骨密度及骨代谢指标与同型半胱氨酸关系的研究进展

Research progress of the relationship between bone mineral density and bone metabolism index and homocysteine

同型半胱氨酸(homocysteine,Hcy)是一种含硫氨基酸,以蛋氨酸为原料合成的,通过B族维生素,可以再循环生成蛋氨酸,或者通过转硫途径转化为半胱氨酸。通常同型半胱氨酸被认为是心脑血管的独立危险因素,现研究证实同型半胱氨酸也是骨质疏松的危险因素。目前Hcy引起骨质疏松甚至骨折的确切机制已研究出一小部分,仍有待于进一步研究。在机理上,同型半胱氨酸主要通过影响骨胶原的交联,刺激破骨细胞的形成和活性增加,及通过氧化应激产生活性氧促进成骨细胞的凋亡起作用。笔者将从同型半胱氨酸与骨密度及骨代谢指标、骨折的关系进行综述,通过提前干预Hcy的水平,预防骨折的发生,为骨质疏松症患者提供一种新的治疗方案。

Homocysteine(Hcy)is a sulfur-containing amino acid synthesized from methionine.It can be recycled to methionine through the B vitamins or converted to cysteine through the sulfur pathway.Hcy is generally considered to be an independent risk factor for cardiovascular and cerebrovascular diseases.Current studies have confirmed that homocysteine is also a risk factor for osteoporosis.At present,a small part of the exact mechanism of osteoporotic fractures caused by Hcy has been studied,and further study is still needed.In terms of mechanism,homocysteine plays a role mainly by affecting the crosslinking of collagens,by stimulating the formation and activity of osteoclasts,and by promoting the apoptosis of osteoblasts by reactive oxygen species(ROS)through oxidative stress.The relationships between homocysteine and bone mineral density,and homocysteine and bone metabolism and fracture are discussed.By intervening the level of Hcy in advance and by preventing fractures,a new treatment scheme for patients with osteoporosis is proposed.