绝经前、后女性骨代谢指标与白介素-1β受体拮抗剂的关系

Relationship among bone mineral density,interleukin-1 receptor antagonist and some bone biochemical markers in postmenopausal and premenopausal women

目的探讨白介素-1β及其受体拮抗剂在绝经后女性骨代谢中的作用。方法选择绝经后女性128名,绝经前女性47名。用酶联免疫法测定受试者血清白介素-1β(IL-1β)、IL-1受体拮抗剂(IL-1Ra)、血清骨钙素(BGP)、尿I型胶原C末端肽(CTX)水平。用放射免疫法测定总雌二醇(E2)。结果绝经后女性组受试者L_(2-4)、股骨颈、大转子的骨密度、E2、IL-1Ra/IL-1β比值和BGP较绝经前女性低,但CTX较高。L_(2-4)、股骨颈骨密度、BGP与IL-1Ra/IL-1β呈正相关(r=0.709、r=0.801、r=0.729,P=0.023、P=0.021、P=0.005)。L_(2-4)、股骨颈、大转子骨密度与IL-1β负相关(r=-0.855、r=-0.921、r=-0.725,P=0.002;P=0.005、P=0.024)。CTX与IL-1Ra/IL-1β负相关、与IL-1β正相关(r=-0.774,P=0.037;r=-901,P=0.036)。IL-1Ra与IL-1β正相关(r=0.981,P=0.005)。L_(2-4)、大转子骨密度、BGP与E2正相关(r=0.664、r=0.700、r=0.621,P=0.012、P=0.003、P=0.009)。IL-1Ra、IL-1Ra/IL-1β与E2正相关(r=0.874,P=0.004;r=0.802,P=0.024)。结论绝经后女性骨代谢处于高分解、低合成的负平衡状态,性激素水平降低影响IL-1Ra与IL-1β的平衡可能起重要作用。

Objective To test the roles of circulating cytokine, interleukin-1/3 （IL-1/3）, interleukin-1 receptor antagonist （IL-1Ra） and some bone biochemical markers in bone metabolism. Methods Serum IL-1β, IL-IRa, bone Gla protein （BGP）, C-terminal telopeptide of type I collagen （CTX） were measured by ELISA and estradiol （E2） were measured by RIA in 128 postmenopausal women and 47 premenopausal women. Results The postmenopausal women had lower bone mineral density （BMD） in lumbar spine 2-4 （ L24 ）, femoral neck （FN） and greater trochanter, IL-1Ra/IL-1βratio, serum levels of E2 and BGP, but with higher urine level of CTX. BMD in L：.4 and other sites and BGP level were positively but CTX was negatively correlated with IL-1Ra/IL-1βratio. E2 had positive relationship with BMD in some sites and BGP. Further more, IL-1Ra and IL-1Ra/IL-1β ratio were significant correlations with level of E2 （r = 0. 874. P = 0. 004 ; r = 0. 802, P = 0. 024 respectively）. Conclusion The postmenopausal women have lower BMD, bone formation marker BGP and higher bone resorption marker CTX, a condition with negative bone turnover. As a result of decrease of gonad hormones, the imbalance of IL-1Ra and IL-1β may play an important role in bone metabo-lism in postmenopausal women.