性激素及性激素结合球蛋白与老年男性骨转换标志物的相关性

Correlations of sex steroids and sexhormone binding globulin with bone turnover markers among Chinese elderly men

目的探讨老年男性人群骨转换标志物(BTMs)和性腺激素随增龄的变化趋势,以及性腺激素与BTMs的关系。方法收集年龄60至91岁、门诊常规查体人群337例进行单中心横断面研究。收集空腹血测定血清骨钙素(OC)、1型胶原交联C-末端肽(CTX)、1型原胶原N-端前肽(P1NP)、25-羟维生素D(25OHD)、甲状旁腺激素(PTH)、总睾酮(TT)、雌二醇(TE2)、性激素结合球蛋白(SHBG)、卵泡刺激素(FSH)、黄体生成素(LH)及血钙磷;用Vermeulen公式计算游离睾酮(FT)。按每5岁1个年龄段分组,用一般线性模型方差分析比较各年龄组间骨转换标志物及各性腺指标的差异。用多元线性回归分析与骨转换标志物相关的因素。P<0.05表示差异有统计学意义。结果随年龄增长,OC、CTX和P1NP均呈下降趋势,FSH、LH、SHBG呈升高趋势,校正年龄、肝肾功能、体重指数、血钙磷、PTH、Vit D后,性腺指标中仅SHBG与各BTMs明显相关。结论年龄是BTMs的影响因素,SHBG是BTMs的独立影响因子,其通过直接或间接方式影响骨代谢。

Objective To investigate the age-related changes of the levels of bone turnover markers （BTMs） and correlations of sex steroids and sex hormone binding globulin （SHBG） with BTMs in Chinese elderly men. Methods We conducted a cross-sectional study of 337 men aged 60 -91 years who were collected from outpatients. Serum osteo- calcin （OC）, cross linked C-telopeptide of type 1 collagen （CTX）, amino-terminal propeptide of type I collagen （ P1 NP）, 25-hydroxy-vitamine D （ 25OHD）, parathyroid hormone （ PTH）, total testosterone （ TF）, estradiol （ TE2 ）, SHBG, follicle-stimulating hormone （FSH）, luteinizing hormone ~LH） were tested. Free testosterone （FT） was calcu- lated using Vermeulen＇s formula. Differences of BTMs among various age groups were analyzed by the general linear model covariance. Linear regression analysis was used for association analyses multiple factors and BTMs. Results OC, CTX and P1 NP decreased with age. SHBG was positively correlated with OC, CTX and P1NP, which was independent of age and sex steroids. Conclusion Aging is an important factor influencing BTMs. SHBG is an independent factor of BTMs and it may affect directly or indirectly on bone metabolism.