围绝经期和绝经后女性雌二醇和卵泡刺激素水平与骨密度的关系

The relationship between estradiol and follicle stimulating hormone with bone mineral density in pre- and postmenopausal women

目的研究围绝经期女性血清雌二醇(E2)及卵泡刺激素(FSH)变化规律及其与腰椎、髋部、股骨颈骨密度(bone mineral density,BMD)之间的关系。方法采用化学发光法测定402例就诊于北京友谊医院妇产科更年期门诊的40～65岁健康中国汉族女性早卵泡期或绝经后任意时期空腹血清E2和FSH水平,并采用双光能X线DXA测定其腰椎、总髋部、股骨近端BMD,分析血清E2和FSH与BMD的关系。结果低骨量组血清FSH水平显著高于正常组(P<0.05),E2水平显著低于正常组(P<0.05)。E2与BMD变化呈正相关(r=0.017～0.42,P<0.05);FSH与BMD变化呈负相关(r=-0.012～-0.94,P<0.05)。绝经后低骨量组FSH高于正常组,而E2无明显变化。结论血清E2和FSH水平与绝经前后妇女的BMD有关,绝经后FSH与BMD进一步丢失有关,而低水平雌激素可能不再是继续影响骨量的主要因素。

Objective To study the relationship of estradiol （F-e） and follicle stimulating hormone （FSH） with lumbar, femoral neck and hip bone mineral density （BMD） in pre- and post-menopausal women. Methods To measure the concentration of fasting plasma estradiol and FSH during early follicular stage or any time after meno- pause in 402 pre - and postmenopausal women aged 40 to 65 years old in the morning who came to climacteric clinic in the Beijing Friendship Hospital. Lumbar, femoral neck and hip BMD was also measured. Results Elevated FSH and decreased estradiol were observed in patients with osteopenia than normal subjects （P〈0. 05）. FSH was negatively correlated with BMD, especially with lumbar BMD. Estrodiol was positively correlated with BMD and the correlation coeffeciency was 0. 017-0. 42 （P%0. 05）. FSH was negatively correlated with BMD and the correlation coeffeciency was -0. 012-0. 94 （P〈0. 05）. E2, femoral neck and hip BMD decreased significantly after 55years while lumbar BMD decreased after 50years. As for the premenopausal women, E2 deereased and FSH elevated significantly, while the lumbar BMD decreased only after 55years. Conclusions Plasma estradiol and FSH was related to BMD of pre - and postmenopausal women. FSH was related to BMD in postrnenopausal women but estradiol couldn＇t affect BMD any more.