加载中........
×

JCEM:围绝经期骨吸收增加与体重指数呈负相关

2013-5-27 作者:JCEM   来源:dxy 我要评论0

为了描述最后一次月经期(FMP)、生殖激素、体重指数(BMI),以及种族相关的骨吸收变化,来自美国波士顿麻省总医院内分泌科的Joel S Finkelstein教授及其团队进行了一项研究,该研究发现在绝经过渡期,在FMP前约2年,卵巢功能开始下降,紧接着骨吸收和随后的骨丢失增加。骨吸收增加的量与BMI成负相关。校正BMI后,种族差异在骨吸收变化中的作用被减弱,但没有消失。BMI的种族差异,以及相应的骨吸收种族差异,似乎大部分归因于围绝经期骨丢失的种族差异。该研究结果在线发表在2013年5月10日的美国《临床内分泌代谢杂志》(The journal of clinical endocrinology & metabolism)上。

该研究中,在918例女性非裔美国人、中国人、日本人或白种人,跨越绝经过渡期的长达8年期间,每年一次测量尿Ⅰ型胶原氨基末端肽(NTX)、雌二醇和FSH水平。

该研究结果表明,尿NTX在FMP前约2年开始急剧增加,在FMP后约1–1.5年达到峰值水平。NTX水平在FMP后2–6年小幅下降,但仍比绝经过渡期前高大约20%。FSH水平开始快速增长的不久之后,FSH大幅上升与雌二醇大幅下降相发生结合。整个绝经过渡期,尿NTX在BMI<25 kg/m2的女性平均增加值最高,而在BMI>30 kg/m2.的女性,平均增加值最少。在日本女性,NTX的增加最高,而在非裔美国人最少。当分析校正协变量,特别是BMI后,这些差异缩小,但没有消失。

该研究发现,在绝经过渡期,在FMP前约2年,卵巢功能开始下降,紧接着骨吸收和随后的骨丢失增加。骨吸收增加的量与BMI成负相关。校正BMI后,种族差异在骨吸收变化中的作用被减弱,但没有消失。BMI的种族差异,以及相应的骨吸收种族差异,似乎大部分归因于围绝经期骨丢失的种族差异。

Changes in bone resorption across the menopause transition: Effects of reproductive hormones, body size, and ethnicity.
Objective
To characterize changes in bone resorption in relation to the final menstrual period (FMP), reproductive hormones, body mass index (BMI), and ethnicity.
Methods
Urinary type I collagen N-telopeptide (NTX), estradiol, and FSH levels were measured annually for up to 8 years spanning the menopause transition in 918 African-American, Chinese, Japanese, or Caucasian women.
Results
Urinary NTX began to increase sharply about 2 years before the FMP, reaching its peak level about 1-1.5 years after the FMP. NTX levels declined modestly from 2-6 years after the FMP but remained about 20% higher than before the menopause transition. The sharp rise in FSH occurred in conjunction with a sharp decline in estradiol and shortly after FSH levels began increasing rapidly. The mean increase in urinary NTX across the menopause transition was greatest in women with BMI's <25 kg/m2 and smallest in women with BMI's >30 kg/m2. Increases in NTX were greatest in Japanese women and smallest in African-Americans. These differences were attenuated, but not eliminated, when analyses were adjusted for covariates, particularly BMI.
Summary
During the menopause transition a decline in ovarian function beginning about 2 years before the FMP is followed by an increase in bone resorption and subsequently by bone loss. The magnitude of the increase in bone resorption is inversely associated with BMI. Ethnic differences in changes in bone resorption are attenuated, but not eliminated, by adjustment for BMI. Ethnic differences in BMI, and corresponding ethnic differences in bone resorption, appear to account for much of the ethnic variation in peri-menopausal bone loss.



小提示:78%用户已下载梅斯医学APP,更方便阅读和交流,请扫描二维码直接下载APP

所属期刊:J CLIN ENDOCR METAB 期刊论坛:进入期刊论坛

只有APP中用户,且经认证才能发表评论!马上下载

web对话