卵泡刺激素和雌二醇与 2 型糖尿病男性的骨密度和骨折风险相关。
Follicle-stimulating hormone and estradiol are associated with bone mineral density and risk of fractures in men with type 2 diabetes mellitus.
机构信息
Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai, China.
Tong-ren Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai, China.
出版信息
J Diabetes. 2020 Jun;12(6):426-437. doi: 10.1111/1753-0407.13011. Epub 2019 Dec 18.
BACKGROUND
Type 2 diabetes mellitus (T2DM) is associated with a higher fracture risk. Sex hormones are important for maintaining skeletal health. It is not clear which sex hormone(s) contribute(s) to bone mineral density (BMD) and fracture risk in males with T2DM. This study investigated the relationships of these parameters in males with T2DM.
METHODS
This study involved 482 men with T2DM. BMDs at the lumbar spine (L2-4), femoral neck (FN), and total hip (TH) were measured by dual-energy X-ray absorptiometry (DXA). The 10-year probability of fractures was assessed using the modified Fracture Risk Algorithm (FRAX) tool. Serum levels of sex hormones were measured.
RESULTS
Follicle-stimulating hormone (FSH) and estradiol (E2) were associated with BMDs at L2-4 (FSH, β = -.162, P < .05; E2, β = .176, P < .001), and E2 was associated with BMD at FN (β = .137, P < .05) and TH (β = .140, P < .05). FSH was associated with major osteoporotic fractures (β = .288, P < .001) and hip fractures (β = .235, P < .001). Higher FSH was a risk factor for osteoporosis/osteopenia (odds ratios [OR] = 2.92, 95% CI = 1.66-5.14, P < .001), whereas higher E2 was a protective factor (OR = 0.37, 95% CI = 0.22-0.60, P < .001). Patients in the higher tertile of FSH and lower tertile of E2 had an increased risk of osteoporosis/osteopenia (OR = 5.05, 95% CI = 1.37-18.65, P < .05).
CONCLUSIONS
For males with T2DM, FSH and E2 are significantly associated with BMD, osteoporosis/osteopenia, and fracture risk.
背景
2 型糖尿病（T2DM）与更高的骨折风险相关。性激素对于维持骨骼健康非常重要。目前尚不清楚哪种性激素（如果有的话）会对 T2DM 男性的骨密度（BMD）和骨折风险产生影响。本研究旨在探究 T2DM 男性的这些参数之间的关系。
方法
本研究纳入了 482 名 T2DM 男性患者。采用双能 X 线吸收法（DXA）测量腰椎（L2-4）、股骨颈（FN）和全髋（TH）的 BMD。使用改良骨折风险算法（FRAX）工具评估 10 年骨折风险。检测血清性激素水平。
结果
卵泡刺激素（FSH）和雌二醇（E2）与 L2-4 处的 BMD 呈负相关（FSH，β=-.162，P<.05；E2，β=-.176，P<.001），E2 与 FN 处的 BMD 呈正相关（β=.137，P<.05），与 TH 处的 BMD 也呈正相关（β=.140，P<.05）。FSH 与主要骨质疏松性骨折（β=.288，P<.001）和髋部骨折（β=.235，P<.001）相关。较高的 FSH 是骨质疏松/骨量减少的危险因素（比值比[OR] = 2.92，95%可信区间[CI] = 1.66-5.14，P<.001），而较高的 E2 是保护因素（OR = 0.37，95%CI = 0.22-0.60，P<.001）。FSH 较高组和 E2 较低组的患者发生骨质疏松/骨量减少的风险增加（OR = 5.05，95%CI = 1.37-18.65，P<.05）。
结论
对于 T2DM 男性患者，FSH 和 E2 与 BMD、骨质疏松/骨量减少和骨折风险显著相关。
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