老年男性代谢综合征患者血睾酮水平与骨密度及骨转换指标的相关性研究

The correlation between serum testosterone and bone mineral density and bone turnover markers in aged male patients with metabolic syndrome

目的分析老年男性代谢综合征(MS)患者血睾酮(T)水平与骨密度(BMD)及骨转换指标之间的相互关系。方法收集60～90岁老年男性111例,分为MS组(61例)和非MS组(50例)。测定T、N-MID骨钙素(N-MID-OC)、总I型胶原氨基端延长肽(PINP)、血清β-胶原特殊系列(β-CTX)水平,同时使用双能X线骨密度测量仪测量左前臂、左髋部及腰椎的BMD,分析血清T水平与BMD及骨转换指标的相关性。结果 MS组的T、N-MID-OC、PINP、腰椎、髋骨及桡骨BMD水平均低于非MS组(P<0.05),β-CTX高于非MS组(P<0.05),且随着MS组分的增加,血T、N-MID-OC、PINP水平及腰椎、髋部、桡骨BMD平逐渐下降,β-CTX逐渐增高,差异有统计学意义(P<0.05)。相关性分析表明:血清T与N-MID-OC、PINP及腰椎、髋部、桡骨BMD呈正相关,与β-CTX水平呈负相关(P<0.05)。结论老年男性MS患者中血T水平与BMD及骨转换指标密切相关,低T水平可作为老年男性骨质疏松(OP)的预测因子。

Objective To investigate the relationship between serum testosterone（T）levels and parameters of bone mineral density（BMD）and bone turnover markers in aging male patients with metabolic syndrome（MS）.Methods One hundred and eleven aged 60-90 years male patients were divided into two groups,namely MS group（sixty-one）and non-MS group（fifty）.Serum T,N-MID-Osteocalcin（N-MID-OC）,total type I collagen N-terminal extension peptide（PINP）,serum β-collagen special series（β-CTX）levels were measured,and left forearm,left hip and lumbar vertebrae BMD were detected by dual energy X-ray densitometer.The relationship between T levels and parameters of BMD and bone turnover markers was analysed.Results T,N-MID-OC,PINP,left forearm BMD,left hip BMD,lumbar vertebrae BMD levels were lower andβ-CTX level were higher in MS group than those in non-MS group（P0.05）.As the increase of MS contents,serum T,N-MID-OC,PINP levels and lumbar vertebrae BMD,hip BMD,forearm BMD decreased gradually,and β-CTX level increased.In MS group,there were significant positive correlation respectively between the levels of T and N-MID-OC,PINP,lumbar vertebrae BMD,hip BMD,forearm BMD.There was a negative relationship between the levels of serum T and β-CTX.Conclusion Serum T level is closely related to BMD and biochemical markers of bone turnover in aged male patients with metabolic syndrome.Lower serum T level may be an the independent factor for osteoporosis in aged men.