老年人血清炎症因子与骨密度变化及骨吸收相关性研究
Correlation between changes in serum inflammatory factors and bone mineral density and bone resorption in older people
  
DOI:10.3969/j.issn.1006-7108.2020.02.013
中文关键词:  炎症因子  骨密度  骨吸收  老年人
英文关键词:inflammatory factors  bone density  bone resorption  older people
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作者单位
韩学明* 孙忠良 徐建华 吴俊 新疆生产建设兵团四师医院骨科,新疆 伊犁 835000 
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中文摘要:
      目的 探讨老年人血清炎症标志物与骨密度(bone mineral density, BMD)变化和尿吡啶啉(PYR)及肌酐(Cr)比值变化之间的关系。方法 共纳入168名随机选择的受试者(年龄52~78岁,平均63岁,女性占48%)。BMD通过双能X线吸收测定法在基线时和平均2.9年后测量(平均T值:-0.18~ -0.61)。测定受试者血清高敏感性(hs)C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,并测量尿PYR/Cr比率。结果 受试者全身、腰椎和髋部BMD平均年损失分别为0.15%、0.15%和0.34%。全身BMD的变化与基线hs-CRP、IL-6、TNF-α (β:-0.41%/ U,95%置信区间:-0.68%,-0.15%)以及hs-CRP与IL-6(β:-0.62%/ U,95%置信区间:-1.01%,-0.23%)的变化密切相关。如果将这些标记置于相同的预测模型中,则只有IL-6基本保持不变。IL-6(髋部和腰椎)和TNF-α(仅腰椎)可显著预测其他部位BMD的变化。最后,PYR/Cr比值的变化与女性基线的IL-6、hs-CRP及其变化呈正相关(P均<0.05),而与男性无关。结论 本研究中观察到的IL-6的改变和骨密度降低及骨吸收有关。
英文摘要:
      Objective To determine the associations between serum markers of inflammation and changes in bone mineral density (BMD) and urinary pyridinoline (PYR) to creatinine (Cr) ratio in older adults. Methods A total of 168 randomly selected subjects (mean age 63 years, range 52-78, 48% female) were studied. BMD was measured by dual-energy X-ray absorptiometry at baseline (mean T-score: -0.18 to -0.61) and 2.9 years later. Serum high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), and the urinary PYR/Cr ratio were measured on both occasions. Results The mean annual loss of BMD was 0.15%, 0.15%, and 0.34% at total body, spine, and hip, respectively. Change in total body BMD was associated with baseline hs-CRP, IL-6 and TNF-α, as well as change in hs-CRP (β: -0.41%/U, 95% confidence interval -0.68%, -0.15%) and IL-6 (β: -0.62%/U, 95% confidence interval -1.01%,-0.23%). When these markers were put in the same predictive model, only IL-6 remained largely unchanged. Changes in other BMD sites were significantly predicted by IL-6 (hip and spine) and TNF-α (spine only). Finally, change in the PYR/Cr ratio was positively associated baseline IL-6, hs-CRP, and their changes (all P<0.05) in women, but not in men. Conclusions In this study, we found that changes in IL-6 were associated with decreased bone mineral density and bone resorption.
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