绝经后骨质疏松与胰岛素样生长因子

目的骨质疏松是老年妇女常见病。绝经后骨丢失主要原因是骨重建单位的骨吸收与骨形成之间平衡失调。胰岛素样生长因子－１（ＩＧＦ－１）是由肝和骨骼合成的生长因子，它参与骨重建，增强成骨细胞活性。方法应用单光子骨密度仪测量非优势前臂桡尺骨中远端１／３交界处桡骨骨密度（ＢＭＤ），ＢＭＤ低于０．６０１ｇ／ｃｍ２（ｘ－２ｓ）则诊断为骨质疏松。据此将７６名妇女分为绝经前正常妇女（ＮＯＰ１）、绝经后非骨质疏松妇女（ＮＯＰ２）和绝经后骨质疏松妇女（ＯＰ）三组，测定受试者ＩＧＦ－１水平及其他骨代谢指标。结果随着增龄和绝经年限延长，ＩＧＦ－１是维持骨质的重要因子，绝经后妇女增龄，雌激素缺乏，Ｅ２、ＰＴＨ升高可引起血清ＩＧＦ－１水平下降，ＯＰ组低于ＮＯＰ１、ＮＯＰ２组（Ｐ＜０．０５）。所有受试者的ＩＧＦ－１与ＢＭＤ、Ｅ２呈显著正相关（Ｐ＜０．００１）、与年龄（Ａｇｅ）、甲状旁腺激素（ＰＴＨ）呈显著负相关。结论绝经后骨质疏松为高转换率骨质疏松，ＩＧＦ－１水平下降，导致骨吸收超过骨形成，引起骨丢失和骨质疏松。表明ＩＧＦ－１合理用药可以预防骨质疏松

Relationship between postmenopausal osteoporosis and insulin-like growth factor-1

Objective Bone mass loss in postmenopausal women mainly results from imbalance between bone resorption and bone formation. Insulin like growth factor 1(IGF 1),produced from the bone and liver, takes part in bone remodeling, and enhances the osteoblast activities. Methods Osteoporosis in a woman is diagnosed when the bone mineral density (BMD) of radius measured by single photon absorptionmetry at a point one third of the distance from the distal end of ulna and radius is less than 0 601g/cm 2.Based on the BMD,76 women were divided into three groups:non osteoporotic women 1 (NOP1),non osteoporotic women2 (NOP2) and osteoporotic women (OP).Serum IGF 1 levels were assayed by immunoradioassay,and various indexes of bone formation and resorption were examined in 76 premenopausal or postmenopausal women.These data were treated with SAS 6 0 for statistical analysis. Results IGF 1 level was much lower in group OP than those in group NOP1 and NOP2 ( P <0 05).Its level in serum decreased with aging and duration of menopause,and was positively correlated with radial BMD.IGF 1 level was negatively correlated with age and parathyroid hormone in the 76 women,whereas it was positively correlated with estradiol. Conclusions The turnover rate of postmenopausal osteoporosis is high and IGF 1 is considered as a main factor for maintaining bone mass.As its production rate in bone slows down,it may cause osteoporosis.Our experiment shows that aging and changes in systemic hormones,such as growth hormone,estradiol and parathyroid hormone, will affect the bone remodeling by adjusting the IGF 1 production.Therefore,IGF 1 can be used clinically for the treatment of postmenopausal osteoporosis and senile osteoporosis.