摘要
目的探讨影响老年男性慢性阻塞性肺疾病患者骨代谢变化的相关因素。方法采用双能X 线骨密度仪测量40例老年男性COPD患者骨密度并检测其肺功能。以骨钙素(BGP)和Ⅰ型前胶原氨基端前肽(PINP)作为反映骨形成及骨转换的指标,以尿脱氧吡啶啉排泄率(D-Pyr／Cr)作为反映骨吸收的指标;观察参与骨代谢的相关激素如生长激素(GH)、甲状旁腺激素(PTH)、25- 羟维生素D3、降钙素(CT)、雌二醇(E2)、睾酮(T)等以及骨代谢相关细胞因子如白介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)、瘦素(Leptin)、胰岛素样生长因子-Ⅰ(IGF-Ⅰ),测定上述指标并记录其年龄、身高、体重及吸烟情况等,与40例对照组比较。结果 COPD组中骨质疏松组 Leptin、IGF-Ⅰ均明显低于非骨质疏松组。以COPD组患者骨密度为因变量进行回归分析,瘦素、 IGF-Ⅰ、FEV1／FVC％与Ward’s区骨密度的标准化回归系数较其他因素为高。结论慢性阻塞性肺疾病继发骨质疏松症为高转换型;在COPD患者中IL-6、TNF-α等促进破骨细胞性因子增多, 而IGF-Ⅰ等成骨细胞性因子减少,使骨吸收超过骨形成,从而促进了骨质疏松症的发生。
Objective To explore the related factors to bone metabolism in patients with COPD in aged men. Methods Hipbone and lumbar vertebra bone mineral density in 40 elderly male patients with COPD were measured by dual energy X-ray absorptiometry and their pulmonary function were also tested. The BGP and PINP were used as markers for bone formation and bone turnover, and D-Pyr / Cr for the bone absorbable. GH, PTH, 25- (OH) D3, CT, E2, T, IL-6, IL-8, TNF-α, leptin and IGF-I were measured, Results The levels of leptin and IGF-I in osteoporotic subjects were significantly lower than that of the non-osteoporotic subjects of the COPD group. With the bone mineral density of the COPD group as dependent variance to make multiple linear regression analysis, the results showed that the standardization regression coefficient of leptin, IGF-I and FEV1/FVC% with the bone mineral density of Ward's area were higher than other factors. Conclusions Chronic obstructive pulmonary diseases induced osteoporosis is high change-over pattern osteoporosis; The osteoclastic factors such as IL-6 and TNF-α increase and the osteoblastic factors such as IGF-1 decrease in COPD patients. The more re-absorption of bone tissues over bone formation might accelerate osteoporosis.
出处
《中国骨质疏松杂志》
CAS
CSCD
2005年第2期221-224,共4页
Chinese Journal of Osteoporosis
