健康老年男性不同骨量、骨代谢生化指标及其他相关因素的初步研究

An elementary study of bone metabolic biochemical markers and other related factors under different bone mineral content in the elder healthy men

目的 观察健康老年男性不同骨量、骨代谢生化指标及其他相关因素的变化 ,以探讨原发性男性骨质疏松症 (OP)的发病机制。方法 6 0例健康老年男性按照宽波段超声衰减 (BUA)值分成骨量正常组 (A组 )、骨量减少组 (B组 )和骨质疏松组 (C组 )。采用酶联免疫吸附法 (ELISA)测定各种骨形成及骨吸收的生化标志物 ,采用放射免疫分析法 (RIA)测定血清雌二醇 (E2 )、睾酮 (T)、卵泡刺激素 (FSH)、黄体生成素 (LH)。结果 B、C两组分别与A组比较 ,吡啶酚 (PYD)、脱氧吡啶酚 (DPD)明显升高 ,而骨钙素 (BGP)仅在C组明显升高。C组分别与A、B两组比较 ,体重、体重指数 (BMI)、E2 、T明显下降 ,而FSH、LH明显升高 ,且E2 在B组明显下降。直线相关分析显示 ,BUA与BMI、体重、E2 、T呈正相关 (r分别为 0 .387、0 .2 89、0 .4 5 5、0 .2 97,P <0 .0 5 ) ,多元逐步回归分析显示 ,BUA与BMI、E2 相关 (P分别为 0 .0 1、0 .0 16 ) ,回归方程为Y =3.14 9+0 .6 6 5X1+8.916×10 -2 X2 。结论 原发性男性OP的骨吸收生化标志物明显升高 ,骨形成指标轻度升高 ,属高转换型 ;雌、雄激素下降 ,尤其是前者的下降可能是其主要发病机制 ;低体重是原发性男性OP的危险因素之一。

Objective To explore the relationship between bone metabolic biochemical markers and other related factors under different bone mineral contents in the elder healthy men. Methods 60 elderly healthy men were divided into three groups, 20 with normal bone density(Group A), 20 with osteopenia(Group B) and 20 with osteoporosis(Group C ),according to broadband ultrasound attenuation(BUA). Markers of bone formation and resorption were measured by enzyme linked immunosorbent assay(ELISA). The serum estradiol (E 2),free testosterone(T), lutinizing hormone (LH)and folliclular stimulating hormone (FSH) were measured by radioimmunoassay(RIA). Body height and weight were also measured. Results Pyridinodine(PYD)and Deoxypyridinoline(DPD) were significantly increased in Group C and B comparing with A,but Osteocalcin(BGP) was only apparently elevated in Group C. Weight , Body mass index(BMI), E2 ,T were significantly decreased in Group C comparing with Group A and B,whereas LH and FSH were significantly increased. E 2 was also significantly decreased in Group B comparing with A. Linear regression analysis showed that BUA was positively correlated with BMI,weight,E 2 and T ( r=0.387, P<0.01; r=0.289, P<0.05;r=0.455, P<0.01; r=0.297, P <0.05).Multple stepwise regression analysis showed that BUA was correlated with BMI and E 2 ( P =0.01, 0.016 individually). Conclusion Bone formation and resorption markers were all elevated in primary male osteoporosis,especially the latter. The predominant pathogene mechanism may be the decreased estrogen and testosterone. Low weight may be one of risk factors in primary male osteoporosis.