骨质疏松症与心血管疾病之间的联系:共享机制、危险因素及治疗方法综述

The link between osteoporosis and cardiovascular diseases: a review of shared mechanisms, risk factors, and therapeutic approaches.

作者信息

Sharafi Mohammad Hasan, Nazari Afshin, Cheraghi Mostafa, Souri Faraz, Bakhshesh Morteza

机构信息

Department of Orthopaedic Surgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran.

出版信息

Osteoporos Int. 2025 Jun 2. doi: 10.1007/s00198-025-07553-7.

Abstract

BACKGROUND

Osteoporosis (OP) and cardiovascular diseases (CVDs) are prevalent age-related conditions that share common risk factors and underlying mechanisms, suggesting a bidirectional relationship.

METHODS

This review explores the intricate link between OP and CVD, focusing on shared pathways such as inflammation, oxidative stress, and the receptor activator of the nuclear factor-κB ligand-osteoprotegerin (OPG) system, which contribute to both bone loss and vascular calcification. Epidemiological studies reveal that low bone mineral density has been linked to an increased risk of cardiovascular mortality and morbidity, highlighting the interconnected nature of these conditions.

RESULTS

Key biological processes, including the osteogenic differentiation of vascular smooth muscle cells (VSMCs) and the role of bone-related proteins like osteopontin (OPN) and OPG, further underscore the overlap between bone metabolism and cardiovascular health. Common risk factors, such as aging, estrogen deficiency, vitamin D insufficiency, and lifestyle factors like smoking and physical inactivity, further link OP and CVD. Therapeutic interventions, including bisphosphonates, denosumab, and statins, have shown potential in addressing both conditions, suggesting that treatments targeting bone health may also benefit cardiovascular outcomes. However, the precise molecular mechanisms underlying these dual effects remain unclear, necessitating further research.

CONCLUSION

This review synthesizes current knowledge on the shared pathophysiology, risk factors, and therapeutic approaches for OP and CVD, emphasizing the need for integrated management strategies. By understanding the interplay between bone and cardiovascular health, healthcare providers can develop more effective, holistic approaches to prevent and treat these interconnected conditions, ultimately improving patient outcomes.

摘要

背景

骨质疏松症(OP)和心血管疾病(CVD)是常见的与年龄相关的病症,它们具有共同的风险因素和潜在机制,提示存在双向关系。

方法

本综述探讨了OP与CVD之间的复杂联系,重点关注炎症、氧化应激以及核因子κB受体激活剂配体-骨保护素(OPG)系统等共同途径,这些途径导致骨质流失和血管钙化。流行病学研究表明,低骨矿物质密度与心血管疾病死亡率和发病率增加有关,突出了这些病症的相互关联性。

结果

关键生物学过程,包括血管平滑肌细胞(VSMC)的成骨分化以及骨桥蛋白(OPN)和OPG等骨相关蛋白的作用,进一步强调了骨代谢与心血管健康之间的重叠。常见风险因素,如衰老、雌激素缺乏、维生素D不足以及吸烟和缺乏体育锻炼等生活方式因素,进一步将OP和CVD联系起来。治疗干预措施,包括双膦酸盐、地诺单抗和他汀类药物,已显示出在治疗这两种病症方面的潜力,表明针对骨骼健康的治疗也可能有益于心血管结局。然而,这些双重作用背后的确切分子机制仍不清楚,需要进一步研究。

结论

本综述综合了关于OP和CVD共同病理生理学、风险因素及治疗方法的现有知识,强调了综合管理策略的必要性。通过了解骨骼与心血管健康之间的相互作用,医疗保健提供者可以制定更有效、全面的方法来预防和治疗这些相互关联的病症,最终改善患者结局。

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