Kashii Masafumi, Matuso Yohei, Sugiura Tsuyoshi, Fujimori Takahito, Nagamoto Yukitaka, Makino Takahiro, Kaito Takashi, Ebina Kosuke, Iwasaki Motoki, Yoshikawa Hideki
Department of Orthopedic Surgery, Faculty of Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
J Bone Miner Metab. 2016 May;34(3):315-24. doi: 10.1007/s00774-015-0671-5. Epub 2015 Jun 4.
Sclerostin and dickkopf-1(DKK1) are Wnt/β-catenin signal antagonists that play an important role in bone formation. Ossification of the posterior longitudinal ligament (OPLL) of the spine is characterized by pathological ectopic ossification of the posterior longitudinal ligament and ankylosing spinal hyperostosis. The aims of this study were to evaluate serum sclerostin and DKK1 levels in persons with OPLL and to identify its relationship with bone metabolism and bone mass in persons with OPLL. This was a case-control study, and 78 patients with OPLL were compared with 39 age- and sex-matched volunteers without OPLL. We analyzed the relationship with calciotropic hormones, bone turnover markers, OPLL localization, number of ossified vertebrae, and bone mineral density of total hip (TH-BMD). Serum sclerostin levels in men with OPLL were significantly higher than in men in the control group (control group: mean = 45.3 pmol/L; OPLL group: mean = 75.7 pmol/L; P = 0.002). Age and sclerostin levels were positively correlated in men with OPLL (r = 0.43; P = 0.002). Serum sclerostin levels in men with OPLL had a positive correlation with TH-BMD Z-score (r = 0.511; P = 0.011, n = 30). There was a strong negative correlation between serum sclerostin levels and serum DKK1 levels in men with OPLL (r = -0.506; P < 0.001). Bone and mineral metabolism in OPLL differs between men and women. In men with OPLL, systemic secretion of sclerostin increases with advancing age and with higher bone mass. These two Wnt/β-catenin signal antagonists have the opposite effect in persons with OPLL, and higher serum sclerostin levels are counterbalanced by underproduction of DKK1.
硬化蛋白和 Dickkopf-1（DKK1）是 Wnt/β-连环蛋白信号拮抗剂，在骨形成中起重要作用。脊柱后纵韧带骨化（OPLL）的特征是后纵韧带的病理性异位骨化和脊柱强直性骨质增生。本研究的目的是评估 OPLL 患者的血清硬化蛋白和 DKK1 水平，并确定其与 OPLL 患者骨代谢和骨量的关系。这是一项病例对照研究，将 78 例 OPLL 患者与 39 例年龄和性别匹配的无 OPLL 志愿者进行比较。我们分析了其与钙调节激素、骨转换标志物、OPLL 定位、骨化椎骨数量以及全髋骨密度（TH-BMD）的关系。OPLL 男性患者的血清硬化蛋白水平显著高于对照组男性（对照组：平均值 = 45.3 pmol/L；OPLL 组：平均值 = 75.7 pmol/L；P = 0.002）。OPLL 男性患者的年龄与硬化蛋白水平呈正相关（r = 0.43；P = 0.002）。OPLL 男性患者的血清硬化蛋白水平与 TH-BMD Z 评分呈正相关（r = 0.511；P = 0.011，n = 30）。OPLL 男性患者的血清硬化蛋白水平与血清 DKK1 水平之间存在强烈的负相关（r = -0.506；P < 0.001）。OPLL 患者的骨和矿物质代谢在男性和女性之间存在差异。在 OPLL 男性患者中，硬化蛋白的全身分泌随着年龄的增长和骨量的增加而增加。这两种 Wnt/β-连环蛋白信号拮抗剂在 OPLL 患者中具有相反的作用，较高的血清硬化蛋白水平被 DKK1 的分泌不足所抵消。
