绝经妇女补充大豆异黄酮和钙后骨密度的改变及与ER基因Px单倍型的关系  

Relationship between estrogen receptor gene Px haplotype and the effect of calcium and soy isoflavone supplementation on bone mineral density of Chinese postmenopansal women

作　　者：董杰[1] 黄振武[1] 朴建华[1] 李芳[2] 曾晶[2] 龚洁[2] 杨晓光[1] 

机构地区：[1]中国疾病预防控制中心营养食品所,北京100050 [2]武汉市疾病预防控制中心

出　　处：《中华预防医学杂志》2008年第5期329-334,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（30300286）

摘　　要：目的 探讨绝经妇女补充大豆异黄酮和钙1年后骨密度（BMD）的改变及与雌激素受体（ER）基因Px单倍型的关系。方法 应用多聚酶链反应-限制性片段长度多态性（PCR—RFLP）检测691名汉族45～65岁绝经妇女的ER-a的PvuⅡ和Xba I酶切位点多态性，从497名Pvu Ⅱ-Xba I单倍体确定者中抽取93名进行为期1年的随机对照干预实验。根据基线时BMD测定结果，将T〈-1．5者纳入干预组（共52名），其余的作为观察组（共29名）。将干预组对象随机分为2组：补钙＋维生素D（VD）组和补钙＋VD＋大豆异黄酮组。给予的剂量分别为：钙440mg／d；VD100IU／d；大豆异黄酮100mg／d，正常观察组不给予任何特殊处理，干预期为12个月。采用双能x线吸收仪（DXEA）测量测定基线和终期腰椎及髋部的BMD。结果 试验结束后，观察组的绝经后妇女，全身、腰椎及股骨颈的BMD较基线时降低，变化率分别为-1．88％，-3．31％，-3．09％。ER-a的Px基因型全身BMD较基线时性降低2．44％，而non-Px基因型则无显著性改变。补钙组和补钙＋大豆异黄酮组，全身及股骨颈的BMD都较基线时降低，但组间的变化率差异并无统计学意义；而腰椎、大转子的BMD较基线未有显著性的改变，甚至有略微升高。补钙和补大豆异黄酮对BMD的影响与ER-a的基因型无关。结论 妇女绝经后骨量开始丢失，丢失速率似乎与ER基因Px单倍型有相关性。已出现骨量减少的绝经后妇女补钙1年能降低骨量的丢失速率，但补充大豆异黄酮1年尚未观察到对BMD保护的作用。补钙及大豆异黄酮对BMD的干预效果与ER-a基因多态性无关。Objective To investigate the relationship between estrogen receptor gene Px haplotype and the effect of calcium and soy isoflavone supplementation on bone mineral density （ BMD ） of Chinese postmenopausal women. Methods It was a randomly controlling test for 12 months. The Pvu II and Xba I polymorphlsms of ER-a gene were detected by using restriction fragment length polymorphisms （RFLP） in 691 Chinese postmenopansal women, aged 45 - 65 years. In 497 carriers of definitive Pvu II-Xba I haplotype, 93 subjects were chosen randomly. BMD was measured by dual energy X-ray absorptiometry （DXEA）. According to BMD T score in any skeleton site of 81 subjects at baseline, 29 subjects with T≥ - 1.5 were grouped into observation group, and 52 subjects with T 〈 - 1.5 were randomly assigned into two intervention groups and received either a 100 mg soy isoflavone and 440 mg Ca and 100 IU VD supplement/ d （n = 26） or 440 mg Ca and 100 IU VD supplement/d （n = 26）. BMD of the whole body, lumber （L2-L4） , and hip were measured at baseline and after 12 months. Results After one year fellow-up, the BMD at L2- L4, femur neck site and whole body were significantly decreased as compared with those of baseline （P 〈 0.05 ,change percent of BMD as follows： -3.31% , -3. 09% , - 1.88% ） in observation group, and the whole body BMD was significantly lower at 12 month than that at baseline in subjects with Px haplotype （ percent change was - 2.44% , P 〈 0. 05 ） , but no difference was found in subjects without Px haplotype. Whole body and femur neck BMD were significantly decreased in both Ca group and Ca ＋ soy isoflavone group, but no significant difference of change percent between two groups. There were no significant changes in L2-L4 and trochanter BMD irrespective of treatment. ER-a Px haplotype had no effect on the changes in BMD in both Ca group and Ca ＋ soy isoflavone group. Conclusion The rate of bone loss in Chinese postmenopausal women seems to haverelation to ER Px haplotype. Calcium su

关 键 词：异黄酮类 钙 骨密度 雌激素受体 多态性 限制性片段长度 黄豆 绝经后妇女 

分 类 号：R686[医药卫生—骨科学]