Tian Xiaoyuan, Zhang Bocheng
Second Affiliated Hospital, Dalian Medical University, Dalian, China.
Front Med (Lausanne). 2024 Dec 12;11:1425210. doi: 10.3389/fmed.2024.1425210. eCollection 2024.
Age and gender are commonly recognized as risk factors for osteoarthritis (OA), implying a potential association between sex hormones and OA pathogenesis. However, the precise role of sex hormones in OA remains elusive. Meanwhile, testosterone to estradiol (TT/E2) ratio is a new biomarker of sex hormone milieu. In this study, we aimed to investigate the relationship between sex hormones, specifically TT/E2 ratio, and the prevalence of OA among adults in the United States.
This study is a cross-sectional study, and the data sourced from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 cycles. This study primarily focuses on individuals aged 50 and above, employing multivariable logistic regression to examine the association between sex hormones and OA.
We included 2,615 participants (972 females). No significant association was observed between testosterone or estradiol levels and OA prevalence when analyzed separately. However, the TT/E2 ratio exhibited a robust inverse association with OA, particularly in females (adjusted OR = 0.61, 95% CI: 0.41-0.91, = 0.02). A nonlinear relationship was observed in females, with a threshold effect indicating reduced OA risk when the TT/E2 ratio exceeded 0.3.
The TT/E2 ratio was inversely associated with OA risk, with a stronger and more consistent effect observed in females. These findings suggest the TT/E2 ratio as a potential biomarker for OA risk stratification, particularly in postmenopausal females. Future longitudinal studies are warranted to clarify the causal role of the TT/E2 ratio in OA.
年龄和性别通常被认为是骨关节炎（OA）的风险因素，这意味着性激素与OA发病机制之间可能存在关联。然而，性激素在OA中的具体作用仍不明确。同时，睾酮与雌二醇（TT/E2）的比值是性激素环境的一种新生物标志物。在本研究中，我们旨在调查性激素，特别是TT/E2比值，与美国成年人OA患病率之间的关系。
本研究为横断面研究，数据来源于2013 - 2016年国家健康与营养检查调查（NHANES）周期。本研究主要关注50岁及以上的个体，采用多变量逻辑回归分析来研究性激素与OA之间的关联。
我们纳入了2615名参与者（972名女性）。单独分析时，未观察到睾酮或雌二醇水平与OA患病率之间存在显著关联。然而，TT/E2比值与OA呈现出显著的负相关，在女性中尤为明显（调整后的OR = 0.61，95% CI：0.41 - 0.91，P = 0.02）。在女性中观察到一种非线性关系，存在阈值效应，即当TT/E2比值超过0.3时，OA风险降低。
TT/E2比值与OA风险呈负相关，在女性中观察到更强且更一致的效应。这些发现表明TT/E2比值可能是OA风险分层的潜在生物标志物，尤其是在绝经后女性中。未来有必要进行纵向研究以阐明TT/E2比值在OA中的因果作用。
