Gorai I, Taguchi Y, Chaki O, Kikuchi R, Nakayama M, Yang B C, Yokota S, Minaguchi H
Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Japan.
J Clin Endocrinol Metab. 1998 Feb;83(2):326-32. doi: 10.1210/jcem.83.2.4584.
We examined sequential changes of bone-resorbing cytokines and bone metabolic markers and the effect of ovarian hormones on bone metabolism during the menstrual cycle in 10 healthy Japanese women, aged 22-43 yr, with normal ovarian function. Serum soluble interleukin-6 receptor (sIL-6R) showed a significant variation; a rise during the early and late follicular periods followed by a fall during the early luteal period (P = 0.0423, P = 0.0334) and an increase during the mid and late luteal periods. There were significant changes in the levels of markers of bone formation: a rise in serum bone-specific alkaline phosphatase (ALP) during the mid and late follicular (P = 0.0265) periods and a fall in serum carboxyl-terminal propeptide of type I procollagen (PICP) during the midluteal period (P = 0.0161). As for the levels of bone resorption markers, urinary type I collagen C-telopeptide breakdown products (CTx) and free deoxypyridinoline (D-Pyr) decreased significantly during the early and midfollicular periods, urinary free D-Pyr and serum pyridinoline cross-linked carboxyl-terminal telopeptide of type I collagen (ICTP) (P = 0.0440) increased significantly during the early luteal period, and urinary CTx, free D-Pyr, and serum ICTP decreased significantly during the late luteal period (P = 0.0170-0.0008). The serum PTH level was significantly higher during the follicular than the luteal period (P = 0.0132). Serum sIL-6R significantly correlated with urinary CTx (r = 0.190, P < 0.05) and serum ALP (r = 0.209, P < 0.05) and serum estradiol with intact osteocalcin (r = 0.309, P < 0.0005) and serum ALP (r = 0.181, P < 0.05). These observations strongly suggest that cyclic variations in the levels of bone formation and resorption markers and of a bone-resorbing cytokine may be modulated by cyclic changes in serum steroid hormones during the menstrual period. In addition, the specific days of biochemical events in the menstrual cycle are crucial for evaluating osteoclastic and osteoblastic activities in pre- and perimenopausal women or in women starting GnRH agonist therapy.
我们研究了10名年龄在22 - 43岁、卵巢功能正常的健康日本女性在月经周期中骨吸收细胞因子和骨代谢标志物的连续变化,以及卵巢激素对骨代谢的影响。血清可溶性白细胞介素-6受体(sIL-6R)呈现出显著变化;在卵泡早期和晚期升高,随后在黄体早期下降(P = 0.0423,P = 0.0334),并在黄体中期和晚期再次升高。骨形成标志物水平有显著变化:血清骨特异性碱性磷酸酶(ALP)在卵泡中期和晚期升高(P = 0.0265),血清I型前胶原羧基末端前肽(PICP)在黄体中期下降(P = 0.0161)。至于骨吸收标志物水平,尿I型胶原C末端肽降解产物(CTx)和游离脱氧吡啶啉(D-Pyr)在卵泡早期和中期显著下降,尿游离D-Pyr和血清I型胶原吡啶啉交联羧基末端肽(ICTP)(P = 0.0440)在黄体早期显著升高,尿CTx、游离D-Pyr和血清ICTP在黄体晚期显著下降(P = 0.0170 - 0.0008)。血清甲状旁腺激素(PTH)水平在卵泡期显著高于黄体期(P = 0.0132)。血清sIL-6R与尿CTx(r = 0.190,P < 0.05)和血清ALP(r = 0.209,P < 0.05)显著相关,血清雌二醇与完整骨钙素(r = 0.309,P < 0.0005)和血清ALP(r = 0.181,P < 0.05)显著相关。这些观察结果强烈表明,月经期间骨形成和吸收标志物以及骨吸收细胞因子水平的周期性变化可能受血清类固醇激素周期性变化的调节。此外,月经周期中生化事件的特定日期对于评估绝经前和围绝经期女性或开始使用促性腺激素释放激素(GnRH)激动剂治疗的女性的破骨细胞和成骨细胞活性至关重要。