Miyasaka Naoyuki, Akiyoshi Mihoko, Kubota Toshiro
Department of Pediatric, Perinatal and Maternal Medicine, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-5819, Japan,
J Bone Miner Metab. 2014 Sep;32(5):588-92. doi: 10.1007/s00774-013-0534-x. Epub 2013 Nov 8.
The autonomic nervous system (ANS) has attracted attention as a regulator of bone remodeling and the effects of beta-blockers on the prevention of osteoporosis have been studied. However, results are as yet inconclusive and the physiological role of the ANS in bone metabolism has not been clarified. Thus, we investigated the relationship between bone mineral density (BMD) and ANS activity in non-medicated perimenopausal women. ANS activity was evaluated by power spectral analysis of heart rate variability, and overall ANS activity and the balance between sympathetic and parasympathetic nervous activities (SNS and PNS) were quantified. Pre- and postmenopausal subjects were divided into higher or lower overall ANS activity groups, and were also divided into SNS- and PNS-dominant groups. BMD (percentage of young adult mean) was significantly higher in the higher overall ANS group than in the lower group (112.2 ± 16.2 % vs 99.7 ± 14.8 %, p < 0.05) of premenopausal subjects, but not in postmenopausal subjects (91.5 ± 15.9 % vs 91.0 ± 14.9 %). BMD was significantly higher in the SNS-dominant group than in the PNS-dominant group (94.1 ± 16.3 % vs 88.4 ± 18.8 %, p < 0.05) of postmenopausal subjects, but not in the premenopausal subjects (103.5 ± 18.4 % vs. 107.2 ± 14.6 %). Our study revealed that ANS influences bone metabolism under physiological conditions. Thus, it appears to be worthwhile to introduce ANS activity evaluation into the management of bone health in perimenopausal women.
自主神经系统（ANS）作为骨重塑的调节因子已引起关注，并且人们已经研究了β受体阻滞剂对预防骨质疏松症的作用。然而，结果尚无定论，自主神经系统在骨代谢中的生理作用尚未阐明。因此，我们研究了未用药的围绝经期妇女骨矿物质密度（BMD）与自主神经系统活动之间的关系。通过心率变异性的功率谱分析评估自主神经系统活动，并对整体自主神经系统活动以及交感神经和副交感神经活动（SNS和PNS）之间的平衡进行量化。将绝经前和绝经后的受试者分为整体自主神经系统活动较高或较低的组，也分为以SNS为主和以PNS为主的组。绝经前受试者中，整体自主神经系统活动较高组的BMD（占年轻成人平均值的百分比）显著高于较低组（112.2±16.2%对99.7±14.8%，p<0.05），但绝经后受试者中并非如此（91.5±15.9%对91.0±14.9%）。绝经后受试者中，以SNS为主的组的BMD显著高于以PNS为主的组（94.1±16.3%对88.4±18.8%，p<0.05），但绝经前受试者中并非如此（103.5±18.4%对107.2±14.6%）。我们的研究表明，自主神经系统在生理条件下会影响骨代谢。因此，将自主神经系统活动评估引入围绝经期妇女的骨骼健康管理似乎是值得的。
