雌激素与骨量的定量关系研究

Quantitive analysis on the relation between estrogen and bone mass

目的 探讨雌激素与骨量变化的定量关系。方法 选择 45例腰椎退行性变患者 ,按绝经与否分为两组 :绝经前妇女、绝经后妇女组。选择 5 0例年龄、绝经与否与实验组相匹配的健康人 ,分为相应对照组。测定血清雌二醇 (E2 )、睾酮 (T) ,并计算E2 T比值。骨代谢测定血清骨钙素 (BGP)和尿Ⅰ型胶原C末端肽 (Crosslaps)。并测量患者腰椎的骨密度。结果 腰椎退行性变患者绝经前妇女组血清E2水平低于对照组 ,差异有显著性 (P <0 .0 5 ) ;血清T、BGP水平 ,E2 T比值与对照组比较差异无显著性 (P均 >0 .0 5 )。绝经后妇女患者组血清E2 、T水平低于对照组 (P均 <0 .0 1) ;血清BGP水平、E2 T比值比对照组升高 (P <0 .0 5 ,P <0 .0 1)。绝经前、绝经后妇女、尿Crosslaps水平与相应对照组相比均明显升高 (P <0 .0 5 ,P <0 .0 1,P <0 .0 5 )。腰椎退行性变绝经后妇女患者组E2与Crosslaps直线负相关 ,相关系数r分别为 -0 .5 6,-0 .41(P <0 .0 1,P <0 .0 5 )。绝经前妇女患者组E2 与Crosslaps未发现有相关性。

Objective To investigate the relation between estrogen and bone mass.Methods 45 female patients with degeneration of lumbar spine (DLS) were selected in the study.According to menopause condition,they were divided into two groups:premenopausal group and postmenopausal group.50 healthy subjects were selected and divided into two corresponding control groups.The levels of serum estradiol (E 2) and testosterone (T) were tested by RIA,and E 2/T ratio was calculated.The levels of serum BGP and urine crosslaps were measured by ELISA.Results The serum E 2 level of premenopausl patients with DLS were obviously lower than that of control group,and there was a significant difference between the two groups (P<0.05),while there were no significant differences in the serum T,BGP and E 2/T ratio between two groups (P>0.05).The levels of E 2 and T of postmenopausal patients were lower than those of control group (P<0.01),but the BGP levels and E 2/T ratio were significantly increased (P<0.05,P<0.01).There was a negative liner correlation between E 2 and crosslaps of postmenopausl patient group.There was no correlation between E 2 and crosslaps of premenopausal group.Conclusion The level of estrogen is closely related with bone mass.