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原发性骨质疏松症与肌-骨-脂关系

摘要:背景 骨质疏松症作为慢性老年性疾患,其发病过程缓慢隐秘,在学术界素有“沉默杀手”之称,目前针对“肌-骨-脂”之间和骨质疏松症发病联系的研究较少。目的 检测受试者T值、脂肪质量、肌肉质量和骨矿含量相关指标,记录一般信息,计算BMI和脂肪百分比,探讨骨质疏松症与肌-骨-脂关系。方法 纳入108例受试者,记录一般资料,DXA检测受试者T值、脂肪质量、肌肉质量和骨矿含量,Elisa法检测钙、骨形态发生蛋白-2(BMP2)、骨保护素(OPG)等骨形成相关血清指标,根据受试者的不同年龄段分组,用单因素方差分析法比较不同年龄段受试者的身高、体重、BMI、T值、脂肪质量、肌肉质量、脂肪百分比和骨矿含量。根据T值将受试者分为正常组、骨量减少组、骨质疏松组,比较不同组别间脂肪质量、肌肉质量、脂肪百分比、骨矿含量和骨形成相关血清指标。结果 不同年龄段的受试者T值差异有统计学意义(P<0.05),其中≥69岁年龄段与49~58岁年龄段T值差异具有显著统计学意义(P<0.01)。不同骨密度组别间脂肪质量、肌肉质量、骨矿含量差异有统计学意义(P<0.05),其中骨矿含量差异有显著统计学意义(P<0.01)。与正常组相比,骨量减少组和骨质疏松组的骨矿含量差异有显著统计学意义(P<0.01),骨质疏松组脂肪含量差异具有统计学意义(P<0.05)。不同骨密度组别间OPG、BMP2、BCL2表达差异均有统计学意义(P<0.05),与正常组比较,骨量减少组和骨质疏松组BMP2表达差异有统计学意义(P<0.05),骨质疏松组OPG表达差异有统计学意义(P<0.05)。结论 “肌-骨-脂”之间的动态平衡与骨质疏松症发病过程密切相关。随着年龄的增大,人体骨密度呈下降趋势,骨密度是影响人体脂肪质量、肌肉质量、骨矿含量的重要因素;血清BMP2、OPG和Bcl2含量降低,这可能与凋亡蛋白不能很好发挥作用抗凋亡和促骨形成作用,使得成骨细胞活性降低,骨形成活动减弱有关。

英文摘要:Background Osteoporosis, as a chronic senile disease, has a slow and stealthy onset process and is known as a "silent killer" in the academic community. At present, there are few studies on the relationship between "muscle-bone-fat" and the incidence of osteoporosis. Objective T value, fat mass, muscle mass and bone mineral content of subjects were detected, general information was recorded, BMI and fat percentage were calculated, and the relationship between osteoporosis and muscle-bone-fat was discussed. Methods A total of 108 subjects were enrolled, and general data were recorded. T value, fat mass, muscle mass and bone mineral content of the subjects were detected by DXA. Serum parameters related to bone formation such as calcium, bone morphogenetic protein-2 (BMP2) and bone protectin (OPG) were detected by Elisa. The height, weight, BMI, T value, fat mass, muscle mass, fat percentage and bone mineral content of subjects in different age groups were compared by one-way anOVA. According to T value, subjects were divided into normal group, osteopenia group and osteoporosis group, and the fat mass, muscle mass, fat percentage, bone mineral content and serum parameters related to bone formation were compared among different groups. Results There was statistically significant difference in T values between subjects of different age groups (P<0.05), and there was statistically significant difference between subjects of ≥69 years old and 49-58 years old (P<0.01). There were statistically significant differences in fat mass, muscle mass and bone mineral content among different BMD groups (P<0.05), and there were statistically significant differences in bone mineral content among different BMD groups (P<0.01). Compared with the normal group, the difference of bone mineral content between the osteoporotic group and the osteoporotic group was statistically significant (P<0.01), and the difference of fat content between the osteoporotic group was statistically significant (P<0.05). There were significant differences in the expression of OPG, BMP2 and BCL2 among different BMD groups (P<0.05). Compared with the normal group, there were significant differences in the expression of BMP2 between bone mass loss group and osteoporosis group (P<0.05), and there were significant differences in the expression of OPG in osteoporosis group (P<0.05). Conclusion The dynamic balance between muscle - bone - fat is closely related to the pathogenesis of osteoporosis. Bone mineral density (BMD), which is an important factor affecting fat mass, muscle mass and bone mineral content, tends to decrease with age. The contents of serum BMP2, OPG and Bcl2 decreased, which may be related to the fact that apoptotic proteins could not play a good role in anti-apoptosis and promoting bone formation, which reduced the activity of osteoblasts and weakened the activity of bone formation.

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[V1] 2022-08-12 18:31:09 chinaXiv:202208.00087V1 下载全文
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