75岁以上男性的骨密度、骨转换及激素水平

Bone density, bone turnover, and hormone levels in men over age 75.

作者信息

Kenny A M, Gallagher J C, Prestwood K M, Gruman C A, Raisz L G

机构信息

Department of Internal Medicine, University of Nebraska Medical Center and the Veterans Administration Medical Center, Omaha, USA.

出版信息

J Gerontol A Biol Sci Med Sci. 1998 Nov;53(6):M419-25. doi: 10.1093/gerona/53a.6.m419.

DOI:10.1093/gerona/53a.6.m419

PMID:9823745

Abstract

BACKGROUND

Osteoporosis is a substantial problem in older men, with 25% of all hip fractures occurring in men. The mechanisms of bone loss in older men are unknown, but elevated parathyroid hormone (PTH) and diminished testosterone (T) levels are postulated as contributing factors.

METHODS

We measured bone mineral density (BMD), sex hormones, bone turnover markers, and calcium regulating hormones in a group of community-living men over the age of 75.

RESULTS

Thirty-five men (mean age 79; range 75-88 years) without disease or medication known to affect bone metabolism participated in the study. Whole body BMD was 1.21+/-.15 g/cm2; lumbar spine BMD (L1-L4) was 1.10+/-.15 g/cm2; femoral neck BMD was .77+/-.14 g/cm2; and trochanteric region was .71+/-.13 g/cm2. The femoral neck and trochanteric region values were more than 1 SD below the mean for adult men (age 25-33 years) in 28/35 and 15/35 men, respectively. Deoxypyridinoline levels were above the normal range for premenopausal women in 23% of the men; N-telopeptide and C-telopeptide demonstrated a wide scatter, but the values remained in the normal range. T levels were found to be below normal range for adult men in 12 of 32 (38%) subjects and the PTH levels above the normal range in 8 of 35 (23%) subjects. Bone resorption markers correlated inversely with BMD of the whole body, femur, and spine (r=-.22 to -.48). There was an inverse correlation between total T and spine BMD which became insignificant after correcting for body mass index (BMI). In addition, there was no correlation between free or bioavailable testosterone and BMD. 1,25-(OH)2D levels correlated inversely with BMD at the femur and whole body, but no association was found with PTH or 25 OH-D.

CONCLUSIONS

Men over 75 years of age had a wide range of BMD but frequently had low values at femoral sites. T levels were below the normal range in 38% of men, and PTH levels were elevated in 23% of men. There was an inverse correlation between total T and spine BMD which may have been dependent on the common effect of BMI. Bone mineral density was inversely related to markers of bone resorption.

摘要

背景

骨质疏松症在老年男性中是一个严重问题，所有髋部骨折中有25%发生在男性身上。老年男性骨质流失的机制尚不清楚，但甲状旁腺激素（PTH）升高和睾酮（T）水平降低被认为是促成因素。

方法

我们测量了一组75岁以上社区居住男性的骨矿物质密度（BMD）、性激素、骨转换标志物和钙调节激素。

结果

35名（平均年龄79岁；范围75 - 88岁）无已知影响骨代谢疾病或药物治疗的男性参与了研究。全身骨密度为1.21±0.15g/cm²；腰椎骨密度（L1 - L4）为1.10±0.15g/cm²；股骨颈骨密度为0.77±0.14g/cm²；转子区为0.71±0.13g/cm²。28/35和15/35的男性，其股骨颈和转子区的值分别比成年男性（25 - 33岁）的平均值低1个标准差以上。23%的男性脱氧吡啶啉水平高于绝经前女性的正常范围；N - 端肽和C - 端肽呈广泛离散，但值仍在正常范围内。32名受试者中有12名（38%）的T水平低于成年男性的正常范围，35名受试者中有8名（23%）的PTH水平高于正常范围。骨吸收标志物与全身、股骨和脊柱的骨密度呈负相关（r = -0.22至 -0.48）。总T与脊柱骨密度之间存在负相关，在校正体重指数（BMI）后变得不显著。此外，游离或生物可利用睾酮与骨密度之间无相关性。1,25 -（OH）₂D水平与股骨和全身的骨密度呈负相关，但未发现与PTH或25 - OH - D有关联。