老年男性血清睾酮水平与骨量及骨代谢的关系

Relationships of Serum Testosterone Levels between Bone Mass and Bone Metabolism

目的探讨老年男性血清睾酮(TT)水平与骨质疏松(OP)及骨代谢的关系.方法选取53名健康老年男性.使用DXEA骨密度检测仪测量腰椎(L2～4)、股骨上端(Femneck、Trock、Wards)骨量,并分别计算腰椎、股骨T值,分成腰椎、股骨、腰椎-股骨综合评判组,以T≤-2.0 SD为标准分成OP和非骨质疏松(NOP)两组.用ELLES放免法检测TT、雌二醇(E2);以TT 13 nmol/L为标准,分为TT正常组和TT不足组.用试剂盒测定血清骨钙素(BPG),尿1型胶原纤维N端多肽(NTX)及C端多肽(CLP).应用SPSS10.0软件进行分析.结果(1)股骨组OP与NOP之间TT比较有统计学意义(P＜0.05),其余各组OP与NOP之间TT、E2水平未见明显差异.(2)TT正常组与TT不足组在血清BPG、尿CLP、股骨T值及Femneck、Trock、Wards部位骨密度值比较均有统计学意义(P＜0.05).结论老年男性TT水平绝对或相对不足可能通过抑制骨合成、增强骨吸收等多方面使骨量逐渐丢失,这种影响似乎对股骨更明显.

Objective To investigate the relationships between the levels of total testostorone （TT） and osteoporosis（OP） as well as bone metabolism in eider men. Methods Bone mineral density（BMD） in lumbar spines（L2-4）, and hip（femneck, trock, wards） were measured by dual energy X-ray absorptiometry （DEXA） in 53 heathly elderly men. The T score were also calculated. The 53 men were divided into OP and no osteoporosis（NOP） group according to the standard of T≤-2.0 SD of lumbar, thighbone and lumbar-thighbone. TT and estradiol（Fa） were determined by RIA. It were divided into normal androgen and androgen deficiency group according to the standard of TT 13 nmol/L. Serum osteocalcin（BPG）, N-terminal telopeptide of type I collagen（NTX）, C-terminal telopeptide of type I collagen（CLP） were measured by ELLSA. Results （1）There was significantly difference of the level of TT between OP and NOP group of thighbone; there was no significantly difference of the level of TT between OP and NOP group of lumbar and lumbar-thighbone. （2）There were significantly differences in serum BPG, urine CLP, T score of thighbone and BMD of femoral bone（points of Femneek, Trock, and Wards） between normal TT and TT deficiency group. Conclusion utterly or relatively deficiency of TT may cause bone mass lose gradually by restraining bone formation, boosting up bone absorb and other aspects. Such effection seems more evident in thighbone group.