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慢性胰腺炎相关代谢性骨病:流行病学、发病机制和临床进展。

Chronic pancreatitis-associated metabolic bone diseases: epidemiology, mechanisms, and clinical advances.

机构信息

Department of Emergency, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Am J Physiol Endocrinol Metab. 2024 Jun 1;326(6):E856-E868. doi: 10.1152/ajpendo.00113.2024. Epub 2024 Apr 24.

DOI:10.1152/ajpendo.00113.2024
PMID:38656128
Abstract

Chronic pancreatitis (CP) is a progressive inflammatory disease with an increasing global prevalence. In recent years, a strong association between CP and metabolic bone diseases (MBDs), especially osteoporosis, has been identified, attracting significant attention in the research field. Epidemiological data suggest a rising trend in the incidence of MBDs among CP patients. Notably, recent studies have highlighted a profound interplay between CP and altered nutritional and immune profiles, offering insights into its linkage with MBDs. At the molecular level, CP introduces a series of biochemical disturbances that compromise bone homeostasis. One critical observation is the disrupted metabolism of vitamin D and vitamin K, both essential micronutrients for maintaining bone integrity, in CP patients. In this review, we provide physio-pathological perspectives on the development and mechanisms of CP-related MBDs. We also outline some of the latest therapeutic strategies for treating patients with CP-associated MBDs, including stem cell transplantation, monoclonal antibodies, and probiotic therapy. In summary, CP-associated MBDs represent a rising medical challenge, involving multiple tissues and organs, complex disease mechanisms, and diverse treatment approaches. More in-depth studies are required to understand the complex interplay between CP and MBDs to facilitate the development of more specific and effective therapeutic approaches.

摘要

慢性胰腺炎(CP)是一种进行性炎症性疾病,其全球患病率呈上升趋势。近年来,CP 与代谢性骨病(MBDs),特别是骨质疏松症之间存在密切关联,这一发现引起了研究领域的广泛关注。流行病学数据表明 CP 患者中 MBDs 的发病率呈上升趋势。值得注意的是,最近的研究强调了 CP 与营养和免疫状态改变之间的深刻相互作用,这为理解 CP 与 MBDs 的关系提供了新的视角。在分子水平上,CP 会引发一系列生化紊乱,破坏骨稳态。其中一个重要观察结果是 CP 患者体内维生素 D 和维生素 K 的代谢受到破坏,而这两种维生素都是维持骨骼完整性所必需的微量营养素。在本综述中,我们提供了 CP 相关 MBDs 的发生和机制的生理病理学观点。我们还概述了一些治疗 CP 相关 MBDs 的最新治疗策略,包括干细胞移植、单克隆抗体和益生菌治疗。总之,CP 相关的 MBDs 是一个日益严峻的医学挑战,涉及多个组织和器官,其疾病机制复杂,治疗方法多样。为了深入了解 CP 和 MBDs 之间的复杂相互作用,需要进行更多的研究,以促进更具针对性和更有效的治疗方法的发展。

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