与年龄相关的骨质流失中发挥作用。