老年男性抑郁情绪对原发性骨质疏松症骨代谢影响

摘要

Objective To investigate the effect of depression on bone metabolism in the elderly males with primary osteoporosis. Methods Sixty-eight senile male patients with primary osteoporosis in the Department of Geriatrics were selected.All the patients were divided into 2 groups ( depressive group and normal group ) according to the depression scores assessed with Geriatric Depression Scale (GDS).The serum levels of parathyroid hormone (PTH), 25-hydroxy-vitamin D (25-OH-Vit D), bone Gla protein (BGP), amino-terminal cross-linked telopeptide of type I collagen (INTP), carboxy-terminal cross-linked telopeptide of type I collagen ( ICTP) were detected using chemiluminescence immunoassay ( CLIA) method.The serum levels of PTH, 25-OH-VitD, BGP, INTP, and ICTP were compared between the 2 groups.The correlation between depression scores and the serum levels of PTH, 25-OH-Vit D, BGP, INTP, and ICTP were analyzed, in order to explore the potential mechanism of depression in affecting bone metabolism in senile males with primary osteoporosis.Results The bone mineral density in depressive group was significantly lower than that in the normal group (P=0.01), but no difference of age and body mass index (BMI) between the 2 groups was observed.There was no difference of PTH and 25-OH-Vit D between the 2 groups.The serum BGP level in the depressive group was lower than that in normal group, while the serum levels of INTP and ICTP were higher than those in normal group.The depression score showed no correlation with the serum levels of PTH and 25-OH-VitD.It was positively correlated with BGP (r=0.172, P=0.04), while it was negatively correlated with INTP (r=-0.265, P=0.00) and ICTP (r=-0.198, P=0.02).Conclusion Depression can aggravate osteoporosis in the elderly males by increasing bone destruction.%目的：研究老年男性抑郁情绪对原发性骨质疏松症骨代谢的影响。方法选取于我院老年科住院的老年男性原发性骨质疏松患者68例，老年抑郁量表（ GDS）评估抑郁值，根据抑郁评分分为抑郁组和正常组。化学发光免疫分析法测定血清甲状旁腺激素（ PTH）、25-羟基-维生素D（25-OH-Vit D）、骨钙素（ BGP）、Ⅰ型胶原交联氨基末端肽（ INTP）、Ⅰ型胶原交联羧基末端肽（ ICTP）水平，比较两组PTH、25-OH-Vit D、BGP、INTP、ICTP水平，分析抑郁评分与PTH、25-OH-Vit D、BGP、INTP、ICTP相关性，探讨抑郁情绪对骨质疏松骨代谢影响的途径。结果（1）抑郁组骨密度明显低于正常组（P＝0．01），而年龄、体重指数均无差别。（2）两组间PTH、25-OH-Vit D水平无差别，抑郁组血清BGP水平低于正常组，而血清INTP、ICTP水平高于正常组。（3）抑郁评分与PTH、25-OH-Vit D无相关性，与BGP呈正相关（r＝0．172，P＝0．04），与INTP、ICTP呈负相关（r＝-0．265， P＝0．00；r＝-0．198，P＝0．02）。结论老年男性抑郁情绪增加骨破坏而加重骨质疏松。