雌激素的来源及其在骨代谢中的作用  

The source of estrogen and its effect on bone metabolism

作　　者：王俊玲[1] 黄思敏[1] 梁启瑶 魏秋实[1] 谭新[1] 邓伟民[1] 

机构地区：[1]广州军区广州总医院,广州510010

出　　处：《中国骨质疏松杂志》2015年第6期729-732,共4页Chinese Journal of Osteoporosis

摘　　要：雌激素是一类具有广泛生物活性的类固醇激素,具有多种存在形式,其中17β-雌二醇发挥主要生理作用。绝经前的雌激素来源于由卵巢内分泌入血的循环雌激素。绝经后卵巢功能衰退,由卵巢分泌的雌激素急剧减少,而一些非性腺组织和细胞却可以旁分泌或自分泌的形式合成的雌激素,并在局部发挥作用。雌激素与骨代谢密切相关,可通过多种途径维持骨内微环境的稳态,不仅参与成骨细胞和破骨细胞的生理过程,维持成骨和破骨能力的动态平衡,还可影响骨髓间充质干细胞向成骨方向分化。此外,雌激素缺乏还与甲状旁腺素、生长激素、胰岛素样生长因子等的生物活性相关,从多种途径导致破骨水平大于成骨水平,从而诱发骨质疏松。因此,对绝经后女性骨质疏松症可采用雌激素替代疗法。然而,目前的研究对于长期使用激素带来的副作用褒贬不一,尚需进一步研究。本文对雌激素的来源及其对骨代谢平衡的影响作一综述,初步探讨雌激素的非性腺来源以及长期激素替代疗法的可行性。Estrogens are a series of bioactive steroid hormone, existing in many statuses. 17β estradiol plays the major physiological role. In premenopausal women,the ovaries are the principle source of estrogen,which functions as a circulating hormone to act on distal target tissues. However,in postmenopausal women the ovaries cease to produce estrogen. Instead,estrogens are produced in a number of extragonadal sites and act locally at these sites as a paracine or even intracirne factor but no longer a solely endocrine factor. Estrogen is closely associated with bone metabolism and maintains the balance of bone microenvironment in many ways. Estrogens are not only involved in the physiological process of osteoblasts and osteoclasts in order to maintain the dynamic equilibrium between bone formation and bone resorption,but also involved in the differentiation of osteoblasts by bone mesenchymal stem cells. Furthermore,estrogen deficiency is associated with biological activities of PTH,GH,and IGF-1,leading to bone resorption over bone formation and the onset of osteoporosis. So estrogen replacement therapy( ERT) is effective in treating postmenopausal osteoporosis. However,it is still controversial whether long-term use of ERT would bring side effects. This reviewsummarizes the sources of estrogen and their importance in bone metabolism,and explores the possibility of extragonadal source of estrogen and the long-term use of ERT.

关 键 词：雌激素 骨代谢 非性腺来源 雌激素替代疗法(ERT) 

分 类 号：R580[医药卫生—内分泌]