脂代谢紊乱与骨质疏松症的关系及中医药干预研究进展

骨质疏松症（osteoporosis，OP）是一种常见的全身代谢性疾病，是造成骨折的主要原因之一，其发病机制较为复杂，不同原因引起的OP涉及了体内多种代谢途径的紊乱，近年来随着代谢组学在中医药治疗OP过程中的不断研究，发现脂代谢紊乱会抑制骨髓间充质干细胞（bone mesenchymal stemcells，BMSCs）向成骨细胞（osteoblast，OB）增殖分化，促进造血干细胞（stem cell，SC）向破骨细胞（osteoporosis，OC）的分化。其中，脂质异常聚集、炎症反应、氧化应激、氧化脂质、对氧磷酶（paraoxonase，PON）等因素对OB的增殖及分化具有负向调控作用，同时，脂代谢紊乱会使白细胞介素-1（Interleukin-1，IL-1）、白细胞介素-6（interleukin- 6，IL-6）、肿瘤坏死因子（tumor necrosis factor，TNF）等炎症因子的表达上调，产生氧化应激与炎症反应，导致OC分化及增殖和骨吸收加剧。近年来，中医药在预防和治疗OP方面的研究也逐渐增多，其疗效也得到了普遍认可，有诸多研究发现中药有效成分和中药复方可以通过靶向信号分子调控脂代谢的过程来影响OB和OC的分化，在纠正骨代谢失衡方面潜力巨大。因此，通过调控脂代谢相关靶点通路来预防和治疗OP已成为了当下研究热点，现通过对中医药防治OP的作用机制及相关靶点方面的研究进行整理，总结了中医药通过调控脂代谢关键因子来治疗OP的部分机制，旨在为中医药防治OP的深入研究提供参考依据。

The relationship between lipid metabolism disorder and osteoporosis and the research progress in the intervention with traditional Chinese medicine

Osteoporosis (OP) is a common systemic metabolic disease in bone medicine. It is one of the leading causes of bone fractures. Its pathogenesis is complicated. OP resulting from different causes involves the disorders of multiple metabolic pathways. In recent years, with the continuous study of metabolomics in the TCM treatment of OP, lipid metabolism has been found to inhibit osteoblast (OB) proliferation and differentiation by bone marrow mesenchymal stem cells (BMSCs) and to promote osteoclast (OC) differentiation by hematopoietic stem cells (SC). Among those, abnormal lipid aggregation, inflammatory response, oxidative stress, oxidative lipids, paraoxonase (PON), and other factors have negative regulatory effects on the proliferation and differentiation of OB. Meanwhile, Disorder of lipid metabolism causes up-regulated levels of interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor (TNF), and other inflammatory factors, oxidative stress, and the inflammatory response, leading to increased OC differentiation and proliferation and bone resorption. In recent years, the research of TCM in the prevention and treatment of OP has gradually increased, and its efficacy has been widely recognized. Many studies have found that effective TCM ingredients and TCM compound affect the differentiation of OB and OC by regulating the process of lipid metabolism through targeted signaling molecules. They have great potential in correcting the imbalance of bone metabolism. Therefore, prevention and treatment OP through the regulation of lipid metabolism-related target pathways has become the current research hot spot. By the study of mechanism of TCM and the related targets for the prevention of OP, this paper summarizes the mechanism OP treatment with Chinese medicine by regulating key factors of lipid metabolism, aiming to provide reference for the further study of OP prevention.