Manolagas S C, Anderson D C, Lindsay R
Lancet. 1979 Sep 22;2(8143):597-600. doi: 10.1016/s0140-6736(79)91663-5.
To explore the possibility that the wide variation in bone loss among oophorectomised women might be due to differences in adrenal androgens or their biosynthetic pathways, 18 women (10 with very fast and 8 with very slow bone loss) were selected. Serum levels of nine adrenal steroids, including the major androgens and cortisol, were measured under basal conditions and after overnight suppression followed by acute corticotropin stimulation. In addition, basal serum oestrone, oestradiol, dehydroepiandrosterone sulphate, sex-hormone-binding-globulin, corticosteroid binding globulin, and urinary free cortisol were measured. The only significant differences found were that women who lost bone rapidly had significantly higher urinary free-cortisol excretion (p less than 0.001) and a paradoxically diminished cortisol response to corticotropin. These data make it unlikely that endogenous adrenal androgens or oestrogens are a major factor in preventing bone loss after cessation of ovarian function; cortisol by its catabolic effect, however, may be a significant factor in causing osteoporosis.
为探究卵巢切除术后女性骨量流失差异较大是否可能归因于肾上腺雄激素或其生物合成途径的不同，研究选取了18名女性（10名骨量流失非常快的女性和8名骨量流失非常慢的女性）。在基础条件下、过夜抑制后以及急性促肾上腺皮质激素刺激后，测量了包括主要雄激素和皮质醇在内的9种肾上腺类固醇的血清水平。此外，还测量了基础血清雌酮、雌二醇、硫酸脱氢表雄酮、性激素结合球蛋白、皮质类固醇结合球蛋白以及尿游离皮质醇。唯一显著的差异是，骨量快速流失的女性尿游离皮质醇排泄量显著更高（p小于0.001），且对促肾上腺皮质激素的皮质醇反应反常降低。这些数据表明，内源性肾上腺雄激素或雌激素不太可能是卵巢功能停止后预防骨量流失的主要因素；然而，皮质醇因其分解代谢作用，可能是导致骨质疏松的一个重要因素。
