炎症标志物的循环水平可预测老年人骨矿物质密度和骨吸收的变化：一项纵向研究。

Circulating levels of inflammatory markers predict change in bone mineral density and resorption in older adults: a longitudinal study.

作者信息

Ding Changhai, Parameswaran Venkat, Udayan Ray, Burgess John, Jones Graeme

机构信息

Menzies Research Institute, University of Tasmania, Hobart, Tasmania 7000, Australia.

出版信息

J Clin Endocrinol Metab. 2008 May;93(5):1952-8. doi: 10.1210/jc.2007-2325. Epub 2008 Feb 19.

DOI:10.1210/jc.2007-2325

PMID:18285417

Abstract

CONTEXT

IL-1, IL-6, and TNF-alpha play an important role in the pathogenesis of osteoporosis in animals; however, evidence that these play a similar role in bone loss in human studies is limited.

OBJECTIVE

Our objective was to determine the associations between serum markers of inflammation and changes in bone mineral density (BMD) and urinary pyridinoline (PYR) to creatinine (Cr) ratio over 2.9 yr in older adults.

METHODS

A total of 168 randomly selected subjects (mean 63 yr, range 52-78, 48% female) was studied. BMD was measured by dual-energy x-ray absorptiometry at baseline (mean T score: -0.18 to -0.61) and 2.9 yr later. Serum high-sensitivity (hs) C-reactive protein (CRP), IL-6, TNF-alpha, and the urinary PYR/Cr ratio were measured on both occasions.

RESULTS

The mean annual loss of BMD was 0.15, 0.15, and 0.34% at total body, spine, and hip, respectively. Change in total body BMD was associated with baseline hs-CRP, IL-6, and TNF-alpha, as well as change in hs-CRP (beta: -0.41%/U, 95% confidence interval -0.68%, -0.15%) and IL-6 (beta: -0.62%/U, 95% confidence interval -1.01%, -0.23%). If these markers were put in the same predictive model, only IL-6 remained largely unchanged. Changes in other BMD sites were significantly predicted by IL-6 (hip and spine) and TNF-alpha (spine only). Finally, change in the PYR/Cr ratio was positively associated baseline IL-6, hs-CRP, and their changes (all P < 0.05) in women, but not men.

CONCLUSIONS

Variation within the low levels of inflammatory markers observed in this study, especially IL-6, predicts bone loss and resorption, suggesting that targeted antiinflammatory therapy has potential for the prevention of osteoporosis.

摘要

背景

白细胞介素-1（IL-1）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）在动物骨质疏松症发病机制中起重要作用；然而，在人体研究中这些因子在骨质流失方面起类似作用的证据有限。

目的

我们的目的是确定老年成年人2.9年间炎症血清标志物与骨矿物质密度（BMD）变化以及尿吡啶啉（PYR）与肌酐（Cr）比值之间的关联。

方法

共研究了168名随机选择的受试者（平均年龄63岁，范围52 - 78岁，48%为女性）。在基线时（平均T值：-0.18至-0.61）和2.9年后通过双能X线吸收法测量BMD。在两个时间点均测量血清高敏（hs）C反应蛋白（CRP）、IL-6、TNF-α以及尿PYR/Cr比值。

结果

全身、脊柱和髋部的BMD年均丢失率分别为0.15%、0.15%和0.34%。全身BMD变化与基线hs-CRP、IL-6和TNF-α以及hs-CRP变化（β：-0.41%/U，95%置信区间-0.68%，-0.15%）和IL-6变化（β：-0.62%/U，95%置信区间-1.01%，-0.23%）相关。如果将这些标志物纳入同一预测模型，只有IL-6基本保持不变。其他BMD部位的变化可由IL-6（髋部和脊柱）和TNF-α（仅脊柱）显著预测。最后，PYR/Cr比值变化在女性中与基线IL-6、hs-CRP及其变化呈正相关（均P < 0.05），但在男性中并非如此。