In this study, we found that older men with total testosterone or estradiol overall deficit is likely to be
osteoporosis in the hip. Conversely, older men with hip osteoporosis is likely to be total testosterone or total estradiol >> << enough. Older men with total testosterone deficiency, and possibly men with total estradiol deficiency had increased risk
further rapid bone loss hip. There was little association of testosterone or estradiol deficiency with source
osteoporosis of the spine, but the results indicate that both sex steroid deficiencies may increase the risk of further rapid bone loss >> spine. << Our analysis, in a statement that the total deficit of estradiol may have been a stronger predictor of hip osteoporosis than
total testosterone deficiency and that the low bioavailability of estradiol was associated with osteoporosis while the low bioavailability of testosterone
was not, in general agreement with other studies in older men (,,,,,
). However, our conclusion that the total lack of testosterone is associated with osteoporosis regardless of estradiol
contrasts with the results of previous studies (,
). In addition, our findings that low levels of total and bioavailable testosterone was probably stronger predictors of rapid
thigh bone loss than were low overall and bioavailability of estradiol are not compatible with previous reports (,,
). While previous studies have used correlation to compare the relative advantages of combining all levels of sex steroids
and bioavailability fraction of ON and bone loss, this was not the purpose of this study considering its abbreviation
point approach based on the analysis and the lack of clearly defined thresholds for bioavailable testosterone and estradiol deficiency >>. << This study also seems to be different from previously published works in connection with non-union setting a threshold bioavailable estradiol >> << with the risk of osteoporosis and rapid bone loss. Previous research conducted longitudinal in 130
men aged 60-90 years was suggested that men with total estradiol levels less than 31 pg / ml (and bioavailability of estradiol
11 pg / ml) were higher rates of bone loss weight than men with levels above threshold values (
). The conclusions of authors of this study to seem to have been based mainly on the observed rate of bone loss in
radial and ulnar. However, older people in this early study tested net income in the IPC in the hip and a net loss >> << BMD in the spine, and the authors reported that there was no threshold effect of estradiol on these biologically skeletal
sites. Currently, the study examined the prevalence and odds of osteoporosis and rapid bone loss at the hip and spine, as well
about not collect data on other sites of the skeleton. Biochemical criteria used to determine total testosterone and estradiol deficiency were based on previously published recommendations
(,,,,,
), although within the proposed cut points we chose those that qualify only a small part of MROs men
abnormal. In comparison, there is no conventional definition of bioavailable testosterone and estradiol deficiency
We Kvintiliya categories of people for these variables. Then, as even the lowest fifth classify large share of MROs >> << men as abnormal and may be any weakening of the association low bioavailability of testosterone and estradiol with osteoporosis
and rapid loss of bone mass, we also examined the risk of osteoporosis and rapid bone loss in men in the bottom fifth percentile >> << bioavailability of these sex steroid fractions. Our findings have several implications for clinical practice and further research. These data show that older people with
documented total testosterone or estradiol deficiency, measurement of the IPC should be considered. In MROs for every eight >> << general lack of testosterone, and every seven men with total estradiol deficiency, approximately one was identified as
osteoporosis.
subsequent fractures (
). Although these studies show that older men with osteoporosis have an increased prevalence of total testosterone or estradiol deficiency >> << there is no assurance measure levels of sex steroids in men with osteoporosis provides additional >> << information that should change their clinical management. Because of osteoporosis, these people may already be candidates for bisphosphonates therapy
(
), and there is still no evidence that sex hormone treatment provides added protection from destruction or sex steroid
levels predict response to ON bisphosphonates (
). Having regard to the clinical practice in this area remains controversial, people in this group may be candidates for randomized trials
study the influence of testosterone, selective androgen receptor modulators, or modulators selective estrogen receptor
versus or in combination with bisphosphonates or other therapy changes in ON and destruction. Planned clinical trials >> << to determine whether the potential benefits of treatment nonbone testosterone outweighs the risk in older men more
inform clinical decisions (
). Finally, our results show that the reduction of points is used here to define osteoporosis, total lack of testosterone, and
total estradiol deficiency may be useful in clinical practice, at least on the relationship between sex steroids and bone
, . Our results show that less extreme cut points for total testosterone and estradiol deficiency overall deficit
likely to be weak predictors of osteoporosis and rapid bone loss. Further investigation, including regular analysis of MROs
data (
) can determine whether the best clinical thresholds for determining total testosterone and estradiol deficiency
older men and whether clinically useful reduction points to determine the deficiency of biologically estradiol and testosterone. It will also be important to study these events can be shown to predict incident fractures. This study has many advantages. To our knowledge, this is the largest to examine the association of sex steroids on
. IPC in older men and one of relatively few to examine the longitudinal associations of sex steroids on bone loss in older men
However, it is of great value could be that he considers the relationship between sex steroids and bone in older men with
clinical point of view, using specific cut points that may guide the decision-making. This study also has several limitations. First, we used neekstrahirovannyh RIA methods for determining the general level of sex hormones. Although
strict quality control procedures were used to increase the accuracy of the analysis, this method is more or less reliable in measuring
very low overall level of estradiol [for lasix furosemide side effects men with total estradiol ≤ 10 pg / ml (n = 78) , intraassay CV 22. 3%]. Second, although men
were classified as total testosterone or estradiol not only on the basis of biochemical criteria and without
clinical symptoms, reduction of points used harsh and had to identify people who were stronger, hypogonadism
(
). Third, our definition of rapid bone loss was based on the rate of bone loss that predict increased risk of fractures in the incident >> << populations postmenopausal women (
), since such data were not registered in older men. Fourth, the relationship between sex hormone measurements and spine ABOUT
could be partially impressed spinal osteoarthritis and / or aortic calcification. Finally, because MROs participants
is a residential community, and mostly Caucasian, the results may not apply to other populations. In conclusion, we found that older men with total testosterone or estradiol deficiency is likely to have osteoporosis. Conversely, older men with osteoporosis, often with total testosterone or estradiol deficiency. Older men with
total testosterone deficiency are more likely to experience further rapid bone loss. BMD testing of older men having sex
steroid deficiency may be warranted to identify persons with osteoporosis, who could potentially benefit from therapy, bisphosphonates. Currently there is sufficient evidence that sex steroid deficiency in elderly men osteoporosis guarantee
changes in the conduct of patients, but data on the prevalence of deficiency of sex steroids in this population may help in planning
future clinical trials. . << >>
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