青春期延迟和性腺功能减退年轻男性的定量骨SPECT：对低骨密度治疗的意义

Quantitative bone SPECT in young males with delayed puberty and hypogonadism: implications for treatment of low bone mineral density.

作者信息

Lubushitzky R, Front D, Iosilevsky G, Bettman L, Frenkel A, Kolodny G M, Israel O

机构信息

Department of Endocrinology, Haemek Hospital, Afula, Israel.

出版信息

J Nucl Med. 1998 Jan;39(1):104-7.

PMID:9443746

Abstract

UNLABELLED

Constitutional delayed puberty (DP) and idiopathic hypogonadotropic hypogonadism (IHH) lead to osteoporosis in adult men. We were interested in whether response to treatment of these conditions by testosterone could be predicted by in vivo quantitative bone SPECT (QBS) measurement of bone turnover and whether testosterone administration affects bone mineral density (BMD) in these subjects.

METHODS

In vivo QBS and BMD measurements were performed in the lumbar spine (LS) and femoral neck (FN) of 29 young men with DP and 16 young men with IHH. In vivo QBS and BMD values in these patients were compared to the values obtained from 27 age-matched normal controls. The effect of testosterone treatment was determined by measuring changes in QBS and BMD, before and after treatment of 22 patients with DP and of all 16 patients with IHH. Seven patients with DP were not treated.

RESULTS

In vivo QBS values in patients with DP were significantly higher than those in controls (8.44% +/- 2.55%ID/ml compared to 5.63% +/- 1.12%ID/ml x 10(-3), p < 0.001, for the LS; and 7.86% +/- 3.01%ID/ml compared to 4.29% +/- 1.25%ID/ml, p < 0.001, for the FN). One year after testosterone treatment, QBS values in DP were significantly reduced. Pretreatment BMD values in patients with DP were significantly lower than those in normal subjects (0.77 +/- 0.11 g/cm2 compared to 1.03 +/- 0.14 g/cm2, p < 0.0001, for the LS; and 0.89 +/- 0.11 g/cm2 compared to 1.08 +/- 0.18 g/cm2, p < 0.006, for the FN). One year after treatment, BMD values increased significantly (0.91 +/- 0.14 g/cm2, p < 0.0001, for the LS; and 0.97 +/- 0.11 g/cm2, p < 0.0001, for the FN). The seven untreated young men with DP still had significantly lower-than-normal BMD values (0.82 +/- 0.08 g/cm2, p < 0.008, for the LS; and 0.89 +/- 0.05 g/cm2, p < 0.04, for the FN). In patients with IHH, QBS values were not significantly different from those found in normal controls. The values for BMD were significantly lower for both the LS (p < 0.0001) and the FN (p < 0.001). After treatment, BMD values in patients with IHH were still significantly lower than those of normals (p < 0.009 for the LS; and p < 0.006 for the FN).

CONCLUSION

Young men with maturation abnormalities show low bone density. Patients with DP and high bone turnover, as revealed by high QBS values, respond to testosterone treatment. Patients with IHH have normal bone turnover and do not respond to testosterone.

摘要

未标注

体质性青春期延迟（DP）和特发性低促性腺激素性性腺功能减退（IHH）会导致成年男性骨质疏松。我们感兴趣的是，通过体内定量骨SPECT（QBS）测量骨转换是否可以预测这些疾病对睾酮治疗的反应，以及给予睾酮是否会影响这些受试者的骨密度（BMD）。

方法

对29名患有DP的年轻男性和16名患有IHH的年轻男性的腰椎（LS）和股骨颈（FN）进行体内QBS和BMD测量。将这些患者的体内QBS和BMD值与27名年龄匹配的正常对照者的值进行比较。通过测量22名DP患者和所有16名IHH患者治疗前后QBS和BMD的变化来确定睾酮治疗的效果。7名DP患者未接受治疗。

结果

DP患者的体内QBS值显著高于对照组（LS：8.44%±2.55%ID/ml，对照组为5.63%±1.12%ID/ml×10⁻³，p<0.001；FN：7.86%±3.01%ID/ml，对照组为4.29%±1.25%ID/ml，p<0.001）。睾酮治疗一年后，DP患者的QBS值显著降低。DP患者治疗前的BMD值显著低于正常受试者（LS：0.77±0.11g/cm²，正常受试者为1.03±0.14g/cm²，p<0.0001；FN：0.89±0.11g/cm²，正常受试者为1.08±0.18g/cm²，p<0.006）。治疗一年后，BMD值显著增加（LS：0.91±0.14g/cm²，p<0.0001；FN：0.97±0.11g/cm²，p<0.0001）。7名未接受治疗的DP年轻男性的BMD值仍显著低于正常水平（LS：0.82±0.08g/cm²，p<0.008；FN：0.89±0.05g/cm²，p<0.04）。在IHH患者中，QBS值与正常对照组无显著差异。LS和FN的BMD值均显著较低（p<0.0001和p<0.001）。治疗后，IHH患者的BMD值仍显著低于正常水平（LS：p<0.009；FN：p<0.006）。