【作者】 赵莉莉；

【导师】 樊继援； 邱明才；

【作者基本信息】 天津医科大学 ， 内分泌与代谢病， 2005， 硕士

【摘要】 目的:中老年性男性骨质疏松症（OP）的发生率较女性低,但随着人均寿命的延长,男性OP同女性OP的发生率一样也逐年增加。绝大多数研究是针对女性,对男性OP和女性OP发病机制的差异尚不清楚。体重和骨量密切相关,脂肪组织和性激素可能在其中起重要的介导作用。本研究对中老年男性体成分、瘦素（LEP）、睾酮（Tes）、雌二醇（E₂）、胰岛素（INS）和骨密度（BMD）进行观察,探讨男性OP的发病机制,有助于男性OP高危人群早期发现和防治。 方法:1.选择中老年男性82例,用双能X线吸收测量法（DXA）测量腰椎2～4（L2-4）BMD、全身（TOT）BMD和体成分并以中老年女性106例作为对照。2.选择中老年男性82例,用放射免疫测定法（RIA）检测空腹血清LEP、Tes、E₂、INS水平。 结果:1.体成分与BMD的关系分析,（1）脂肪量（FM）、非脂肪量（FFM）和中老年男性和女性L2-4BMD（男FM:r=0.259,P=0.046,男FFM:r=0.266,P=0.041;女FM:r=0.364,P=0.016,女FFM:r=0.273,P=0.036）、TOT BMD（男FM:r=0.315,P=0.012,男FFM:r=0.415,P=0.001;女FM:r=0.505,P=0.000,女FFM:r=0.376,P=0.008）均呈显著正相关;（2）腹部脂肪含量（ABDFM）R与L2-4BMD正相关（男:r=0.293,P=0.019;女:r=0.525,P=0.000）。与L2-4BMD相比,两性TOT BMD与更多的身体构成变量有更强的正性关系。（3）多元线性回归分析显示,FFM（L2-4BMD:Std.β=0.461,P=0.004;TOT BMD:Std.β=0.564,P=0.000）是影响中老年男性BMD变化的主要决定因素;而FM（L2-4BMD:Std.β=0.390,P=0.003;TOT BMD:Std.β=0.385,P=0.004）是影响中老年女性BMD变化的主要决定因素。2.激素与BMD的关系分析,（1）校正年龄和体重指数（BMI）后,BMD与Tes（P<0.01）、E₂更多还原

【Abstract】 Objective: The incidence of aged osteoporosis （OP） in men was lower than that in women. However, with the extension of human life span, the incidence of male OP had been increasing as that of women OP year by year. Most of the studies in this area have been in women while the pathogenesis difference between OP in men and women was not known. Body weight are closely related to bone mass and various hormones may be involved in this relationship. In order to understand the pathogenesis of male OP and early find susceptible people for OP and thus conduct preventive measures, we had studied the impact of body composition, circulatory leptin（LEP）, testosterone（Tes）, estradiol（E2） and insulin （INS） levels on bone mineral density （BMD） in middle-aged and aged men.Methods: 1. We measured BMD at lumber spine2⁴（L2-4） and total（TOT） bone and body composition by dual energy X-ray absorptiometry（DXA） in 82 middle-aged and aged men, 106 middle-aged and aged women were controlled. 2. Fasting serum LEP, Tes, E₂ and INS concentration were measured in 82 apparently healthy men by Radioimmunoassay（RIA）.Results: 1. （1）We founded that fat mass （FM）, fat-free mass （FFM） were all positively correlated with BMD at lumer spine（male FM: r =0.259, P=0.046, male FFM: r =0.266, P=0.041; female FM: r =0.364, P=0.016, female FFM: r=0.273, P=0.036） and total bone(maleFM: r=0.315, P=0.012, male FFM:更多还原