老年男性慢性阻塞性肺疾病患者并发骨质疏松症与血清睾酮水平的关系

Relationship between elderly male chronic obstructive pulmonary disease patients complicated with osteoporosis and serum testosterone level

目的探讨老年男性慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)并发骨质疏松症患者血清睾酮水平的变化及其与病情严重程度的相关性。方法选取2015年1月至12月入院的117例稳定期老年男性COPD患者,并选择同期入院的非COPD患者40例为对照组。根据骨密度(bone mineral density,BMD)病情严重程度进行分组,比较不同组别之间血清睾酮水平,并分析其与患者病情严重程度相关指标的相关性。结果 COPD组患者的血清睾酮水平显着低于对照组;骨质疏松组患者的睾酮水平显着低于骨量正常组和骨量减少组、骨量减少组的睾酮水平显着低于骨量正常组,差异均有统计学意义(P<0.05);随着COPD病情的加重,血清睾酮水平下降越明显,差异有统计学意义(P<0.05);血清睾酮水平与患者的一秒用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)和FEV1%Pre呈正相关(r=0.267、0.291,P=0.011、0.009),与吸烟指数(r=-0.405,P=0.005)、体质量指数(body maxx index,BMI)(r=-0.304,P=0.006)、CAT评分(r=-0.583,P=0.000)、腰椎BMD(r=-0.611,P=0.000)、股骨颈BMD(r=-0.382,P=0.002)均呈负相关关系。结论 COPD并发骨质疏松症患者血清睾酮水平下降显着,且随病情严重程度呈递减状态。检测睾酮水平在一定程度上有助于COPD并发骨质疏松症患者病情严重程度的判断。

Objective To investigate the changes of serum testosterone levels in elderly male chronic obstructive pulmonary disease（ COPD） patients complicated with osteoporosis and its correlation with the severity of the disease.Methods A total of 117 COPD patients and 40 non-COPD patients who were admitted to hospital from January 2015 to December 2015 were enrolled into this study. According to the bone mineral density（ BMD） and severity of illness,the patients were divided into different groups. The serum levels of testosterone were compared. The correlation of serum testosterone levels with the index of the severity was analyzed. Results The serum testosterone level in COPD patients was significantly lower than that of non-COPD patients（ P 0. 05）. In the COPD patients,the serum testosterone level in osteoporosis group was significantly lower than that of normal bone mass group and low bone mass group,and that of low bone mass group was significantly lower than normal bone mass group（ P 0. 05）. With the aggravation of COPD,the serum testosterone level decreased significantly（ P 0. 05）. The serum testosterone level was positively correlated to forced expiratory volume in one second（ FEV1）/forced vital capacity（ FVC）（ r =-0. 267,P = 0. 011）,FEV1%pre（ r =-0. 291,P = 0. 009）,and negatively correlated to smoking index（ r = 0. 405,P = 0. 005）,body mass index（ BMI）（ r =-0. 304,P = 0. 006）,CAT score（ r =-0. 583,P = 0. 000）,lumbar spine BMD（ r=-0. 611,P =0. 000）,and femoral neck BMD（ r =-0. 382,P = 0. 002）. Conclusions The serum testosterone level was significantly decreased in COPD patients complicated with osteoporosis. It was positively correlated to the severity of the disease. Detection of testosterone levels would help to assess of the severity of disease and prognosis of COPD.