女性血清FSH和LH与骨转换生化指标的关系

The relationships among serum FSH,LH and biochemical markers of bone turnover in women

目的了解女性卵泡刺激素(FSH)和黄体生成素(LH)水平的变化与各种骨转换生化指标之间的关系。方法健康女性694例,年龄20～82岁。放射免疫法测定血清FSH和LH,ELISA测定血清骨特异性碱性磷酸酶(BAP)、骨钙素(OC)、骨Ⅰ型胶原N末端肽(sNTX)和C末端肽(sCTX)、尿骨Ⅰ型胶原N末端肽(uNTX)和C末端肽(uCTX)、尿骨Ⅰ型胶原交联脱氧吡啶酚(uDPD)。结果血清FSH和LH与BAP、OC、sCTX、uNTX和uDPD之间的关系,采用复合曲线模型拟合优度最佳,与sNTX和uCTX之间的关系采用线性模型拟合优度最佳,FSH和LH与BAP(R2=0.392和0.382,P=0.000)之间的决定系数最大,与uDPD(R2=0.027和0.017,P=0.002)之间的决定系数最小。多元线性回归分析显示,BAP43.0%、OC22.1%、uCTX11.8%、sNTX8.2%、uNTX8.2%、sCTX6.6%和uDPD1.9%的变化是由FSH决定的,LH只能解释0.7%～2.1%的变化,FSH对各种骨转换指标的决定性作用大约是LH的7～20倍。结论女性FSH和LH水平与骨转换速率有关,血清FSH和LH水平增加者骨转换增加,FSH对骨转换的作用远大于LH,对骨形成指标的作用远大于骨吸收指标。

Objective To learn the relationships among changes of the levels of follicle-stimulating hormone （FSH） and luteinizing hormone （LH） , and varied kinds of hone turnover markers in women. Methods Six hundred and ninety-four healthy women aged 20-82 years old were included. Serum FSH and LH were measured using RIA. BAP, OC, sNTX, sCTX, uNTX, uCTX, and uDPD were measured using ELISA. Results The relationships among serum FSH, LH, BAP, OC, sCTX, uNTX, and uDPD were analyzed using a compound model for goodness-of-fit. The relationship between uCTX and sNTX was analyzed using a linear model for goodness-of-fit. The determinant coefficients （R2） of serum FSH with BAP （R2 = 0. 392） and LH （R2 =0. 382） with BAP were the highest. The determinant coefficients of serum FSH with uDPD and LH with uDPD were the lowest （R2= 0. 027 and R2 = 0. 017, respectively）. Multiple linear stepwise regression analysis showed that the changes of BAP （43%）, OC （22.1%）, uCTX （ 11.8% ） , sNTX （ 8.2% ）, uNTX （ 8.0% ）, sCTX （6.6%） , and uDPD （ 1.9% ） were determined by FSH, while the effect of LH was only 0.7% -2. 1%. The determined value of serum FSH was 7-20 times more than that of serum LH in all bone turnover markers. Conclusion FSH and LH levels in women had close correlation with bone turnover rate. Bone turnover rate increased when serum FSH and LH levels elevated. The effect of FSH had much greater power than that of LH. Moreover, the effect of FSH on bone formation was much more than that on bone resorption.