Lkhagvasuren Unentsatsral, Jav Sarantuya, Zagdsuren Battogtokh
Department of Obstetrics and Gynecology, Health Sciences, University of Mongolia, Ulaanbaatar, Mongolia.
Department of Molecular Biology and Genetics, Health Sciences, University of Mongolia, Ulaanbaatar, Mongolia.
Cent Asian J Glob Health. 2016 May 6;4(2):239. doi: 10.5195/cajgh.2015.239. eCollection 2015.
Postmenopausal osteoporosis is the most common bone metabolic disease associated with low bone mineral density (BMD) and osteopathic fragility fractures, which can lead to significant morbidity. The objective of this study was to investigate the relationship between serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and bone mineral density (BMD) across the stages of menopause in Mongolian women.
Two hundred sixty participants aged 50.1±4.4 years were enrolled in the study. Blood samples were obtained from each participant and analyzed using ELISA. Data were first stratified and analyzed by bone mineral density status (osteoporotic, osteopenic, and normal) and then by menopause status. Between group differences were analyzed using t-tests, and correlations were assessed using the Spearman rank order test, with Bonferonni correction. The data were analyzed using Statistical Package Statistical Software version 20.0 (SPSS Inc., Chicago, IL). Significance was set at <0.05.
The mean menopausal age was 48.4±3.4, which is comparable to the Mongolian population mean menopausal age. The mean serum estradiol level in the normal BMD group was 18.3±13.1 pg/ml and 15.8±10.7 pg/ml in the osteoporotic group. The mean serum FSH in the normal BMD group was 54.5±44.1 pg/ml and 81.3±34.2 pg/ml in the osteoporotic group. The mean serum LH level in the normal BMD group was 53.1±41.2 and 75.1±26.1 pg/ml in the osteoporotic group. The mean T and Z score were lower in the osteoporotic group. FSH and LH levels significantly differed across menopause stages in that those who were post-menopausal had higher levels compared to those who were pre- or peri-menopausal. Both hormones, FSH and LH, showed weak negative correlations with BMD level, but not E2. There were significant negative correlations between FSH and Speed of Sound (SOS) (r=-0.16; p<0.01), and between osteoporosis with age (r=-0.30, p<0.05) and number of childbirths (r=-0.14 p<0.05).
Osteoporosis is a significant problem with associations to hormone levels in post-menopausal women. In our study, mean serum estradiol levels decreased with age, and the mean FSH and LH levels were higher in women of later menopausal stage. Further study is warranted to investigate the bone related studies to establish better statistical references among Mongolian women.
绝经后骨质疏松症是最常见的骨代谢疾病，与低骨矿物质密度（BMD）和骨质疏松性脆性骨折相关，可导致显著的发病率。本研究的目的是调查蒙古族女性绝经各阶段血清促卵泡激素（FSH）、促黄体生成素（LH）和雌二醇（E2）水平与骨矿物质密度（BMD）之间的关系。
260名年龄在50.1±4.4岁的参与者纳入本研究。采集每位参与者的血样并使用酶联免疫吸附测定（ELISA）进行分析。数据首先按骨矿物质密度状态（骨质疏松、骨量减少和正常）分层并分析，然后按绝经状态分析。组间差异采用t检验分析，相关性采用Spearman等级顺序检验评估，并进行Bonferonni校正。数据使用统计软件包统计软件20.0版（SPSS公司，伊利诺伊州芝加哥）进行分析。显著性设定为<0.05。
平均绝经年龄为48.4±3.4岁，与蒙古族人群平均绝经年龄相当。正常骨密度组的平均血清雌二醇水平为18.3±13.1 pg/ml，骨质疏松组为15.8±10.7 pg/ml。正常骨密度组的平均血清FSH为54.5±44.1 pg/ml，骨质疏松组为81.3±34.2 pg/ml。正常骨密度组的平均血清LH水平为53.1±41.2，骨质疏松组为75.1±26.1 pg/ml。骨质疏松组的平均T值和Z值较低。FSH和LH水平在绝经各阶段存在显著差异，绝经后的女性水平高于绝经前或围绝经期的女性。FSH和LH这两种激素与BMD水平均呈弱负相关，但与E2无关。FSH与声速（SOS）之间存在显著负相关（r=-0.16；p<0.01），骨质疏松与年龄之间（r=-0.30，p<0.05）以及分娩次数之间（r=-0.14，p<0.05）也存在显著负相关。
骨质疏松症是绝经后女性中与激素水平相关的一个重要问题。在我们的研究中，平均血清雌二醇水平随年龄下降，绝经后期女性的平均FSH和LH水平较高。有必要进一步开展相关骨研究，以建立蒙古族女性更好的统计参考标准。
