垂体激素和激素替代治疗对骨代谢调控的研究进展

既往研究多认为垂体分泌的激素通过其靶内分泌腺对骨代谢进行间接调控。但近年来,越来越多的研究发现垂体激素如生长激素、促甲状腺素、促性腺素、促肾上腺皮质素以及催产素等对骨代谢具有直接调节作用,这些激素通过作用于相应的受体,激活不同的信号通路,直接作用于成骨细胞、破骨细胞,从而发挥生物学效应,影响骨量及骨质疏松性骨折的发生率。垂体功能低下患者长期使用生长激素、糖皮质激素、性激素、甲状腺素等替代治疗亦对骨代谢有着不同的调控作用。它们也是直接与成骨或破骨细胞膜上相应的受体结合,通过基因或非基因效应,从而对骨量进行调节。本文综述了垂体激素对骨骼的直接作用及激素长期替代治疗对骨代谢的调控,旨在为疾病的早期诊断、精准个体化治疗提供一些思路。

Research progress of pituitary hormone and hormone replacement therapy on the regulation of bone metabolism

Previous studies have suggested that pituitary hormones indirectly regulate bone metabolism through its target glands. However, more and more studies have demonstrated that pituitary hormones such as growth hormone, thyroid stimulating hormone, gonadotropin, adrenocorticotropic hormone, oxytocin, etc. have a direct regulatory effect on bone metabolism in recent years. They exert biological effects by acting on the corresponding receptors, activating different signaling pathways, acting directly on osteoblasts and osteoclasts, and thus leading to reduced bone mass and osteoporotic fractures. Long term use of hormone replacement therapy, such as growth hormone, glucocorticoids, sex hormones, and thyroid hormone, also has different effects on bone metabolism. They also bind directly to the corresponding receptors on the osteoblast or osteoclast membrane and to regulate bone mass through gene or non-gene effects. This article reviews the direct effects of pituitary hormones on bones and the effects of long-term hormone replacement on bones, aiming to help provide insights for early diagnosis of the disease and for precise individualized treatment.