GH/IGF-1轴与绝经后女性骨密度、骨代谢的相关性研究  

Correlation Between GH/IGF-1 Axis and Bone Mineral Density, Bone Metabolism in Postmenopausal Women

作　　者：陈艳婷 孙伟珊 崔侨娜 喻佩 罗玉婷 罗洁 刘宗辉 王晓东[1] 邓伟民 CHEN Yanting;SUN Weishan;CUI Qiaona;YU Pei;LUO Yuting;LUO Jie;LIU Zonghui;WANG Xiaodong;DENG Weimin(Department of Osteoporosis,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou Guangdong 510080,China)

机构地区：[1]广东药科大学附属第一医院骨内科,广东广州510080 [2]南部战区总医院康复科

出　　处：《华南国防医学杂志》2022年第6期422-427,共6页Military Medical Journal of South China

基　　金：军委后勤保障部卫生局课题(16BJZ57)。

摘　　要：目的 分析绝经后女性血清生长激素(growth hormone, GH)、胰岛素样生长因子-1(insulin-like growth factors-1,IGF-1)水平与骨密度(bone mineral density, BMD)、骨代谢的相关性。方法 将符合研究标准的绝经后女性按BMD检查参数分为骨质疏松组(n=63)、骨量低下组(n=108)及骨量正常组(n=67),对比3组间以下指标的差异:①临床一般资料;②BMD;③骨质疏松生化指标:甲状旁腺激素(parathyroid hormone, PTH)、总Ⅰ型胶原氨基端前肽(total N-terminal propeptide of typeⅠcollagen, PINP)、β-胶原降解产物(β-crosslaps,β-CTX)、N端骨钙素(osteocalcin, OC)、1-25羟基维生素D3 (1,25-dihydroxy vitamin D,1-25-OH-D3);④ GH、IGF-1。并对GH及IGF-1与各部位BMD及骨质疏松生化指标的相关性进行分析。结果①骨质疏松组患者的年龄高于骨量低下组与骨量正常组,体质量、体质量指数(body mass index, BMI)、各部位BMD水平低于骨量低下组与骨量正常组,组间比较差异有统计学意义(P均<0.05);②骨质疏松组PINP、β-CTX水平高于骨量低下组及骨量正常组,OC显著高于骨量正常组,组间比较差异有统计学意义(P均<0.05);③骨质疏松组GH水平低于骨量低下组与骨量正常组,IGF-1水平低于骨量正常组,组间比较差异有统计学意义(P均<0.05)。GH与腰椎、左股骨颈、左股骨上端BMD均呈正相关(r分别为0.372、0.249、0.276,P均<0.05),IGF-1与腰椎BMD呈正相关(r=0.200,P<0.05);GH与PTH呈负相关(r=-0.112,P<0.05),IGF-1与PTH、β-CTX均呈负相关(r分别为-0.155、-0.240,P均<0.05)。结论 GH、IGF-1与绝经后女性BMD呈正相关,与绝经后女性高骨转换率状态呈负相关,GH及IGF-1水平对维持机体BMD有重要作用,对调节绝经后女性高骨转换率状态具有重要意义。Objective To analyze the correlation between serum growth hormone(GH), insulin-like growth factors-1(IGF-1) levels and bone mineral density(BMD), bone metabolism in postmenopausal women. Methods The postmenopausal women were divided into osteoporosis group(n=63), low bone mass group(n=108) and normal bone mass group(n=67) according to BMD parameters. The differences of the following indicators among the three groups were compared:①general clinical data;②BMD;③ osteoporosis biochemical indicators: parathyroid hormone(PTH), total N-terminal propeptide of type Ⅰ collagen(PINP), β-crosslaps(β-CTX), osteocalcin(OC), 1,25-dihydroxy vitamin D(1-25-OH-D3);④ GH, IGF-1. The correlation between GH, IGF-1 and BMD, osteoporosis biochemical indicators was analyzed. Results① The age of the osteoporosis group was significantly higher than that of the low bone mass group and the normal bone mass group, and the weight, body mass index(BMI) and BMD were significantly lower than those of the low bone mass group and the normal bone mass group, the difference among groups was statistically significant(all P<0.05).② The level of PINP and β-CTX in the osteoporosis group were significantly higher than those in the low bone mass group and the normal bone mass group, the level of OC in osteoporosis group was significantly higher than that in normal bone mass group, the difference among groups was statistically significant(all P<0.05).③ The level of GH in osteoporosis group was lower than that of the low bone mass group and the normal bone mass group, and the IGF-1 level was lower than that of the normal bone mass group, the difference was statistically significant(all P<0.05). GH was positively correlated with the BMD of the lumbar spine, left femoral neck and upper left femur(r=0.372, 0.249, 0.276 respectively, all P<0.05). IGF-1 was positively correlated with the BMD of lumbar spine(r=0.200, P<0.05), GH was negatively correlated with PTH(r=-0.112, P<0.05), IGF-1 was negatively correlated with PTH and β-CTX(r=-0.155、-

关 键 词：绝经后骨质疏松症 生长激素/胰岛素样生长因子-1 骨密度 骨代谢 相关性 

分 类 号：R580[医药卫生—内分泌]