绝经后骨质疏松患者骨免疫系统相关因子与肠道菌群的相关性

目的探究绝经后骨质疏松患者骨免疫系统相关因子与肠道菌群的相关关系。方法选取2017年5月—2021年4月收治的绝经后骨质疏松60例作为观察组,另选取绝经后健康体检者60例作为对照组。比较两组核转录因子-κB受体活化因子配体(RANKL)、核转录因子-κB受体活化因子(RANK)、骨保护素(OPG)水平,大肠杆菌、双歧杆菌及乳酸杆菌数量;分析骨免疫系统RANKL/RANK/OPG相关因子、肠道菌群对绝经后骨质疏松的影响,评价其对绝经后骨质疏松的诊断价值;分析骨免疫系统RANKL/RANK/OPG相关因子与肠道菌群的相关性。结果观察组RANKL水平、大肠杆菌数量高于对照组,OPG水平及双歧杆菌、乳酸杆菌数量低于对照组(P<0.01)。骨免疫系统RANKL/RANK/OPG相关因子、肠道菌群对绝经后骨质疏松联合诊断的AUC为0.912。RANKL、大肠杆菌为绝经后骨质疏松独立危险因素,OPG、双歧杆菌、乳酸杆菌为绝经后骨质疏松独立保护因素(P<0.05)。绝经后骨质疏松患者RANKL水平与双歧杆菌、乳酸杆菌数量呈负相关关系(r=-0.594、-0.579,P<0.01),与大肠杆菌数量呈正相关关系(r=0.602,P<0.01);OPG水平与双歧杆菌、乳酸杆菌数量呈正相关关系(r=0.601、0.581,P<0.01),与大肠杆菌数量呈负相关关系(r=-0.613,P<0.01)。结论绝经后骨质疏松患者骨免疫系统RANKL/RANK/OPG与肠道菌群失调有关,临床可通过调节肠道菌群失调治疗骨质疏松,为防治绝经后骨质疏松提供新思路。

Correlations between Osteoimmune Factors with Intestinal Flora in Postmenopausal Women with Osteoporosis

Objective To explore the correlations between osteoimmune factors with intestinal flora in postmenopausal women with osteoporosis.Methods A total of 60 postmenopausal women with osteoporosis admitted between May 2017 and April 2021 were selected as observation group,while another 60 healthy postmenopausal women undergoing physical examinations were selected as control group.Levels of receptor activator of nuclear factor-κB ligand(RANKL),receptor activator of nuclear factor-κB(RANK),osteoprotegerin(OPG),as well as numbers of Escherichia coli(E.coli),bifidobacterium and Lactobacillus were compared between two groups.Effects of osteoimmune factors RANKL/RANK/OPG and intestinal flora on postmenopausal women with osteoporosis were analyzed,and diagnostic values of the above indicators in postmenopausal women with osteoporosis were evaluated.The correlations between osteoimmune factors RANKL/RANK/OPG with osteoporosis in postmenopausal women were analyzed.Results In observation group,RANKL level and number of E.coli were significantly higher,while OPG level,and numbers of bifidobacterium and lactobacillus were significantly lower than those in control group(P<0.01).The area under curve(AUC)of the combined diagnosis of osteoimmune factors RANKL/RANK/OPG and intestinal flora in postmenopausal women with osteoporosis was 0.912.RANKL and E.coli were independent risk factors,while OPG,bifidobacterium and lactobacillus were independent protective factors for postmenopausal women with osteoporosis(P<0.05).In postmenopausal women with osteoporosis,RANKL level was negatively correlated with numbers of bifidobacteria and Lactobacillus(r=-0.594,-0.579,P<0.01),and it positively correlated with the number of E.coli(r=0.602,P<0.01);OPG level was positively correlated with numbers of bifidobacterium and Lactobacillus(r=0.601,0.581,P<0.01),and it negatively correlated with the number of E.coli(r=-0.613,P<0.01).Conclusion The osteoimmune factors RANKL/RANK/OPG are related to intestinal flora imbalance in postmenopausal women with osteoporosis.In clinical practice,adjustment of the intestinal flora imbalance is recommended in treatment of postmenopausal women with osteoporosis,which provides a new avenue for prevention and treatment of postmenopausal women with osteoporosis.