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目的:探讨女性性激素水平与骨代谢指标的关系。方法:202例女性按年龄分为<40、40~49、50~59、60~69、≥70岁组,用化学发光法测定血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(TES)和骨钙素(OC)、I型胶原羟基端肽β特殊序列(β-CTX)、I型前胶原氨基端前肽(PINP)。比较各组间性激素水平与骨代谢指标的差异,并进一步分析其相关性。结果:血清FSH和LH随年龄增长而升高,50岁以后达高峰;E2随年龄增长而降低,50岁以后各年龄组显著低于49岁以下年龄组(P<0.05);血清OC、β-CTX、PINP随年龄增长而升高,50岁以后各年龄组显著高于49岁以下年龄组(P<0.05)。校正年龄后,血清FSH、LH与OC、β-CTX呈显著正相关,E2与β-CTX呈显著负相关(均P<0.01)。将FSH、LH、E2水平由低到高分成四等分组,随着FSH、LH的递增,OC、β-CTX逐渐递增;随着E2水平的递增,β-CTX逐渐递减(趋势P均<0.05)。多元线性回归分析显示,FSH与β-CTX独立正相关(β=0.218,P=0.033),LH与OC独立正相关(β=0.322,P=0.004),而E2与OC、β-CTX、PINP均未见独立相关性。结论:女性骨代谢与循环中性激素水平变化有关,其主要影响因素可能是FSH、LH水平的增加,雌激素水平的下降可能起次要作用。
Objective: To investigate the relationship between female sex hormone levels and bone metabolism indexes. Methods: 202 women were divided into groups <40,40 ~ 49,50 ~ 59,60 ~ 69, ≥70 years old by chemiluminescence method for the determination of serum FSH, LH, (E2), testosterone (TES) and osteocalcin (OC), type I collagen β-terminal special peptide (β-CTX) and type I procollagen amino terminal propeptide (PINP). The differences of sex hormone levels and bone metabolism index between the groups were compared and their correlations were further analyzed. Results: Serum FSH and LH increased with age and peaked after 50 years of age. E2 decreased with age, and were significantly lower in all age groups after 49 years of age than those under 49 years of age (P <0.05) -CTX, PINP increased with age, after 50 years of age groups was significantly higher than 49 years of age (P <0.05). Serum FSH, LH and OC, β-CTX showed a significant positive correlation after age correction, and E2 was negatively correlated with β-CTX (all P <0.01). The levels of FSH, LH and E2 were divided into four groups from low to high. With the increasing of FSH and LH, OC and β-CTX gradually increased. With the increasing of E2, the β-CTX gradually decreased (all P <0.05 ). Multivariate linear regression analysis showed that FSH was positively correlated with β-CTX (β = 0.218, P = 0.033), LH was positively correlated with OC (β = 0.322, P = 0.004) No independent correlation was found. CONCLUSION: The bone metabolism in women is related to the changes of circulating levels of sex hormones. The main influencing factors may be the increase of FSH and LH levels and the decrease of estrogen levels may play a secondary role.