老年男性骨密度与年龄和性激素关系的研究

目的 探讨老年男性骨密度与年龄和性激素之间的关系.方法 双能X线吸收测定法(DEXA)测定360例老年男性腰椎正位(L1～4)、股骨颈、股骨大转子、ward's三角区和股骨干的骨密度,化学发光法测定血清总睾酮和雌二醇.根据年龄和骨密度进行分值,比较不同骨密度老年男性年龄和性激素的差异.结果 360例中共检出骨质疏松者48例,骨密度减少者72例,非骨质疏松者240例.老年男性股骨颈、股骨大转子、Ward's三角区、股骨干的骨密度随年龄的增长而下降(F值分别为3.038,3.029,3.024,3.021,P<0.05),年龄大于80岁组股骨颈、股骨大转子、Ward's三角区、股骨干骨密度分别为(0.701±0.140)、(0.682±0.185)、(0.629±0.211)、(0.986±0.160)g/cm2;年龄大于70岁组分别为(0.829±0.156)、(0.765±0.170)、(0.698±0.187)、(1.042±0.190)g/cm2;年龄大于60岁组分别为(0.875±0.138)、(0.800±0.130)、(0.731±0.145)、(1.071±0.125)g/cm2,但L1～4的骨密度差异无统计学意义(F=2.988,P>0.05).骨密度正常、骨密度减低和骨质疏松组血清总睾酮水平差异无统计学意义(F=3.032,P>0.05),而血清雌二醇水平在骨密度正常、骨密度减低和骨质疏松组分别为(180.6±62.3)、(130.5±39.9)、(110.5±68.5)ρmol/L,随骨密度减少,血清雌二醇水平降低,且差异有统计学意义(F=3.059,P<0.05).结论 老年男性骨密度随年龄增加而下降,雌激素水平可能影响老年男性骨质疏松的发生.

Relationship of bone mineral density with age and sex hormone in elderly men

Objective To determine the relationship of bone mineral density (BMD) with age and sex hormone in elderly men. Methods The BMD in orthotope lumbar vertebra, femur neck, greater trochanter, Wards triangle region and shaft of femur were measured by dual-energy X-ray absorptiometry (DEXA), and serum testosterone (TT) and estradiol (E2) were determined by chemiluminescence in 360 elderly men. According to age and BMD, the elderly men were divided into several groups. The differences in BMD, serum TT and E2 among the groups were compared. Results There were 48 cases in osteoporosis group, 72 cases in bone mass reduction group and 240 cases in normal control group. The BMD in femur neck, greater trochanter of femur, Wards triangle region and shaft of femoral were decreased with ageing (F=3. 038,3. 029,3. 024,3. 021, respective, all P<0.05). In>80 age group, the BMD in femur neck, greater trochanter of femur, Wards triangle region and shaft of femoral were (0. 70±0. 140), (0. 682±0. 185), (0. 629±0.211), (0. 986± 0. 160)g/cm2, respectively;In 70-80 age group, they were (0. 829±0. 156), (0. 765±0. 170), (0. 698±0.187), (1. 042±0. 190) g/cm2, respectively;In 60-70 age group, they were (0. 875± 0. 138), (0. 800±0. 130), (0. 731±0. 145), (1. 071±0. 125)g/cm2, respectively. The differences in BMD of L1-4 had no statistical significance among different age groups(F=2. 988, P>0.05). There was no difference in level of serum TT among normal control group, bone mass reduction group an dosteoporosis group (F=3. 032, P>0. 05), while the level of serum E2 in the three groups were (180. 6±62. 3), (130. 5±39.9) pmol/L and (110. 5±68. 5) pmol/L, respectively. Bone mass was decreased with the decreased serum E2 level(F=3. 059,P<0. 05). Conclusions BMD is declined with ageing, and the level of serum E2 may affect the occurrence of osteoporosis in elderly men.