Suh Kuen Tak, Lee Sang-Sup, Hwang Sang Hyun, Kim Seong-Jang, Lee Jung Sub
Department of Orthopaedic Surgery, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, 602-739, Pusan, Republic of Korea.
Eur Spine J. 2007 Oct;16(10):1563-9. doi: 10.1007/s00586-007-0390-2. Epub 2007 May 23.
Generalized low bone mass and osteopenia in both axial and peripheral skeleton in adolescent idiopathic scoliosis (AIS) have been reported in literature. However, the exact mechanisms and causes of the bone loss in AIS are not identified yet. Therefore, this study examined the relationship between serum concentration of soluble receptor activator of nuclear factor-kappaB ligand (RANKL), serum level of osteoprotegerin (OPG) and bone mass in 72 patients with AIS and compared to those of 64 age- and gender-matched healthy controls. The mean lumbar spinal bone mineral density (LSBMD) and femoral neck BMD (FNBMD) in patients with AIS were decreased compared with that in control individuals, respectively (P = 0.0029 and P = 0.0192, respectively). The mean RANKL and RANKL to OPG ratio in patients with AIS were increased compared with that in control subjects, respectively (P = 0.0004 and P = 0.0032, respectively). The RANKL and RANKL to OPG ratios were negatively correlated to the LSBMD and serum OPG levels in both groups. Serum OPG levels were positively correlated to the LSBMD and FNBMD in both groups. These findings mean that the imbalance and the disturbed interaction of RANKL and OPG may be an important cause and pathogenesis in reduced BMD in AIS.
文献报道青少年特发性脊柱侧凸（AIS）患者中轴骨和外周骨均存在全身性低骨量和骨质减少。然而，AIS患者骨质流失的确切机制和原因尚未明确。因此，本研究检测了72例AIS患者血清中核因子κB受体活化因子配体（RANKL）浓度、骨保护素（OPG）水平与骨量之间的关系，并与64例年龄和性别匹配的健康对照者进行比较。AIS患者的腰椎骨密度（LSBMD）和股骨颈骨密度（FNBMD）均值分别低于对照组（P值分别为0.0029和0.0192）。AIS患者的RANKL均值和RANKL与OPG的比值均高于对照组（P值分别为0.0004和0.0032）。两组中RANKL及RANKL与OPG的比值均与LSBMD及血清OPG水平呈负相关。两组中血清OPG水平均与LSBMD和FNBMD呈正相关。这些研究结果表明，RANKL和OPG的失衡及相互作用紊乱可能是AIS患者骨密度降低的重要原因和发病机制。
