Zeng Mengjie, Davis Susan R, Cicuttini Flavia M, Franks Angus, McNeil John J, Wang Yuanyuan
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia; Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria 3004, Australia.
Maturitas. 2025 Feb;193:108174. doi: 10.1016/j.maturitas.2024.108174. Epub 2024 Dec 14.
To examine whether low circulating sex steroid concentrations are associated with the incidence of knee and hip replacement for osteoarthritis in community-dwelling older women.
This prospective cohort study examined 5535 Australian women recruited into the Aspirin in Reducing Events in the Elderly (ASPREE) trial, aged ≥70 years, not taking medications affecting sex steroid concentrations, and with sex steroid concentrations measured by liquid chromatography-tandem mass spectrometry.
The incidence of knee and hip replacement for osteoarthritis was determined by hospitalisations for knee and hip surgical procedures where osteoarthritis was recorded as the indication.
With a mean follow-up of 3.9 (SD 1.4) years, 311 women underwent knee replacement and 242 underwent hip replacement. A greater incidence of knee replacement was observed in women with the lowest quartile concentrations of oestrone (HR 1.35, 95 % CI 1.04-1.75, p = 0.03) and testosterone (HR 1.35, 95 % CI 1.05-1.72, p = 0.02) compared with quartiles 2 to 4, after adjusting for age, body mass index, socioeconomic status, smoking, alcohol consumption, and comorbidities. A greater likelihood of hip replacement was seen for women with the lowest quartile concentrations of dehydroepiandrosterone compared with quartiles 2 to 4 (HR 1.37, 95 % CI 1.03-1.82, p = 0.03).
Low concentrations of endogenous sex steroids were associated with a greater likelihood of lower-limb joint replacement for osteoarthritis in community-based women aged 70 years or older. These findings suggest sex steroids contribute to musculoskeletal health in later life, although the mechanisms by which sex steroids might influence joint replacement remain unclear.
gov NCT01038583. International Standard Randomized Controlled Trial Number Register ISRCTN83772183.
研究社区居住的老年女性中，循环性激素浓度低是否与骨关节炎膝关节和髋关节置换术的发生率相关。
这项前瞻性队列研究对5535名澳大利亚女性进行了检查，她们被纳入“老年人阿司匹林减少事件（ASPREE）”试验，年龄≥70岁，未服用影响性激素浓度的药物，并通过液相色谱-串联质谱法测量了性激素浓度。
骨关节炎膝关节和髋关节置换术的发生率通过记录骨关节炎为指征的膝关节和髋关节手术住院情况来确定。
平均随访3.9（标准差1.4）年，311名女性接受了膝关节置换术，242名女性接受了髋关节置换术。在调整年龄、体重指数、社会经济地位、吸烟、饮酒和合并症后，与第2至4四分位数相比，雌酮（风险比1.35，95%置信区间1.04-1.75，p = 0.03）和睾酮（风险比1.35，95%置信区间1.05-1.72，p = 0.02）浓度处于最低四分位数的女性膝关节置换术发生率更高。与第2至4四分位数相比，脱氢表雄酮浓度处于最低四分位数的女性髋关节置换术的可能性更大（风险比1.37，95%置信区间1.03-1.82，p = 0.03）。
内源性性激素浓度低与70岁及以上社区女性因骨关节炎进行下肢关节置换的可能性更大有关。这些发现表明性激素对晚年肌肉骨骼健康有贡献，尽管性激素可能影响关节置换的机制尚不清楚。
美国国立医学图书馆临床试验注册中心编号NCT01038583。国际标准随机对照试验编号注册ISRCTN83772183。
