Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland).
Department of Anatomy, Anhui Medical University, Hefei, Anhui, China (mainland).
Med Sci Monit. 2018 Jun 25;24:4363-4371. doi: 10.12659/MSM.905958.
BACKGROUND To investigate the effect of the BMP/Smad signaling pathway on fracture healing and osteogenic ability in senile osteoporotic fracture on humans and rats. MATERIAL AND METHODS Sixty-two patients and well-matched normal controls were enrolled for clinical observation. A rat model of senile osteoporotic fracture was established. Serum BMP2 and Smad4 levels, as well as alkaline phosphatase (ALP) activity, were detected by ELISA. Fracture healing was observed by X-ray radiography and bone formation was analyzed by micro-CT. RESULTS Serum BMP2 and Smad4 levels in patients with senile osteoporotic fracture were significantly lower than those in normal controls (all P<0.01). BMP2 was highly positively correlated with Smad4 in patients with senile osteoporotic fracture (r=0.738). Compared with patients with low serum BMP2 and Smad4 levels, visual analog scale scores decreased, bone mineral density (BMD) increased, and duration of fracture healing was shortened in patients with high levels (all P<0.05). Compared with the Model group, serum BMP2 and Smad4 levels increased, fracture healing was improved, BMD, trabecular bone volume (TBV), tissue volume (TV), bone volume fraction (BV/TV), mean trabecular thickness (Tb. Th), and mean number of trabecular bone (Tb. N) were increased, and ALP activity increased in the BMP2 overexpression group (all P<0.05), while each index in the NC group showed no statistical difference relative to rats in the Model group (all P>0.05). CONCLUSIONS BMP2 overexpression can promote fracture healing and osteogenic ability in senile osteoporotic fractures through activating the BMP/Smad signaling pathway.
研究骨形态发生蛋白（BMP）/Smad 信号通路对人类和大鼠老年性骨质疏松性骨折愈合和成骨能力的影响。
纳入 62 例患者和匹配的正常对照组进行临床观察。建立老年性骨质疏松性骨折大鼠模型。通过 ELISA 检测血清 BMP2 和 Smad4 水平及碱性磷酸酶（ALP）活性。X 射线摄片观察骨折愈合情况，微 CT 分析骨形成情况。
老年性骨质疏松性骨折患者血清 BMP2 和 Smad4 水平明显低于正常对照组（均 P<0.01）。老年性骨质疏松性骨折患者血清 BMP2 与 Smad4 呈高度正相关（r=0.738）。与低血清 BMP2 和 Smad4 水平的患者相比，高血清 BMP2 和 Smad4 水平的患者视觉模拟评分降低、骨密度（BMD）增加、骨折愈合时间缩短（均 P<0.05）。与模型组相比，BMP2 过表达组血清 BMP2 和 Smad4 水平升高，骨折愈合改善，BMD、骨小梁体积（TBV）、组织体积（TV）、骨体积分数（BV/TV）、平均骨小梁厚度（Tb. Th）和平均骨小梁数量（Tb. N）增加，ALP 活性升高（均 P<0.05），而 NC 组各指标与模型组大鼠比较差异均无统计学意义（均 P>0.05）。
BMP2 过表达通过激活 BMP/Smad 信号通路可促进老年性骨质疏松性骨折愈合和成骨能力。
