雌激素调节骨代谢作用的研究进展

雌激素作为一种重要的内源性甾体类激素,具有广泛的生物活性,其可以通过与雌激素受体结合,对生殖系统,中枢神经系统,心血管系统,免疫系统,胰岛功能以及骨代谢等多个方面产生影响。雌激素缺乏是导致绝经后骨质疏松症的主要原因,这一结论已经被多方科研人员证实并得到公认,故雌激素也成为治疗绝经后骨质疏松的主要手段。本文总结了雌激素的来源、雌激素受体的分类和分布、雌激素与骨质疏松的关系、雌激素影响骨代谢的作用机制以及雌激素治疗绝经后骨质疏松症在临床上的应用。其中分别从雌激素通过直接作用和间接作用两方面抑制破骨细胞的重吸收;从减少细胞凋亡、降低氧化应激反应以及减弱NF-k B的活性三种机制总结雌激素增加成骨细胞的形成;从雌激素通过干预骨重建和重吸收过程进而影响骨细胞的整体代谢过程三个大方面入手,将近年来雌激素对骨代谢的作用及机制进行整理归纳,以期为绝经后骨质疏松症的基础实验研究及临床治疗提供更为系统的理论依据。

Review on the research of estrogen in regulating bone metabolism

Estrogen, an important endogenous steroid hormone, has a wide range of biological activities and plays a fundamental role in the pharmacological effect on reproductive, cardiovascular, immune, pancreas, skeletal and central nervous systems by binding to the estrogen receptor. Estrogen deficiency is one of the main reasons leading to postmenopausal osteoporosis. This conclusion has been confirmed and recognized by researchers, and estrogen treatment is also one of the main treatment methods. In this review, we summarized the sources of estrogen, the classification and distribution of estrogen receptors and the relationship between estrogen and osteoporosis, the mechanism of estrogen affecting bone metabolism and the clinical application of estrogen in postmenopausal osteoporosis. It has been suggested that the actions and mechanisms of estrogen on bone metabolism are from the following aspects: estrogen inhibits osteoclastic reabsorption both directly and indirectly;estrogen increases the formation of osteoblasts by decreasing apoptosis, decreasing oxidative stress and decreasing NF-kB activity;estrogen affects bone cells metabolic process through intervening remodeling and resorption. This review may provide the theoretical basis in both the basic experimental study and clinical treatment for postmenopausal osteoporosis.