血清睾酮水平与老年男性COPD合并骨质疏松症 的相关性研究

Relationship between serum testosterone level and COPD complicated with osteoporosis in elderly male patients

摘要:

目的：探讨老年男性慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）合并骨质疏松症患者血清睾酮水平的变化情况及其与病情严重程度的相关性。方法：选取2015年1至12月入院的117例稳定期COPD老年男性患者，并选择同期入院的非COPD患者40例为对照组。根据骨密度病情严重程度进行分组，比较不同组别间血清睾酮水平，并分析其与患者病情严重程度相关指标的相关性。结果：COPD组患者的血清睾酮水平明显低于对照组；骨质疏松组患者的睾酮水平明显低于骨量正常组和骨量减少组，骨量减少组的睾酮水平明显低于骨量正常组（P＜0.05）；随着COPD病情的加重，血清睾酮水平下降越明显（P＜0.05）；血清睾酮水平与患者的FEV1/FVC和FEV1%Pre呈正相关（r=0.267，r=0.291；P=0.011，P=0.009），与吸烟指数（r=-0.405，P=0.005）、体质指数（body mass index，BMI）（r=-0.304，P=0.006）、CAT评分（r=-0.583，P=0.000）、骨密度（bone mineral density，BMD）腰椎（r=-0.611，P=0.000）、BMD股骨颈（r=-0.382，P=0.002）呈负相关关系。结论：COPD合并骨质疏松症患者血清睾酮水平下降显著，且随病情严重程度呈递减状态。检测睾酮水平在一定程度上有助于COPD合并骨质疏松症患者病情严重程度的判断。

Abstract:

Objective：To investigate the changes of serum testosterone levels of elderly male chronic obstructive pulmonary disease （COPD） patients complicated with osteoporosis and its correlation with the severity of the disease. Methods：Totally 117 COPD patients and 40 non-COPD patients who were admitted to hospital from January 2015 to December 2015 were rolled into this study. According to the bone mineral density（BMD） and severity of illness，the patients were divided into different groups. The serum levels of testos－terone were compared. And the correlation of serum testosterone with the index of the severity was analyzed. Results：The serum testosterone level in COPD patients was significantly lower than that of non-COPD patients（P<0.05）. In the COPD patients，the serum testosterone level in osteoporosis group was significantly lower than that of normal bone mass group and low bone mass group，and that of low bone mass group was significantly lower than normal bone mass group（P<0.05）. With the aggravation of COPD，the serum testosterone level decreased significantly（P<0.05）. The serum testosterone level was positively correlated with FEV1/FVC（r=-0.267，P=0.011），FEV1% Pre（r=-0.291，P=0.009），and negatively correlated with smoking index（r=0.405，P=0.005），BMI（r=-0.304，P=0.006），CAT score（r=-0.583，P=0.000），lumbar spine BMD（r=-0.611，P=0.000） and femoral neck BMD（r=-0.382，P=0.002）. Conclusion：The serum testosterone level is significantly de－creased in COPD patients complicated with osteoporosis and is positively correlated with the severity of the disease. Detection of testosterone levels would help to the assessment of the sever－ity of disease.