河南省东北部地区男性血清性激素与骨转换标志物的相关性分析

Association of sex hormones and bone turnover markers among men in the Northeast region of Henan Province

目的探讨不同年龄段成年男性血清性激素水平与骨转换标志物的相关性。方法2015年12月至2016年3月,采用多阶段分层整群随机抽样法从甲状腺疾病、碘状态和糖尿病全国调查(TIDE)研究河南分中心调查队列中抽取707名男性受试者进行横断面调查,采集空腹静脉血测定黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇、总睾酮、硫酸脱氢表雄酮(DHEAS)、雄烯二酮(AD)、性激素结合球蛋白(SHBG)、双氢睾酮(DHT)、游离睾酮(FT)、血清骨钙素、总I型胶原氨基端前肽(PINP)、β-I型胶原交联羧基末端肽(β-CTX)、25-羟维生素D[25(OH)D]和甲状旁腺素(PTH)水平。结果本研究最终纳入697名男性受试者,平均年龄为(46.6±15.9)岁。Pearson相关分析结果显示,年龄与LH、FSH、睾酮、SHBG呈正相关,与雌二醇、DHEAS、AD、FT、β-CTX、骨钙素和PINP呈负相关,与DHT、25(OH)D和PTH无明显相关性。Pearson相关分析和线性回归分析结果显示,雌二醇与骨吸收标志物β-CTX呈负相关;睾酮与骨形成标志物骨钙素呈正相关,FSH与其呈负相关;LH、FSH、SHBG与骨形成标志物PINP呈负相关,雌二醇、睾酮、FT、DHT、AD与其呈正相关。校正年龄和体重指数后,线性回归分析结果显示睾酮仍与骨钙素和PINP呈明显正相关,睾酮每增加1 ng/ml,骨钙素和PINP分别增加0.302 ng/ml和0.015 ng/ml;雌二醇、DHT与PINP呈明显正相关,雌二醇和DHT每增加1 pg/ml,PINP分别增加0.250 ng/ml和0.047 ng/ml。结论年龄是性激素和骨转换标志物的影响因素,血清睾酮、雌二醇和DHT水平与骨形成、骨吸收指标有关。

Objective To examine associations of sex hormone levels with bone turnover markers(BTMs)among men in the Northeast region of Henan Province.Methods From December 2015 to March 2016,707 male subjects were selected from a National Epidemiological Survey-2014(Thyroid Disorders,Iodine status and Diabetes,TIDE)research—Henan sub-center survey by using multistage stratified cluster random sampling.Fasting venous blood was collected to determine the levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2),testosterone(T),dehydroepiandrosterone-sulfate(DHEAS),androstenedione(AD),sex hormone binding globulin(SHBG),dihydrotestosterone(DHT),free testosterone(FT),osteocalcin(OC),pro-collagen type 1 N-terminal propeptide(PINP),C-terminal-cross-linking telopeptide of type 1 collagen(β-CTX),25-hydroxyvitamin D[25(OH)D],and parathyroid hormone(PTH).Results A total of 697 men with an average age of(46.6±15.9)years were included in the study.Pearson correlation analysis showed that age was positively associated with LH,FSH,T,and SHBG,while negatively associated with E2,DHEAS,AD,FT,β-CTX,OC,and PINP,without significant correlation with DHT,25(OH)D,and PTH.Pearson correlation analysis and linear regression analysis showed that E2 was negatively associated withβ-CTX;T was positively associated with OC,FSH was negatively associated with OC;LH,FSH,and SHBG were negatively associated with PINP;E2,T,FT,DHT,and AD were positively associated with PINP.After adjusting for age and BMI,linear regression analysis showed that T was still significantly positively associated with OC and PINP,with 0.302 ng/ml and 0.015 ng/ml increasing for OC and PINP every 1 ng/ml increase in T;E2 and DHT were positively associated with PINP,with 0.250 and 0.047 ng/ml increasing for PINP every 1 pg/ml increase in E2 and DHT.Conclusions Age is an important factor influencing sex hormones and BTMs.Serum levels of T,E2,and DHT are associated with bone formation and bone absorption markers.