老年人血清炎症因子与骨密度变化及骨吸收相关性研究  

Correlation between changes in serum inflammatory factors and bone mineral density and bone resorption in older people

作　　者：韩学明[1] 孙忠良[1] 徐建华[1] 吴俊[1] HAN Xueming;SUN Zhongliang;XU Jianhua;WU Jun(Department of Orthopaedics,Fourth Division Hospital,Xinjiang Production and Construction Corps,Yili 835000,China)

机构地区：[1]新疆生产建设兵团四师医院骨科

出　　处：《中国骨质疏松杂志》2020年第2期221-226,共6页Chinese Journal of Osteoporosis

摘　　要：目的探讨老年人血清炎症标志物与骨密度(bone mineral density,BMD)变化和尿吡啶啉(PYR)及肌酐(Cr)比值变化之间的关系。方法共纳入168名随机选择的受试者(年龄52~78岁,平均63岁,女性占48%)。BMD通过双能X线吸收测定法在基线时和平均2. 9年后测量(平均T值:-0. 18^-0. 61)。测定受试者血清高敏感性(hs) C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,并测量尿PYR/Cr比率。结果受试者全身、腰椎和髋部BMD平均年损失分别为0. 15%、0. 15%和0. 34%。全身BMD的变化与基线hs-CRP、IL-6、TNF-α(β:-0. 41%/U,95%置信区间:-0. 68%,-0. 15%)以及hs-CRP与IL-6(β:-0. 62%/U,95%置信区间:-1. 01%,-0. 23%)的变化密切相关。如果将这些标记置于相同的预测模型中,则只有IL-6基本保持不变。IL-6(髋部和腰椎)和TNF-α(仅腰椎)可显著预测其他部位BMD的变化。最后,PYR/Cr比值的变化与女性基线的IL-6、hs-CRP及其变化呈正相关(P均<0. 05),而与男性无关。结论本研究中观察到的IL-6的改变和骨密度降低及骨吸收有关。Objective To determine the associations between serum markers of inflammation and changes in bone mineral density(BMD) and urinary pyridinoline(PYR) to creatinine(Cr) ratio in older adults. Methods A total of 168 randomly selected subjects(mean age 63 years,range 52-78,48% female) were studied. BMD was measured by dual-energy X-ray absorptiometry at baseline(mean T-score:-0. 18 to-0. 61) and 2. 9 years later. Serum high-sensitivity C-reactive protein(hs-CRP),interleukin 6(IL-6),tumor necrosis factor alpha(TNF-α),and the urinary PYR/Cr ratio were measured on both occasions. Results The mean annual loss of BMD was 0. 15%,0. 15%,and 0. 34% at total body,spine,and hip,respectively. Change in total body BMD was associated with baseline hs-CRP,IL-6 and TNF-α,as well as change in hs-CRP(β:-0. 41%/U,95% confidence interval-0. 68%,-0. 15%) and IL-6(β:-0. 62%/U,95% confidence interval-1. 01%,-0. 23%). When these markers were put in the same predictive model,only IL-6 remained largely unchanged. Changes in other BMD sites were significantly predicted by IL-6(hip and spine) and TNF-α(spine only). Finally,change in the PYR/Cr ratio was positively associated baseline IL-6,hs-CRP,and their changes(all P<0. 05)in women,but not in men. Conclusion In this study,we found that changes in IL-6 were associated with decreased bone mineral density and bone resorption.

关 键 词：炎症因子 骨密度 骨吸收 老年人 

分 类 号：R681[医药卫生—骨科学]