青少年特发性脊柱侧凸的骨密度变化及与血清IL-6浓度关系的研究

Changes of Bone Mineral Density and Relationship between Bone Mineral Density and Serum IL-6 in Adolescent Idiopathic Scoliosis

研究青少年特发性脊柱侧凸的骨密度变化及与血清IL-6浓度关系。选择特发性脊柱侧凸患者36例,男性6例,女性30例,年龄12～18岁,Cobb角34°～109°,且均为胸弯者;36名同年龄段正常青少年为对照,男性7例,女性29例,年龄13～18岁。应用双能X线骨密度吸收仪分别对其腰椎(L2-L4)和股骨近端(股骨颈、大转子、Ward’s 三角)的骨密度进行测量,并用酶联免疫吸附试验检测血清中IL-6水平。结果显示特发性脊柱侧凸患者的腰椎(L2-L4)和股骨所测的3个部位的骨密度均明显低于正常对照组(P<0.001),血清IL-6水平与正常对照组相比明显升高(P<0.005),且特发性脊柱侧凸的腰椎和股骨所测的3个部位的骨密度变化与血清IL-6浓度呈明显负相关(P<0.001),而正常对照组腰椎及股骨所测的3个部位的骨密度变化与血清IL-6浓度无明显相关性(P>0.05)。青少年特发性脊柱侧凸患者存在着骨密度的降低,且细胞因子IL-6过量分泌,此可能是引起特发性脊柱侧凸低骨量的重要因素之一。

This study is to investigate the changes of bone mineral density (BMD) in adolescent idiopathic scoliosis and the relationship between BMD and serum interleukin-6 (IL-6) levels. BMD of the lumbar spines (L2-L4) and proximal femurs (including the femoral necks, the greater trochanters and Ward's triangles) were measured by using dual energy x-ray absorptiometry in 36 patients with idiopathic scoliosis (6 males and 30 females, aged from 12～18 years, Cobb's angle 34°～109°) and 36 age-matched healthy subjects (7 males and 29 females, aged from 13～18 years) as controls. Levels of serum IL-6 were determined by using enzyme-linked immunosorbent assays. The scoliotic patients had significantly lower BMD of the lumbar spines and proximal femurs in three measured regions than that in the control group (P<0. 001). The serum IL-6 in scoliotic patients were significantly higher than those in the control group ( P<0. 005). The BMD of the lumbar spines and proximal femurs in three measured regions was negatively correlated with the levels of serum IL-6 in the scoliotic patients (P<0.001), but the BMD of the lumbar spine and proximal femur in three measured regions was not correlated with the levels of serum IL-6 in the control subjects (P>0.05). There was a lower BMD in patients with adolescent idiopathic scoliosis, and an excessive secretion of IL-6 in the scoliotic patients, which may be one of the important factors of osteopenia in adolescent idiopathic scoliosis.