雄激素对维持性血液透析男性骨质疏松的影响

The impact about androgen upon osteoporosis of hemodialysis man

目的探讨雄激素水平在维持性血液透析（MHD）男性患者骨质疏松发生中的作用。方法将100例MHD男性患者按有／无骨质疏松分观察（A，50例）组与对照（B，50例）组，两组患者均检测血清睾酮（T）、雌二醇（E2）、骨形态发生蛋白-2（BMP-2）、胰岛素样生长因子-1（[GF-1）、甲状旁腺素（PTH）及血钙（Ca）水平，同时用定量CT（QCT）测定腰椎骨密度（8MD）。并以T、BMP-2、IGF-1水平对骨质疏松的诊断绘制ROC曲线。结果观察组血清T、BMP-2、IGF-1水平均低于对照组（P〈0．01）；E2、PTH和Ca水平两组间无显著差异（P=0．643、0．795、0．744）；直线相关分析：观察组T、BMP-2、IGF-1与BMD均呈正相关（r=0．998、0．913、0．972，P〈0．01）。ROC曲线示：T、BMP-2、IGF-1与MHD男性BMD值关系密切。结论血清T水平下降是MHD男性患者骨质疏松发生的-个主要因素，且可以通过提高BMP-2、IGF-1水平而促进骨质疏松的发生。T、BMP-2、IGF—1是监测MHD男性患者骨质疏松的有效指标。

Objectives To explore the role of androgen levels in male patients with osteoporosis occur in maintenance hemodialysis （MHD）. Methods One hundred men who had been undergoing maintenance hemodialysis were divided into observation group （A, 50 ） and control group （B, 50 ） according to whether they had/didn have osteoporosis. Both groups were detected levels of T, E2, BMP -2, IGF -1, PTH,Ca;And drew ROC curve of osteoporosis diagnosis on the basis of T, BMP - 2, IGF - 1 level. Results The observed serum T, BMP - 2, IGF - 1 levels were lower than those in the control group （ P 〈 0.05 ）, there was no significant difference of E2, PTH, Ca levels between two groups （ P = 0. 643,0. 795,0. 744 ） ; Linear correlation analysis revealed ： T, BMP - 2, IGF - 1 had positive correlation of BMD value, （r =0. 998, 0. 913, 0. 972, P 〈0, 01 ）. ROC curves revealed： T, BMP -2, IGF - 1 had close correlation of BMD value of men with maintenance hemodialysis. Conclusions Reduction in the level of serum T is a major factor in the maintenance hemodialysis man with osteoporosis occur, The level of serum T can regulation of BMP -2, IGF - 1 level and promote the occurrence of osteoporosis. The level of serum T, BMP - 2, IGF - 1 is a valid indicator of the monitoring of MHD male patients with osteoporosis.