绝经后血清FSH、LH和E_2水平与骨代谢指标的关系

Correlation of serum FSH,LH,E_2 and bone metabolic indicators:a study in postmenopausal women

目的：分析绝经后妇女促卵泡激素（FS H ）、促黄体生成素（L H ）和雌二醇（E2）与骨代谢指标的关系，为骨质疏松诊断和治疗提供参考。方法选取中国医科大学附属盛京医院门诊和住院就诊绝经后患者220例。通过罗氏Cobas 8000对血钙（Ca）、碱性磷酸酶（ALP）、甲状旁腺素（PTH）、β‐胶原降解产物（β‐Crossl）、N‐端骨钙素（N‐Osteoc）、总Ⅰ型前胶原氨基末端前肽（TPINP）进行检测，利用美国Beckman DXI‐800对FSH、LH、E2进行检测。结果绝经后妇女 FSH、LH和 FSH／LH与N‐Os‐teoc、TPINP呈正相关（P＜0．05），且FSH／LH和E2也与β‐Crossl呈正相关（P＜0．05）。其中FSH／LH与TPINP的相关系数最高（r＝0．341）。经多元线性回归分析发现血清FSH和FSH／LH作为自变量可解释各种骨转换生化指标水平变化的百分比范围分别为0．5％～6．6％，1．1％～30．9％，FSH／LH作为自变量可解释各骨转换指标水平变化的百分比最大，而 LH仅为0．4％～2．3％。经多元Logistic回归分析显示年龄、FSH、FSH／LH、TPINP为绝经后骨质疏松的独立危险因子。以 FSH＝46．36和FSH／LH＝2．09为临界值能有效诊断绝经后骨质疏松。结论绝经后妇女血清FSH、LH和FSH／LH水平随骨转换指标升高而升高。联合应用FSH和FSH／LH诊断绝经后骨质疏松均高于单独应用FSH或FSH／LH的诊断效能。

Objective To analyze the correlation of serum follicle‐stimulating hormone（FSH） ,luteinizing hormone（LH） ,estra‐diol（E2 ） and bone metabolic indicators in postmenopausal women ,and to provide the reference for the diagnosis and treatment of osteoporosis .Methods A total of 220 postmenopausal women with osteoporosis from May 2010 to October 2012 were collected . Blood calcium （Ca） ,alkaline phosphatase （ALP） ,parathyroid hormone （PTH） ,β‐Crosslaps （β‐Crossl） ,N‐MID Osteocalcin （N‐Os‐teoc） and total N‐terminal propeptide of type I collagen （TPINP） were detected by Cobas 8000 analyzer ,and FSH ,LH and E2 were measured by DXI‐800 analyzer .Results FSH ,LH and FSH/LH were positively correlated with N‐Osteoc and TPINP（P〈0 .05） , meanwhile ,FSH/LH and E2 were also positively correlated with β‐Crossl（P〈0 .05） .The correlation coefficient of FSH/LH and TPINP were the highest （r=0 .341） .Multiple linear regression analysis showed that the changes of bone metabolic indicators ex‐plained by effects of serum FSH and FSH/LH accounted for 0 .7% to 6 .6% ,1 .1% to 30 .9% ,respectively .And the percentage of serum FSH/LH which explained the changes of bone metabolic indicators was the highest ,while that of LH was only about 0 .4%to 2 .3% .Logistic regression analysis showed that age ,FSH ,FSH/LH and TPINP were independent risk factors of postmenopausal osteoporosisis .The critical values of FSH and FSH/LH to diagnose postmenopausal osteoporosisis were 46 .36 and 2 .09 ,respec‐tively .Conclusion With the increasing of the levels of bone metabolic indicators ,serum FSH ,LH and FSH/LH levels are also increasing . The combined detection of FSH and FSH/LH has higher value than single indicator in the diagnosis of postmenopausal osteoporosisis .