Department of Internal Medicine, Seoul Veterans Hospital, Seoul, South Korea.
Osteoporos Int. 2012 Apr;23(4):1235-43. doi: 10.1007/s00198-011-1675-1. Epub 2011 Jun 10.
We determined whether suppression of sclerostin levels by estrogen treatment was mediated by anti-resorptive effect. Raloxifene, but not bisphosphonates, suppressed circulating sclerostin concentration, suggesting that sclerostin may mediate the action of estrogen on bone metabolism, independently of their anti-resorptive effects.
Circulating sclerostin concentrations are higher in postmenopausal than in premenopausal women, and estrogen treatment suppresses sclerostin levels in both men and women. We determined whether anti-resorptives may suppress the circulating sclerostin levels.
We conducted a retrospective observational study. Eighty postmenopausal women were treated with raloxifene for 19.4 ± 7.7 months (n = 16), bisphosphonates for 19.2 ± 6.7 months (n = 32), or were untreated (n = 32) for 17.1 ± 4.6 months. Plasma sclerostin concentrations were measured before and after treatment.
Plasma sclerostin levels after treatment were significantly lower in the raloxifene than in the control group (55.8 ± 23.4 pmol/l vs. 92.1 ± 50.4 pmol/l, p = 0.046), but were similar between the bisphosphonate and control groups. Relative to baseline, raloxifene treatment markedly reduced plasma sclerostin concentration (-40.7 ± 22.8%, p < 0.001), with respect to both control (-7.5 ± 29.1%) and bisphosphonate (-3.1 ± 35.2%) groups. Changes in bone-specific alkaline phosphatase and osteocalcin levels showed reverse associations with sclerostin concentration changes in the raloxifene (γ = -0.505, p = 0.017) and control (γ = -0.410, p = 0.020) groups.
Raloxifene, but not bisphosphonates, significantly suppressed circulating sclerostin concentration, suggesting that sclerostin may mediate the action of estrogen on bone metabolism, independently of their anti-resorptive effects.
我们旨在确定雌激素治疗抑制骨硬化蛋白水平是否通过抗吸收作用来介导。雷洛昔芬而非双膦酸盐可抑制循环骨硬化蛋白浓度，提示骨硬化蛋白可能独立于其抗吸收作用，介导雌激素对骨代谢的作用。
绝经后女性的循环骨硬化蛋白浓度高于绝经前女性，雌激素治疗可降低男性和女性的循环骨硬化蛋白水平。我们旨在确定抗吸收剂是否可抑制循环骨硬化蛋白水平。
我们进行了一项回顾性观察性研究。80 例绝经后女性分别接受雷洛昔芬治疗 19.4±7.7 个月（n=16）、双膦酸盐治疗 19.2±6.7 个月（n=32）或未治疗 17.1±4.6 个月（n=32）。治疗前后测量血浆骨硬化蛋白浓度。
雷洛昔芬组治疗后的血浆骨硬化蛋白水平明显低于对照组（55.8±23.4 pmol/l 比 92.1±50.4 pmol/l，p=0.046），但与双膦酸盐组相似。与基线相比，雷洛昔芬治疗可显著降低血浆骨硬化蛋白浓度（-40.7±22.8%，p<0.001），相对于对照组（-7.5±29.1%）和双膦酸盐组（-3.1±35.2%）。雷洛昔芬组和对照组中骨特异性碱性磷酸酶和骨钙素水平的变化与骨硬化蛋白浓度的变化呈反向相关（γ=-0.505，p=0.017）和（γ=-0.410，p=0.020）。
雷洛昔芬而非双膦酸盐可显著抑制循环骨硬化蛋白浓度，提示骨硬化蛋白可能独立于其抗吸收作用，介导雌激素对骨代谢的作用。
