Biomedical Engineering Graduate Group, University of California Davis, Davis, California, USA.
Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, California, USA.
J Orthop Res. 2021 Apr;39(4):739-749. doi: 10.1002/jor.24867. Epub 2020 Oct 6.
Myocardial infarction (MI) and osteoporotic fracture are leading causes of morbidity and mortality, and epidemiological evidence linking their incidence suggests possible crosstalk. MI can exacerbate atherosclerosis through the sympathetic nervous system (SNS) activation and β adrenoreceptor-mediated release of hematopoietic stem cells, leading to monocytosis. We hypothesized that this same pathway initiates systemic bone loss following MI, since osteoclasts differentiate from monocytes. In this study, MI was created with left anterior descending artery ligation in 12-week-old male mice (n = 24) randomized to β -adrenergic receptor (AR) antagonist (SR 59230A) treatment or no treatment for 10 days postoperatively. Additional mice (n = 21, treated and untreated) served as unoperated controls. Bone mineral density (BMD), bone mineral content (BMC), and body composition were quantified at baseline and 10 days post-MI using dual-energy x-ray absorptiometry; circulating monocyte levels were quantified and the L5 vertebral body and femur were analyzed with microcomputed tomography 10 days post-MI. We found that MI led to circulating monocyte levels increases, BMD and BMC decreases at the femur and lumbar spine in MI mice (-6.9% femur BMD, -3.5% lumbar BMD), and trabecular bone volume decreases in MI mice compared with control mice. β -AR antagonist treatment appeared to diminish the bone loss response (-5.3% femur BMD, -1.2% lumbar BMD), though these results were somewhat inconsistent. Clinical significance: These results suggest that MI leads to systemic bone loss, but that the SNS may not be a primary modulator of this response; bone loss and increased fracture risk may be important clinical comorbidities following MI or other ischemic injuries.
心肌梗死(MI)和骨质疏松性骨折是发病率和死亡率的主要原因,流行病学证据表明它们的发病率之间可能存在相互作用。MI 可通过交感神经系统(SNS)激活和β肾上腺素能受体介导的造血干细胞释放来加重动脉粥样硬化,导致单核细胞增多症。我们假设,由于破骨细胞来源于单核细胞,同一途径会引发 MI 后全身性骨质流失。在这项研究中,通过左前降支结扎在 12 周龄雄性小鼠中创建 MI(n = 24),并随机分为β肾上腺素受体(AR)拮抗剂(SR 59230A)治疗组或术后 10 天不治疗组。另外还设置了未经手术的对照小鼠(n = 21,治疗组和未治疗组)。使用双能 X 射线吸收仪在基线和 MI 后 10 天测量骨密度(BMD)、骨矿物质含量(BMC)和身体成分;通过流式细胞术定量循环单核细胞水平,并在 MI 后 10 天分析 L5 椎体和股骨的 microCT。结果发现,MI 导致循环单核细胞水平升高、股骨和腰椎 BMD 降低(股骨 BMD 降低 6.9%,腰椎 BMD 降低 3.5%),与对照组相比,MI 小鼠的小梁骨体积减少。β -AR 拮抗剂治疗似乎减弱了骨丢失反应(股骨 BMD 降低 5.3%,腰椎 BMD 降低 1.2%),但结果有些不一致。临床意义:这些结果表明 MI 导致全身性骨质流失,但 SNS 可能不是该反应的主要调节剂;MI 或其他缺血性损伤后,骨质流失和骨折风险增加可能是重要的临床合并症。