Effects of raloxifene, a selective estrogen receptor modulator, on bone turnover markers and serum sex steroid and lipid levels in elderly men

被引:79
作者
Doran, PM
Riggs, BL
Atkinson, EJ
Khosla, S
机构
[1] Mayo Clin & Mayo Fdn, Endocrine Res Unit, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Dept Biostat, Rochester, MN 55905 USA
关键词
estrogen; estradiol; raloxifene; osteoporosis; bone loss; bone turnover; male;
D O I
10.1359/jbmr.2001.16.11.2118
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Several lines of evidence implicate estrogen deficiency as a cause of bone loss in elderly men. Thus, in 50 elderly men (mean age +/- SD, 69.1 +/- 6.0 years), we performed a randomized blinded study to assess the effect of 6 months of treatment with 60 mg/day of raloxifene (a selective estrogen receptor modulator [SERM] that has an agonist effect on bone but is not feminizing) versus placebo on bone turnover markers. The mean changes in bone turnover markers, serum sex steroid, or lipid levels with treatment did not differ between groups. However, changes in urinary cross-linked N-telopeptide of type I collagen (NTX) excretion were related directly to the baseline serum estradiol level in the raloxifene (r = 0.57; p = 0.004) but not in the placebo-treated (r = 0.15; p = 0.485) men (p = 0.015 for the difference between groups). Moreover, the men in whom NTX excretion decreased after raloxifene treatment had significantly lower baseline estradiol levels (mean +/- SEM, 22 +/- 2 pg/ml) than the men in whom urinary NTX excretion didn't change or increased after raloxifene therapy (30 +/- 3 pg/ml; p = 0.03), and no such difference was found in the placebo group. Thus, raloxifene has no significant effect on bone turnover markers or lipid levels in elderly men. However, the association noted between baseline estradiol levels and the change in urine NTX excretion in the raloxifene-treated men suggests that a subset of men with low estradiol levels may respond to raloxifene or other SERMs, and further studies are needed to directly test this possibility.
引用
收藏
页码:2118 / 2125
页数:8
相关论文
共 33 条
[1]  
Amin S, 2000, J BONE MINER RES, V15, pS159
[2]   Increased bone mass as a result of estrogen therapy in a man with aromatase deficiency [J].
Bilezikian, JP ;
Morishima, A ;
Bell, J ;
Grumbach, MM .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (09) :599-603
[3]  
BROULIK P D, 1991, Endocrine Regulations, V25, P217
[4]  
Burshell AL, 1999, J BONE MINER RES, V14, pS158
[5]   Effect of testosterone and estradiol in a man with aromatase deficiency [J].
Carani, C ;
Qin, K ;
Simoni, M ;
FaustiniFustini, M ;
Serpente, S ;
Boyd, J ;
Korach, KS ;
Simpson, ER .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (02) :91-95
[6]   EPIDEMIOLOGY OF OSTEOPOROSIS [J].
COOPER, C ;
MELTON, LJ .
TRENDS IN ENDOCRINOLOGY AND METABOLISM, 1992, 3 (06) :224-229
[7]   Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women [J].
Delmas, PD ;
Bjarnason, NH ;
Mitlak, BH ;
Ravoux, AC ;
Shah, AS ;
Huster, WJ ;
Draper, M ;
Christiansen, C .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (23) :1641-1647
[8]  
Draper MW, 1996, J BONE MINER RES, V11, P835
[9]   THE INFLUENCE OF AGE ON BONE-MINERAL REGULATING HORMONES [J].
EPSTEIN, S ;
BRYCE, G ;
HINMAN, JW ;
MILLER, ON ;
RIGGS, BL ;
HUI, SL ;
JOHNSTON, CC .
BONE, 1986, 7 (06) :421-425
[10]   Relative contributions of testosterone and estrogen in regulating bone resorption and formation in normal elderly men [J].
Falahati-Nini, A ;
Riggs, BL ;
Atkinson, EJ ;
O'Fallon, WM ;
Eastell, R ;
Khosla, S .
JOURNAL OF CLINICAL INVESTIGATION, 2000, 106 (12) :1553-1560