Scheidt-Nave C, Bismar H, Leidig-Bruckner G, Woitge H, Seibel M J, Ziegler R, Pfeilschifter J
Departments of Social Medicine and Clinical Epidemiology, University of Heidelberg Medical Center, Germany.
J Clin Endocrinol Metab. 2001 May;86(5):2032-42. doi: 10.1210/jcem.86.5.7445.
The role of serum interleukin 6 (IL-6) as a predictor of bone loss was examined in a population-based, longitudinal study of 137 postmenopausal German women, 52-80 yr old at baseline. Serum IL-6 and other biochemical parameters were measured in baseline blood or urine specimens. Repeat standardized measures of bone mineral density (BMD) at the femur (total hip) and the lumbar spine (L2-L4) were taken by dual x-ray absorptiometry an average of 3.3 yr apart. Medical history and anthropometric measures were obtained from standardized interview and examination. Crude and age-adjusted mean serum IL-6 levels were significantly lower in postmenopausal women with than without hormone replacement therapy at baseline. Among nonusers of hormone replacement therapy, serum IL-6 concentrations were highly predictive of femoral bone loss, independently of potential confounders and plasma sex hormones. Statistical interaction between serum IL-6 and menopausal age or menopausal age group (>10 vs. < or =10 yr) indicated that the effect of IL-6 on bone loss weakened with increasing distance from menopause and was no longer significant in women more than 10 yr after menopause. Among women up to 10 yr past menopause (n = 39), serum IL-6 was the single most important predictor of femoral bone loss, accounting for up to 34% of the total variability of change in BMD. The unadjusted linear model predicted an annual 1.34% (95% confidence interval, 0.67-2.01) decrease in total hip BMD per log unit increase in serum IL-6. A similar, although nonsignificant, effect of serum IL-6 on vertebral bone loss was restricted to women within the first 6 yr after menopause (n = 18). These epidemiological data show that serum IL-6 is a predictor of postmenopausal bone loss, and that the effect appears to be most relevant through the first postmenopausal decade. Whether these findings reflect pathogenetic differences between early and postmenopausal bone loss, and whether serum IL-6 also predicts fracture risk need further elucidation.
在一项基于人群的纵向研究中，对137名年龄在52 - 80岁的绝经后德国女性进行了血清白细胞介素6（IL - 6）作为骨质流失预测指标作用的研究。在基线血液或尿液样本中测量血清IL - 6和其他生化参数。采用双能X线吸收法，平均间隔3.3年重复测量股骨（全髋）和腰椎（L2 - L4）的骨密度（BMD）。通过标准化访谈和检查获取病史和人体测量数据。在基线时，接受激素替代治疗的绝经后女性的粗血清IL - 6水平和年龄调整后的血清IL - 6水平显著低于未接受激素替代治疗的女性。在未使用激素替代治疗的女性中，血清IL - 6浓度高度预测股骨骨质流失，独立于潜在混杂因素和血浆性激素。血清IL - 6与绝经年龄或绝经年龄组（>10年与≤10年）之间的统计交互作用表明，IL - 6对骨质流失的影响随着绝经时间的增加而减弱，在绝经超过10年的女性中不再显著。在绝经后10年内的女性（n = 39）中，血清IL - 6是股骨骨质流失的唯一最重要预测指标，占BMD变化总变异性的34%。未调整的线性模型预测，血清IL - 6每增加一个对数单位，全髋BMD每年下降1.34%（95%置信区间，0.67 - 2.01）。血清IL - 6对椎体骨质流失的类似但不显著的影响仅限于绝经后前6年内的女性（n = 18）。这些流行病学数据表明，血清IL - 6是绝经后骨质流失的预测指标，并且这种影响在绝经后的第一个十年似乎最为相关。这些发现是否反映了绝经早期和绝经后骨质流失之间的发病机制差异，以及血清IL - 6是否也能预测骨折风险，还需要进一步阐明。
