国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2014, Vol. 33 ›› Issue (6): 448-451.

• 综述 • 上一篇    下一篇

男性骨质疏松及其与性激素的关系

左跃，张克勤   

  1. 200065 上海，同济大学医学院附属同济医院内分泌科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-11-15 发布日期:2014-11-15

Relationship between Male Osteoporosis and Sexual Hormones

ZUO Yue，ZHANG Ke-qin   

  1. Department of Endocrinology，Tongji Hospital Affiliated to Tongji University，Shanghai 200065，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-11-15 Online:2014-11-15

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摘要： 随着人口老龄化，男性骨质疏松的发病率也在逐年上升，可以引起骨折等严重后果。骨组织对性激素很敏感，性激素对男性骨骼生长发育起到了必不可少的作用。随着男性年龄的增长，体内血清游离睾酮和游离雌二醇的浓度都下降，但雌激素对于维持男性骨量发挥着更重要的作用。选择性雄激素受体调节剂能减少雄激素替代治疗带来的不良反应；选择性雌激素受体调节剂在骨组织中有类似于雌激素对骨的保护作用，已用于绝经后女性的骨质疏松治疗，也有望用于男性骨质疏松的治疗。

关键词: 骨质疏松, 雌激素类, 雄激素类, 睾酮, 性腺甾类激素

Abstract: The incidence of male osteoporosis is rising year by year with the aging of the population. The serious consequence of osteoporosis is fracture. Bone tissue is very sensitive to sex hormones，which means the essential roles of sex hormones in the development of male skeleton. It has been shown that the estrogen transformed from androgen by aromatase plays more important roles in maintaining bone mass in men than androgen itself. Both serum free testosterone level and serum free estradiol level lowered little by little in middle and old aged men. Testosterone supplemental therapy （ＴＳＴ） ｉs advised for those men with the partial androgen deficiency in the aging male. The selective androgen receptor modulators may attenuate the side effects of TST. The selective estrogen receptor modulators have a protective effect on bone tissue. Those estrogen receptor modulators have been used to treat postmenopausal osteoporosis, suggesting that they could be used in male osteoporosis.

Key words: Osteoporosis, Estrogens, Androgens, Testosterone, Gonadal steroid hormones