Bone Mass and Hormone Analysis in Patients With Spinal Cord Injury: Evidence for a Gonadal Axis Disruption
| Autor: | Cynthia Brandão, Marise Lazaretti-Castro, Alexandra Passos Gaspar |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Clinical Biochemistry Context (language use) Biochemistry Bone and Bones Collagen Type I Young Adult Absorptiometry Photon Endocrinology N-terminal telopeptide Hypogonadotropic hypogonadism Internal medicine Vitamin D and neurology Humans Medicine Vitamin D Gonadal Steroid Hormones Gonads Spinal cord injury Spinal Cord Injuries Paraplegia Bone mineral business.industry Biochemistry (medical) Middle Aged medicine.disease Cross-Sectional Studies Parathyroid Hormone Peptides business Hormone |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 99:4649-4655 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Context: Bone loss is a constant finding in patients with spinal cord injury (SCI). Objective: We sought to evaluate potential modifiable factors that could lead to bone loss in complete motor paraplegia by examining gonadal axis hormones, vitamin D status, and bone markers. Design: This is a cross sectional. Setting: It includes SCI Outpatient. Patients and other Participants: Twenty-nine chronic male patients with SCI were compared with 17 age-matched, able-bodied men. Main Outcome Measure: The bone mineral density (BMD) of lower limbs and lumbar spine were measured using dual x-ray absorptiometry. Parathormone, 25-hydroxyvitamin D [25(OH)D], collagen type I C-terminal telopeptide (CTX), and sexual hormone were measured. Results: Patients with SCI had lower BMD at the inferior limbs sites. CTX showed an inverse relationship with the time since injury. Patients had lower free T levels (SCI, 12.00 ± 2.91 vs controls, 19.51 ± 5.72; P ≤ .001), and the majority (72%) had normal/low levels of gonadotropins. Low T, however, was not related to low bone mass in patients with SCI. In the controls, the 25(OH)D level was positively correlated with the T and with the lumbar spine BMD, but these correlations were not observed in the SCI. Conclusions: Impairment of testicular function after SCI was indicated by the low levels of T and the loss of correlation between T and 25(OH)D levels; this correlation was present in the able-bodied controls. Inappropriate levels of gonadotropins were identified in most patients, featuring a hypogonadotropic hypogonadism and suggesting a disruption of the pituitary-gonadal axis. T concentrations might not be an effective target for bone loss therapy. |
| Databáze: | OpenAIRE |
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