围绝经期女性雌激素水平与骨代谢指标变化的相关性研究
摘要
目的分析围绝经期女性雌激素水平与骨代谢指标变化的相关性。方法选择在医院体检的227例围绝经期妇女分为绝经前期组143例和绝经后期组84例,检测两组受试者血清雌激素水平及骨代谢相关指标,并进行相关性分析。结果绝经前期组受试者血清FSH水平显著低于绝经后期组,E2水平显著高于绝经后期组,两组差异均有统计学意义(P<0.05)。两组受试者1,25-羟维生素D3、PTH、血钙及血磷水平比较差异无统计学意义(P>0.05),绝经前期组受试者骨钙素、P1NP、β-CTx、ABAP水平显著低于绝经后期组,骨密度BMD显著高于绝经后期组,差异均有统计学意义(P<0.05)。经Perason相关性分析显示,FSH与骨钙素、P1NP、β-CTx、ABAP呈显著正相关(P<0.05),E2与骨钙素、P1NP、β-CTx、ABAP呈显著负相关(P<0.05)。结论围绝经期女性机体内雌激素水平变化,可激活破骨信号通路,增强破骨细胞活性,促进骨组织的吸收,最终引起骨密度的降低而引发骨质疏松症。
引文
[1]陈荣滋,陈昆,刘爱刚,等.妇女围绝经期雌激素水平与骨质疏松发生的临床分析[J].中国妇幼健康研究,2016,27(7):811-812,821.
[2]李景龙,贾义军,邱功名,等.结合雌激素片联合用药治疗绝经后骨质疏松症的临床观察[J].中国药房,2016,27(20):2849-2851.
[3]Suthon S,Jaroenporn S,Charoenphandhu N,et al.Anti-osteoporotic effects of Pueraria candollei var.mirifica on bone mineral density and histomorphometry in estrogen-deficient rats[J].J Nat Med,2016,70(2):225-233.
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[5]Luo D,Liu Y,Zhou Y,et al.Association between dietary phytoestrogen intake and bone mineral density varied with estrogenreceptor alpha gene polymorphisms in southern Chinese postmenopausal women[J].Food Funct,2015,6(6):1977-1983.
[6]冯建军,钟慧琴,任江林,等.新疆乌鲁木齐汉族、维吾尔族围绝经期骨量减少女性骨代谢和维生素D水平的差异[J].中国老年学杂志,2014,34(17):4991-4992.
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[11]王瑛,沈建雄,徐旻,等.围绝经期女性骨代谢指标的监测及其与性激素的关系[J].国际检验医学杂志,2014,28(18):2533-2534.
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[13]Lai N,Zhang Z,Wang B,et al.Regulatory effect of traditional Chinese medicinal formula Zuo-Gui-Wan on the Th17/Treg paradigm in mice with bone loss induced by estrogen deficiency[J].J Ethnopharmacol,2015,26(166):228-229.
[14]邢玉鉴.围绝经期妇女应用HRT对血脂及骨密度的影响[J].中国实验诊断学,2014,18(2):286-287.
[15]Farr JN,Khosla S,Miyabara Y,et al.Effects of estrogen with micronized progesterone on cortical and trabecular bone mass and microstructure in recently postmenopausal women[J].J Clin Endocrinol Metab,2013,98(2):E249-E257.
[16]刘达,康夏,谢庆云,等.卵巢切除联合激素注射对绵羊股骨近端骨密度及生物力学性能的影响[J].重庆医学,2015,44(12):1606-1608,1612.
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[19]俞庆声,郭万首,程立明,等.甾体类激素影响骨内微血管内皮细胞表达谱与转录组的初探[J].中华医学杂志,2014,94(48):3817-3820.
[20]石维,卜瑞芳.围绝经期血糖偏高女性血脂、血压与骨密度降低的关系研究[J].中国妇幼保健,2016,31(12):2505-2506.
[21]陆琴,李文佼,金皖玲,等.围绝经期妇女不同雌二醇和卵泡刺激素水平与骨密度的关系[J].中国老年学杂志,2014,34(12):3296-3298.
[22]Cohen A,Kamanda-Kosseh M,Recker RR,et al.Bone density after teriparatide discontinuation in premenopausal idiopathic osteoporosis[J].J Clin Endocrinol Metab,2015,100(11):4208-4214.
[23]李凝旭,涂艳,沈莹,等.淫羊藿和女贞子提取物对骨质疏松症大鼠性激素功能水平的影响[J].中国免疫学杂志,2016,32(8):1145-1149.
[24]肖卓,方远鹏,陈诚,等.雌激素及人重组生长激素对去势大鼠颌骨及股骨骨密度的影响[J].山西医科大学学报,2014,45(10):933-936,1002.
[25]谢楚海,史群伟,郭剑鸿,等.雌激素缺乏条件下MiR-133通过调控间充质干细胞成骨分化参与骨质疏松形成的机制[J].中国老年学杂志,2016,36(13):3105-3107.
[26]顾海峰,徐哲荣,吴月,等.雄激素与辛伐他汀对去势大鼠骨质疏松的治疗作用及其机制[J].中华医学杂志,2015,95(48):3941-3944.
[27]赵琳.低频脉冲电磁场治疗骨质疏松的机制及临床应用[J].中国组织工程研究,2016,20(8):1210-1216.
[28]Ma M,Chen X,Lu L,et al.Identification of crucial genes related to postmenopausal osteoporosis using gene expression profiling[J].Aging Clin Exp Res,2016,28(6):1067-1074.
[29]王冬生,韩婧,康文博,等.植物雌激素防治骨质疏松作用的机制进展[J].中国骨质疏松杂志,2016,22(5):632-640.
[2]李景龙,贾义军,邱功名,等.结合雌激素片联合用药治疗绝经后骨质疏松症的临床观察[J].中国药房,2016,27(20):2849-2851.
[3]Suthon S,Jaroenporn S,Charoenphandhu N,et al.Anti-osteoporotic effects of Pueraria candollei var.mirifica on bone mineral density and histomorphometry in estrogen-deficient rats[J].J Nat Med,2016,70(2):225-233.
[4]Palacios S,Currie H,Mikkola TS,et al.Perspective on prescribing conjugated estrogens/bazedoxifene for estrogen-deficiency symptoms of menopause:a practical guide[J].Maturitas,2015,80(4):435-440.
[5]Luo D,Liu Y,Zhou Y,et al.Association between dietary phytoestrogen intake and bone mineral density varied with estrogenreceptor alpha gene polymorphisms in southern Chinese postmenopausal women[J].Food Funct,2015,6(6):1977-1983.
[6]冯建军,钟慧琴,任江林,等.新疆乌鲁木齐汉族、维吾尔族围绝经期骨量减少女性骨代谢和维生素D水平的差异[J].中国老年学杂志,2014,34(17):4991-4992.
[7]Andersson A,Bernardi AI,Nurkkala-Karlsson M,et al.Suppression of experimental arthritis and associated bone loss by a tissue-selective estrogen complex[J].Endocrinology,2016,157(3):1013-1020.
[8]刘建君,孙菊水,沈鑫华,等.利培酮和奎硫平治疗对女性精神分裂症患者生殖激素和骨密度及体质量的影响[J].中华精神科杂志,2014,47(5):288-292.
[9]Hatlen P,Langhammer A,Forsmo S,et al.Bone mass density,fracture history,self-reported osteoporosis as proxy variables for estrogenand the risk of non-small-cell lung cancer--a population based cohort study,the HUNT study:are proxy variables friends or faults[J].Lung Cancer,2013,81(1):39-46.
[10]Piri F,Khosravi A,Moayeri A,et al.The effects of dietary supplements of calcium,vitamin D and estrogen hormone on serum levels of OPG and RANKL cytokines and their relationship with increased bone density in rats[J].J Clin Diagn Res,2016,10(9):1-4.
[11]王瑛,沈建雄,徐旻,等.围绝经期女性骨代谢指标的监测及其与性激素的关系[J].国际检验医学杂志,2014,28(18):2533-2534.
[12]Movérare-Skrtic S,Wu J,Henning P,et al.The bone-sparing effects of estrogen and WNT16 are independent of each other[J].Proc Natl Acad Sci U S A,2015,112(48):14972-14977.
[13]Lai N,Zhang Z,Wang B,et al.Regulatory effect of traditional Chinese medicinal formula Zuo-Gui-Wan on the Th17/Treg paradigm in mice with bone loss induced by estrogen deficiency[J].J Ethnopharmacol,2015,26(166):228-229.
[14]邢玉鉴.围绝经期妇女应用HRT对血脂及骨密度的影响[J].中国实验诊断学,2014,18(2):286-287.
[15]Farr JN,Khosla S,Miyabara Y,et al.Effects of estrogen with micronized progesterone on cortical and trabecular bone mass and microstructure in recently postmenopausal women[J].J Clin Endocrinol Metab,2013,98(2):E249-E257.
[16]刘达,康夏,谢庆云,等.卵巢切除联合激素注射对绵羊股骨近端骨密度及生物力学性能的影响[J].重庆医学,2015,44(12):1606-1608,1612.
[17]Benetti-Pinto CL,Ferreira VB,Yela DA.Long-term follow-up of bone density in women with primary ovarian insufficiency[J].Menopause,2015,22(9):946-949.
[18]Henning P,Ohlsson C,Engdahl C,et al.The effect of estrogen on bone requires ERαin nonhematopoietic cells but is enhanced by ERαin hematopoietic cells[J].Am J Physiol Endocrinol Metab,2014,307(7):589-595.
[19]俞庆声,郭万首,程立明,等.甾体类激素影响骨内微血管内皮细胞表达谱与转录组的初探[J].中华医学杂志,2014,94(48):3817-3820.
[20]石维,卜瑞芳.围绝经期血糖偏高女性血脂、血压与骨密度降低的关系研究[J].中国妇幼保健,2016,31(12):2505-2506.
[21]陆琴,李文佼,金皖玲,等.围绝经期妇女不同雌二醇和卵泡刺激素水平与骨密度的关系[J].中国老年学杂志,2014,34(12):3296-3298.
[22]Cohen A,Kamanda-Kosseh M,Recker RR,et al.Bone density after teriparatide discontinuation in premenopausal idiopathic osteoporosis[J].J Clin Endocrinol Metab,2015,100(11):4208-4214.
[23]李凝旭,涂艳,沈莹,等.淫羊藿和女贞子提取物对骨质疏松症大鼠性激素功能水平的影响[J].中国免疫学杂志,2016,32(8):1145-1149.
[24]肖卓,方远鹏,陈诚,等.雌激素及人重组生长激素对去势大鼠颌骨及股骨骨密度的影响[J].山西医科大学学报,2014,45(10):933-936,1002.
[25]谢楚海,史群伟,郭剑鸿,等.雌激素缺乏条件下MiR-133通过调控间充质干细胞成骨分化参与骨质疏松形成的机制[J].中国老年学杂志,2016,36(13):3105-3107.
[26]顾海峰,徐哲荣,吴月,等.雄激素与辛伐他汀对去势大鼠骨质疏松的治疗作用及其机制[J].中华医学杂志,2015,95(48):3941-3944.
[27]赵琳.低频脉冲电磁场治疗骨质疏松的机制及临床应用[J].中国组织工程研究,2016,20(8):1210-1216.
[28]Ma M,Chen X,Lu L,et al.Identification of crucial genes related to postmenopausal osteoporosis using gene expression profiling[J].Aging Clin Exp Res,2016,28(6):1067-1074.
[29]王冬生,韩婧,康文博,等.植物雌激素防治骨质疏松作用的机制进展[J].中国骨质疏松杂志,2016,22(5):632-640.