Sambrook P N, Eisman J A, Champion G D, Pocock N A
Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, Darlinghurst, Australia.
Arthritis Rheum. 1988 Aug;31(8):973-8. doi: 10.1002/art.1780310805.
Sex hormones have important effects on bone, especially in postmenopausal women. These hormones may be of particular significance in patients with rheumatoid arthritis (RA), who have a high frequency of osteoporosis. To examine this, we measured estrogen and androgen concentrations and bone mineral density (BMD) in 49 postmenopausal women with RA and 49 normal postmenopausal women. Compared with the controls, postmenopausal RA patients had significantly reduced levels of estrone (median 18 pmoles/liter versus 49; P less than 0.001), dehydroepiandosterone sulfate (DHEAS) (median 0.3 mumoles/liter versus 2.0; P less than 0.001), testosterone (median 0.6 nmoles/liter versus 0.95; P less than 0.001), and femoral BMD (mean 0.72 gm/cm2 versus 0.80; P less than 0.002). Prednisolone therapy in 22 patients (mean dosage 8 mg/day) was associated with reductions in estrone and testosterone levels; however, DHEAS and femoral BMD were also decreased in RA patients who were not receiving corticosteroids. Reduced DHEAS levels in postmenopausal women with RA may increase their risk of osteoporosis.
性激素对骨骼有重要影响，尤其是在绝经后女性中。这些激素在类风湿关节炎（RA）患者中可能具有特殊意义，因为这类患者骨质疏松的发生率很高。为了对此进行研究，我们测量了49名绝经后RA女性患者和49名正常绝经后女性的雌激素和雄激素浓度以及骨密度（BMD）。与对照组相比，绝经后RA患者的雌酮水平显著降低（中位数为18皮摩尔/升，而对照组为49；P<0.001），硫酸脱氢表雄酮（DHEAS）（中位数为0.3微摩尔/升，而对照组为2.0；P<0.001），睾酮（中位数为0.6纳摩尔/升，而对照组为0.95；P<0.001），以及股骨骨密度（平均值为0.72克/平方厘米，而对照组为0.80；P<0.002）。22例患者（平均剂量8毫克/天）接受泼尼松龙治疗后，雌酮和睾酮水平降低；然而，未接受皮质类固醇治疗的RA患者的DHEAS和股骨骨密度也有所下降。绝经后RA女性患者DHEAS水平降低可能会增加其骨质疏松的风险。
