骨质疏松的分子遗传学研究进展

遗传因素在骨质疏松的发病中起重要作用。本文简要介绍近年来在骨质疏松相关基因关联分析方面所取得的研究进展,并对新近发现的删基因在骨量维持中作用的研究进展进行了重点介绍,LRP5基因在骨量和骨密度调控中起着关键作用。     

Association of the estrogen receptor alpha gene polymorphisms with osteoporosis in the Mexican population

The estrogen receptor gene (ER alpha) has been implicated in the development of osteoporosis. In this study, the association of two ER alpha gene polymorphic markers (a TA dinucleotide repeat and a single nucleotide polymorphism, G2014A) with osteoporosis was tested in 70 osteoporotic women, 70 non-osteoporotic women and 500 subjects from the Mexican population. According to the genetic analysis of the Mexican population using eight unlinked polymorphic markers, we found that our population is structured into three subpopulations; therefore, the allele-phenotype relationship was analyzed with a statistical method that considered population stratification. We found that the G2014A polymorphism is associated with the presence of osteoporosis while the TA dinucleotide repeat is not. The G allele and the GG genotype frequencies of the G2014A marker were significantly higher in osteoporotic than in non-osteoporotic women. Likewise, subjects bearing the G allele in heterozygous or homozygous displayed lower values for lumbar bone mineral density and T score than those who did not present any G allele. The effect of confounders for osteoporosis on the association of G allele-osteoporosis was ruled out. In summary, we conclude that the G2014 polymorphism may become a useful marker for genetic studies of osteoporosis in the Mexican population.     

Influence of polymorphisms in insulin-like growth factor-1 on the risk of osteoporosis in a Chinese postmenopausal female population

We conducted a case-control study in a Chinese postmenopausal population, and explore the potential role of the promoter region variation of the IGF-1 gene in bone mineral density and osteoporosis risk. 485 postmenopausal women with a primary diagnosis of osteoporosis and 485 age-matched controls were selected between 2012 and 2014. The Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) was used for rs35767, rs2288377 and rs5742612 of IGF-1 genotyping. By conditional regression analysis, individuals carrying TT genotype and CT+TT genotype of rs35767 were found to be correlated with an elevated risk of osteoporosis, with adjusted ORs (95% CI) of 1.90 (1.23-2.93) and 1.35 (1.04-1.76), respectively. Our study found that CT+TT genotype of rs35767 was significantly associated with moderate increased risk of osteoporosis in smokers and drinkers, and the ORs (95% CI) were 2.11 (1.06-4.20) and 2.36 (1.29-4.32), respectively. We found that those carrying CT+TT genotype of rs35767 had a significant lower BMD levels at L1-L4 vertebrae, femoral neck, total hip and trochanter compared to those with CC genotype. Our study suggests that TT genotype and CT+TT genotype of IGF-I rs35767 were associated with risk of osteoporosis and BMD levels.     

泼尼松所致大鼠骨质疏松的骨密度和力学性能测定

目的：测定泼尼松所致大鼠骨质疏松的骨密度和力学性能。方法：采用１６只３月龄雄性ＳＤ大鼠，体重３４５～３４７ｇ，随机分为对照组和实验组，后者喂醋酸泼尼松４．５ｍｇ／ｋｇ，２次／周。９０天后对两组动物股骨分别进行单光子骨密度测定和扭转试验。结果：实验组股骨近段、中段和远段的骨密度分别减少了１２．４％（Ｐ＜０．０５）、１３．９％（Ｐ＜０．０５）和１１．９％（Ｐ＜０．０５）；股骨干抗扭转各项指标均出现减少趋势。结论：长期使用ＧＣ，会导致骨矿含量减少，由于骨的构筑发生了改变，使其抵抗扭转的能力降低，从而易发生骨折     

三种骨质疏松自我评价工具应用于广西壮族妇女的筛检效果比较

目的:评价亚洲骨质疏松自我评价工具(OSTA)、我国妇女骨质疏松筛选工具(OSTC)、自建的壮族妇女骨质疏松自我评价工具(OSTZ)与广西壮族围绝经和绝经后妇女骨密度的关系,比较三种工具对骨质疏松症的筛检能力,探讨其临床应用价值.方法:2009年12月～2013年12月采用超声骨密度仪筛选获得580名40岁以上围绝经和绝经壮族妇女的跟骨骨密度数据,利用体质量和年龄分别计算OSTA指数、OSTC指数与自建的OSTZ指数,并进行比较.结果:OSTA指数、OSTC指数、OSTZ指数与跟骨骨密度值均呈正相关(r=0.601;r=0.623;r=0.619),OSTA与OSTC、OSTZ筛选指数之间呈正相关(r=0.972和r=0.925),OSTC与OSTZ筛选指数之间呈正相关(r=0.988).按两级危险程度分类界值进行判定,OSTA、OSTC及OSTZ的灵敏度分别为75.7％、88.0％、98.4％,特异度分别为30.3％、43.9％、67.5％.受试者工作特征曲线下面积为0.727、0.721、0.705,Kappa系数为0.455、0.450、0.322.结论:OSTA与OSTC应用于广西壮族绝经后妇女骨质疏松症的筛查效果均不太理想,临床应用价值受限.OSTZ指数应用于广西壮族围绝经和绝经后妇女骨质疏松症的筛查效果较为理想,有一定的临床应用价值.     

Association between osteoporosis and hepatitis B cirrhosis: a case-control study

Background and aimsHepatitis B virus (HBV)-related cirrhosis is associated with decreased bone mineral density (BMD); however, the mechanism is yet unknown. To assess the incidence of osteoporosis in patients with HBV-associated cirrhosis and relevant mechanisms.MethodsA total of 80 hospitalized patients with HBV-associated cirrhosis and 80 healthy controls were enrolled. The levels of serum osteocalcin, total procollagen type 1 amino-terminal propeptide, β-C-terminal telopeptide of type I collagen (β-CTX), and 25-hydroxy vitamin D3 (25(OH)D3) was evaluated in the cirrhosis group.ResultsThe BMDs of the lumbar spine (P<0.001) and hip joints (P=0.015) in the cirrhosis group were significantly lower than those in the controls. The incidence of osteoporosis in the cirrhosis group was significantly higher than that in the control group (P<0.001). Compared to the patients of the Child-Pugh grade A and B, the BMD of lumbar spine and 25(OH)D3 was significantly decreased in patients of grade C, while β-CTX was elevated. Patients in the cirrhosis group faced a higher risk of osteoporosis as compared to the controls(P<0.001).ConclusionsEnhanced bone resorption accounted for increased risk of osteoporosis in severe cirrhosis. Thus, HBV-associated cirrhosis was a risk factor for osteoporosis.     

骨质疏松症治疗中的运动疗法

背景：骨质疏松症是以骨量减少、骨组织显微结构退化为特征,以致骨的脆性增高而骨折危险性增加的一种全身骨病,通常治疗的首要手段为药物治疗。而单纯药物治疗无法提高肌肉力量,改善平衡功能,进而预防跌倒的发生,因此已不能满足骨质疏松症的综合管理。运动作为一种重要的非药物治疗手段,在骨质疏松症的预防中公认应作为首选,在骨质疏松症的治疗中的重要性逐渐被认识。 目的：结合最新的一些研究文献,探讨运动在骨质疏松症治疗中的作用。 方法：以“骨质疏松症,骨密度,骨强度,治疗,运动,应力,太极,肌肉,骨组织构建”为中文检索词,以“osteoporosis,bone mineral density, bone strength, treatment,exercise,stress,tai chi,muscle,bone architecture”为英文检索词,检索中国知网(CNKI)期刊全文数据库和Medline 2001年1月至2013年2月有关不同运动类型对人骨强度的影响特别是对骨质疏松症患者的治疗作用的临床报道及机制研究。排除重复性研究和不典型报道。 结果与结论：治疗性运动包括有氧运动、抗阻运动、冲击性运动、振动运动等类型,可以安全的提高骨强度,提高肌肉力量,改善平衡功能,预防跌倒和骨折。对于脊柱畸形者适当选用矫形器可提高安全性、促进运动治疗。与药物治疗一样,运动治疗也遵循个体化原则,在良好的依从性和安全性条件下进行运动方案的选择,各种运动的效果均较小,包含高应变速率的运动似乎更有效,但均需要长期坚持运动以维持疗效。     

骨代谢相关基因多态性与盐酸雷洛昔芬对绝经后骨质疏松妇女骨密度和骨转换指标影响的关系

目的了解骨代谢相关基因多态性与盐酸雷洛昔芬( raloxifene,RLX)对绝经后骨质疏松妇女骨密度(bone mineral density, BMD)和骨转换指标影响的关系.方法为随机、对照和双盲试验,入选47～74岁68例无亲缘关系的绝经后骨质疏松汉族妇女,随机分为RLX组和安慰剂组(各34例),RLX组日服RLX 60 mg,安慰剂组服与RLX外观一致的安慰剂,共1年.在服药前、服药后6月和12月时,检测BMD和骨转换指标包括血清1型胶原羧基末端肽(C-telopeptide, CTX)和骨钙素(osteocalcin, BGP).分析雌激素受体1基因(estrogen receptor 1 gene,ESR1)Xba Ⅰ和PvuⅡ位点、ESR2基因RasⅠ位点、维生素D受体基因(vitamin D receptor, VDR)FokⅠ和CDX2结合位点的多态性. 结果共58例完成整个试验,研究结束时RLX组腰椎2～4(L2～4)、全髋部和大转子BMD增加的百分数,以及血清CTX和BGP水平下降的百分数与安慰剂组比较差异均有统计学意义(P<0.05或P<0.01).治疗后12个月,RLX组VDR FokⅠ FF基因型者(n=8)全髋部和大转子BMD值平均下降各为1.98%±4.86%和2.26%±4.73%,而Ff/ff基因型者(n=21)平均增加各为2.52%±2.75%和2.74%±2.97%(P<0.05);ESR1 PvuⅡ位点PP/Pp基因型者(n=17)全髋部BMD明显增加(2.12%±2.78%),而pp基因型者(n=12)呈下降(-1.34%±3.73%)(P<0.05).但上述5个位点多态性与安慰剂组各指标变化均无相关性. 结论 RLX对绝经后骨质疏松妇女BMD的作用受VDR基因FokⅠ和ESR1基因PvuⅡ多态性的调节.在临床选择该药物时,可根据应用对象的基因型做有益决策之用.     

骨质疏松症的遗传学研究进展及对相关问题的思考

近10多年来,骨质疏松症的遗传学研究取得长足进展。研究发现多种与骨代谢密切相关的内分泌激素、骨基质蛋白、细胞因子遗传学变异与骨密度、骨质量、骨结构、骨转换率和骨质疏松性骨折率密切相关,本文旨在回顾国内外骨质疏松症遗传学领域重要的代表性研究成果,并思考骨质疏松遗传学研究今后需要关注的问题。     

骨重建失衡导致骨质疏松发生的作用机制及其药物治疗策略

背景:目前骨重建失衡被认为是造成骨质疏松的关键因素,如在骨质疏松发生过程中干预重建失衡,则可一定程度逆转骨质疏松状态并改善预后。破骨抑制和成骨诱导性药物则是针对此致病机制的靶点药物。因此综述性回顾骨质疏松的骨重建失衡机制对于骨质疏松药物治疗具有指导意义,破骨抑制和成骨诱导性药物的临床应用现状和治疗效果也急需进行系统性总结,以起到临床用药指导的作用。目的:综述骨质疏松的骨重建失衡发生机制,并总结破骨抑制药物和成骨诱导药物针对骨重建失衡的调节作用机制,对比2种药物的临床作用效果,为骨质疏松的药物治疗选择进行指导。方法:检索PubMed、WebofScience、中国知网数据库建库至2020年2月发表的相关文献,英文检索词为osteoporosis,bone remodeling,antiresorptive,anabolic,bisphosphonate,RANKL inhibitor,PTH analogue,anti-sclerostin antibody,中文检索词为骨质疏松,骨重建,破骨抑制,成骨诱导,双膦酸盐,RANKL抑制剂,甲状旁腺素类似物,抗硬化素抗体。共检索到相关文献144篇,按照纳入与排除标准,最终纳入84篇文献进行总结。结果与结论:①骨质破坏发生后,可引起机体发生骨重塑,而骨重塑则会导致可逆性非可逆性两种类型的骨缺失发生;②可逆性骨缺失约历时3个月,依次经历骨吸收、骨重填和新骨矿化过程,修复后的骨量和骨质均优;③而不可逆性骨缺失则存在破骨-成骨失衡,虽然也有一定的新骨形成,但新生的骨质较差,易再次发生骨结构破坏;④双膦酸盐、RANKL抑制性抗体属于破骨抑制药物,其作用机制为减慢骨重建速率以减少逆转期骨吸收量,但新生骨量和质量也会相应减少;⑤而特里帕肽、甲状旁腺素类似物等成骨诱导类药物则利于缺损骨质修复,完善破坏的哈弗氏管系统结构,使得新生骨质获得优良的力学强度。     

Prevention and treatment of corticosteroid-induced osteoporosis

Osteoporosis is one of the most serious complications of corticosteroid treatment. Loss of bone mineral density (BMD) and fractures occur early in the course of corticosteroid treatment, and thus early recognition of fracture risk and effective intervention based on evidence-based-medicine (EBM) are needed. A study of meta-analysis representing the highest level in a hierarchy of evidence showed that when the outcome measure of interest was limited to changes in lumbar spine BMD, bisphosphonates were the most effective of the agents studied in comparison with no therapy or treatment with calcium, and were also more efficacious than either vitamin D or calcitonin; the efficacy of bisphosphonates was enhanced when used in combination with vitamin D. Randomized controlled trials (RCTs) representing the second level in a hierarchy of evidence showed that bisphosphonates stabilized BMD not only in the lumbar spine, but also in the hip, and that parathyroid hormone (PTH) markedly increased lumbar spine BMD. According to the EBM, bisphosphonates and possibly PTH are suggested to be the most efficacious for preserving BMD. The efficacy of these agents in reducing the incidence of vertebral fractures in patients exposed to corticosteroids remains to be established in meta-analysis studies, although some RCTs have demonstrated the anti-fracture effects of etidronate, alendronate, and risedronate in the spine. Further RCTs of fracture prevention conducted on a large number of patients and their meta-analysis are needed to confirm the efficacy of bisphosphonates, PTH, or other agents in preventing vertebral and nonvertebral fractures.     

中国中老年人骨质疏松症患病率的Meta分析

背景：中国很多学者对不同地方做过骨质疏松症的流行病学调查,但大样本多中心的随机抽样调查仍相对缺乏,目前的文献仍不能很好地全面描述国内骨质疏松症的总体流行病学趋势。 目的：对中国中老年人骨质疏松流行病学的资料进行汇总,综合分析骨质疏松症流行状况。 方法：采用Meta分析对中国2000至2013年发表的有关中老年人骨质疏松流行病学的文献进行归纳和统计学分析。提取资料中40岁以上人群骨质疏松症的患病率,并以10岁为一个年龄组段分别进行汇总,采用stata12.0软件进行分析。 结果与结论：共对32篇文献进行分析,提取40岁以上人群样本总量58 254例,其中男26 844例,女31 410例。中国40岁以上人群骨质疏松症总体患病率13.2%,其中男性11.8%,女性14.2%,差异有显著性意义     (P < 0.05)。随年龄增加,男性及女性的骨质疏松症患病率均逐渐增加,男性增长则相对平缓,女性进入50岁后,患病率明显增高。从Lumbar,Neck,Troch,Ward's 4个检测部位来看骨质疏松症患病率在北方地区以Lumbar检出率最高,可能与北方地区重体力活动相对南方地区多,加速了腰椎的退变有关。南方地区以Ward's检出率最高,有待进一步研究。男性人群中近5年的患病率较5年前明显增加,女性人群中近5年的患病率较5年前明显减小。提示中国为骨质疏松高发地区,开展骨质疏松宣传和相关疾病的防治意义重大。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

骨密度影像学测量与椎体骨折率评估结合提高骨质疏松的诊断率

背景：临床上用于诊断骨质疏松症的通用指标：脆性骨折或骨密度T ≤ -2.5标准差,只要满足一个条件即可作出骨质疏松的诊断。在做骨密度检查时同时进行椎体骨折评估,可以避免单一因素的评判造成骨质疏松症的漏诊,有利于提高骨质疏松的诊断率。 目的：评估骨密度结合椎体骨折对骨质疏松症临床诊断率的影响。 方法：对217例年龄≥50岁的绝经后女性患者行髋部骨密度检测,同时进行椎体骨折评估,比较单纯依靠骨密度检查与骨密度结合椎体骨折评估对骨质疏松的诊断率的影响,同时探讨骨密度对椎体骨折率的影响。 结果与结论：92例骨密度T ≤ -2.5,达到骨质疏松诊断阈值,占42.4%;102例骨密度-1 > T > -2.5,为低骨量,占47.0%;23例骨密度在正常范围,骨密度T > -1,占10.6%。158例无椎体骨折;59例(27.2%)椎体骨折,101个骨折椎。骨密度T > -2.5的患者椎体骨折率为21.6%,骨密度T ≤ -2.5的患者椎体骨折率34.8%,两组骨折率比较差异有显著性意义(P < 0.05);骨密度结合椎体骨折评估的骨质疏松诊断率为54.8%,比单纯依靠骨密度检查,骨质疏松诊断率提高12.4%(P=0.01)。说明绝经后女性做骨密度检测的同时进行椎体骨折评估可以提高骨质疏松的诊断率。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

温热磁场与干扰电流治疗腰椎骨质疏松的仪器研制与临床应用

目的 :研制一种治疗腰椎骨质疏松的小型仪器 ,进一步探讨温热磁场与干扰电流对骨质疏松患者的作用。方法 :借助于单片机系统 ,研制出了新一代的微电脑骨质疏松治疗仪。临床观察该仪对腰椎骨质疏松的治疗效果 ,运用该仪对 3 0例原发性腰椎骨质疏松患者进行治疗 ,并于治疗前后用双能X线测定第 2～ 4腰椎骨密度。结果 :发现 3 0例中有 2 8例骨密度上升 ,上升幅度 >5 .5 %有 2 0例 ,骨痛等临床症状减轻或消失。结论 :该仪的使用是非药物治疗腰椎骨质疏松的一个有效手段     

骨代谢指标与骨关节炎及绝经后骨质疏松症的关系

背景：研究显示,在绝经后骨质疏松症及骨关节炎状态下,原本正常的骨转换平衡状态被破坏,血清、尿液中一些特异性指标可以较敏感地反映出骨转换的具体变化过程。 目的：测量绝经后原发性膝骨关节炎及绝经后骨质疏松症患者的骨密度及骨代谢指标,分析两疾病骨密度及骨代谢指标的变化特点。 方法：选取248例绝经女性受试者,行骨密度、膝关节X射线片检查,最终选出180例进入试验,分为骨关节炎组、骨质疏松组及对照组。对比分析各组观察对象的骨代谢指标：骨碱性磷酸酶、骨钙素、Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b。通过二元Logistic回归分析判断两疾病发病与各项指标间的相关性。 结果与结论：与对照组比较,骨关节炎组腰椎骨密度升高,Ⅰ型胶原交联C末端肽值降低;骨质疏松组腰椎及全髋部骨密度降低,骨钙素、Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b升高。血清Ⅰ型胶原交联C末端肽水平的降低与骨关节炎发病具有显著相关性;血清骨钙素、Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b水平的升高与骨质疏松发病具有显著相关性。提示绝经女性骨关节炎患者骨吸收速率减低,骨质疏松患者骨转换率加快,骨代谢水平的差异导致两疾病患者骨密度呈现出负相关趋势。监测Ⅰ型胶原交联C末端肽、血清抗酒石酸酸性磷酸酶5b、骨钙素,特别是Ⅰ型胶原交联C末端肽血清水平对骨关节炎及骨质疏松的早期诊断及治疗有一定的参考价值。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程全文链接：     

补肾壮骨方干预去卵巢骨质疏松模型大鼠骨代谢及骨密度的变化

背景：中医药以其良好的治疗效果及安全性越来越多的应用于骨质疏松症的治疗中,补肾壮骨方目前作为山东中医药大学附属医院协定方被广泛应用于临床中,获得了极好的治疗效果。目的：评价补肾壮骨方对去卵巢骨质疏松大鼠骨代谢及骨密度的影响。方法：60只SD大鼠随机分为6组,分别为假手术组、模型组、阿仑膦酸钠组、补肾壮骨方高、中、低剂量组,每组10只,后5组制备去卵巢骨质疏松症模型,假手术组只切除卵巢周围脂肪组织。造模8周后,补肾壮骨方高、中、低剂量组分别予以2.34,1.17,0.58 g/(kg·d)补肾壮骨方,阿仑膦酸钠组予阿仑膦酸钠1 mg/(kg·d),假手术组及模型组给予等体积的生理盐水,1次/d灌胃。连续灌胃12周后检测各组大鼠血清碱性磷酸酶、Runt相关转录因子2及核因子κB受体活化因子配体水平;取右侧股骨观察骨密度及骨微结构;苏木精-伊红染色观察组织病理改变;免疫组化法检测骨组织Wnt1、骨形态发生蛋白2蛋白表达。结果与结论：(1)造模8周后,与假手术组对比,模型组大鼠骨密度、骨小梁数明显降低(P <0.05),提示造模成功;(2)与模型组大鼠对比,补肾壮骨方低、中、高剂量组及阿...     

Comparison of effect of treatment with etidronate and alendronate on lumbar bone mineral density in elderly women with osteoporosis

The purpose of this open-labeled prospective study was to compare the treatment effects of cyclical etidronate and alendronate on the lumbar bone mineral density (BMD), bone resorption, and back pain in elderly women with osteoporosis. Fifty postmenopausal women with osteoporosis, age ranging from 55 to 86 years (mean: 70.7 years), were randomly divided into two groups with 25 patients in each group: the cyclical etidronate group (etidronate 200 mg daily for 2 weeks every 3 months) and the alendronate group (5 mg daily). The BMD of the lumbar spine (L1-L4) measured by DXA, the urinary cross-linked N-terminal telopeptides of type I collagen (NTX) level measured by the enzyme-linked immunosorbent assay, and back pain evaluated by the face scale score were assessed at baseline, 6 months, and 12 months. There were no significant differences in baseline characteristics including age, body mass index, years since menopause, lumbar BMD, urinary NTX level, and face scale score between the two treatment groups. Etidronate treatment sustained the lumbar BMD following a reduction in the urinary NTX level and improved back pain, while alendronate treatment reduced the urinary NTX level more significantly, resulting in an increase in the lumbar BMD, and similarly improved back pain. No serious adverse events were observed in either group. This study confirmed that alendronate treatment had a greater efficacy than etidronate treatment in increasing the lumbar BMD through the reduction of bone resorption in elderly women with osteoporosis.     

抗阻训练干预绝经后骨质疏松患者骨密度的系统综述和Meta分析

背景:抗阻训练已经被证实对于改善绝经后妇女骨质疏松患者的骨密度有所帮助,但抗阻运动的运动方式、训练强度、训练时间、训练频率,以及与不同运动(有氧运动等)方式的结合是否效果更好还有待研究。目的:评价抗阻训练对绝经后妇女骨质疏松患者骨密度的干预效果。方法:搜集抗阻训练干预绝经后妇女骨质疏松患者骨密度的相关随机对照试验,研究对象分为抗阻训练组及空白对照组,检索Pub Med、EMBASE、Web of Science、中国知网和万方医学数据库,检索的时间范围从建库到2019年12月,并且对纳入文献的相关参考文献进行检索。由2名研究者按纳入和排除标准筛选文献并提取有效数据,进行质量评价。采用Rev Man 5.3软件对最终纳入的文献数据进行Meta分析。结果与结论:①最终纳入23篇随机对照试验,对纳入的文献进行风险偏倚评价,结果显示整体文献质量为中等偏上;②Meta分析结果显示,与空白对照组相比,抗阻训练组可显著改善绝经后妇女骨质疏松患者的腰椎骨密度[SMD=0.02,95%CI(0.01,0.03),P<0.0001]、全髋骨密度[SMD=0.25,95%CI(0.06,0.44),P=0.03]、股骨颈骨密度[SMD=0.28,95%CI(0.12,0.04),P=0.0005]及大转子骨密度[SMD=0.02,95%CI(0.00,0.03),P=0.02];③提示抗阻训练有利于维持绝经后妇女骨质疏松患者的骨密度水平,可以作为绝经后妇女骨质疏松运动治疗的重要组成部分。     

Structure of human vertebral lamellar bone in age-associated involution and osteoporosis

We compared the structure of lamellar bone in anterolateral zones of vertebral bodies in adult and senile subjects in health and osteoporosis. The appearance of structural signs of age-related osteopenia and enlargement of coplanar consolidations of the bone matrix crystals were noted. Osteopenia was more pronounced in osteoporosis, while the structural organization of the mineral component did not differ from that in age-matched controls.     

去卵巢骨质疏松模型大鼠小肠钙结合蛋白mRNA表达与菟丝子黄酮的干预

背景：菟丝子是旋花科植物菟丝子Cuscutachinensis Lam.的成熟种子,为温补肾阳的要药,前期研究表明,由菟丝子组成的补肾复方在抑制骨量丢失,改善骨密度方面有明显疗效。 目的：探讨菟丝子黄酮对去卵巢骨质疏松模型大鼠股骨骨密度、血清和肾脏1,25-二羟基维生素D3(1,25(OH)₂ D₃)含量、小肠钙结合蛋白(CaBp-D9K)mRNA表达的影响。 方法：72只SD雌性大鼠,随机数字表法均分为6组(n=12)：假手术组、模型组、维生素 D3组和菟丝子黄酮小、中、大剂量组。假手术组仅行假手术,其余5组分别行卵巢切除,1周后分别灌胃给予维生素D3 (2 mg/kg)以及小、中、大剂量菟丝子黄酮连续给药3个月。腹主动脉取血,分离血清,取出肾脏,采用酶联免疫吸附法检测 1,25(OH)₂ D₃含量。之后处死动物,取出股骨,测定骨密度;取出第2腰椎,采用实时荧光反转录聚合酶链反应(real-time RT-PCR)测定腰椎和肾脏组织维生素D受体mRNA表达。取出小肠,采用RT-PCR测定小肠CaBp-D9K mRNA表达。 结果与结论：与假手术组相比,模型组股骨骨密度、血清和肾脏 1,25(OH)₂ D₃、腰椎组织维生素D受体mRNA、小肠CaBp-D9K mRNA表达均下降。与模型组比较,菟丝子黄酮中、大剂量组和维生素D3组均可使股骨骨密度、血清和肾脏1,25(OH)₂ D₃、腰椎组织维生素D受体mRNA、小肠CaBp-D9K mRNA表达增加。菟丝子黄酮能够显著提高去卵巢大鼠股骨骨密度、血清和肾脏1,25(OH)₂ D₃、腰椎组织维生素D受体mRNA、小肠CaBp-D9K mRNA表达,促进肠钙吸收与成骨细胞活性,增强骨质量。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：