Pepene C E, Seck T, Diel I, Minne H W, Ziegler R, Pfeilschifter J
Department of Internal Medicine I, University of Heidelberg, Germany.
Exp Clin Endocrinol Diabetes. 2004 Jan;112(1):38-43. doi: 10.1055/s-2004-815725.
Previous studies have shown a link between low serum insulin-like growth factor-I (IGF-I) and decreased bone mass of patients with osteoporosis. However, whether serum levels are representative for the growth factor concentration or activity available in human bone tissue is controversial. In the present study, IGF-I was assessed in serum and bone matrix extracts from the iliac crest in 19 eugonadal women with idiopathic osteoporosis and in 38 age-matched controls. In addition, the relationship between the skeletal levels of IGF-I and bone mineral density (BMD) or the susceptibility to osteoporotic fractures in women with osteoporosis was examined. Bone matrix extraction was performed based on a guanidine-HCL/ethylendiamine-tetraacetic acid (EDTA) method. No significant difference in both serum and bone matrix IGF-I levels between groups was observed. Serum IGF-I concentrations failed to be associated with bone matrix IGF-I levels in osteoporotic patients. However, in premenopausal women with idiopathic osteoporosis, skeletal IGF-I positively correlated with BMD at the lumbar spine (r = + 0.58, p = 0.01). In contrast, neither femoral neck BMD nor Ward's triangle BMD was associated with bone matrix IGF-I concentrations. A tendency towards lower levels of bone matrix IGF-I in subjects with vertebral fractures as compared to those without fractures was observed in age-adjusted analyses, however the difference failed to remain statistically significant after adjustment for bone mineral density. These data provide no clear evidence for low bone matrix IGF-I as a determinant factor of age-unrelated osteoporosis. However, low skeletal IGF-I concentrations may aggravate osteoporosis in these women.
以往研究表明，血清胰岛素样生长因子-I（IGF-I）水平低与骨质疏松症患者骨量减少之间存在关联。然而，血清水平是否能代表人体骨组织中生长因子的浓度或活性仍存在争议。在本研究中，对19名性腺功能正常的特发性骨质疏松症女性及38名年龄匹配的对照者的血清和髂嵴骨基质提取物中的IGF-I进行了评估。此外，还研究了骨质疏松症女性的骨骼IGF-I水平与骨密度（BMD）或骨质疏松性骨折易感性之间的关系。骨基质提取采用盐酸胍/乙二胺四乙酸（EDTA）法。两组之间血清和骨基质IGF-I水平均未观察到显著差异。骨质疏松症患者的血清IGF-I浓度与骨基质IGF-I水平无关。然而，在绝经前特发性骨质疏松症女性中，骨骼IGF-I与腰椎骨密度呈正相关（r = + 0.58，p = 0.01）。相比之下，股骨颈骨密度和Ward三角骨密度均与骨基质IGF-I浓度无关。在年龄调整分析中，观察到有椎体骨折的受试者骨基质IGF-I水平有低于无骨折受试者的趋势，然而在调整骨密度后，差异不再具有统计学意义。这些数据没有提供明确证据表明低骨基质IGF-I是与年龄无关的骨质疏松症的决定因素。然而，低骨骼IGF-I浓度可能会加重这些女性的骨质疏松症。
