绝经妇女外周血单个核细胞骨代谢调控因子表达变化

The bone metabolism-related factors expression in peripheral blood monocytes of postmenopausal women

目的：探讨绝经妇女雌激素水平下降所致免疫细胞骨代谢调控因子变化。方法：纳入绝经妇女、未绝经妇女各30例,电化学发光法检测血清雌二醇（E2）水平;RT-PCR法检测外周血单个核细胞（PBMC）中雌激素受体（ERα、ERβ）、白细胞IL-6、TNFα-。核因子κB受体活化因子配基（RANKL）、核因子κB受体活化因子（RANK）mRNA表达;ELISA检测血清IL-6、TNFα-蛋白含量;双能X线骨密度仪检测腰椎2~4（L2-4）前后位骨密度（BMD）。结果：与未绝经组比较,绝经妇女E2水平明显下降,腰椎BMD显著降低（P〈0.05）,外周血单个核细胞ERα、ERβmRNA表达明显降低（P〈0.05）,IL-6、TNFα-、RANKL、RANKmRNA表达明显升高（P〈0.05）,IL-6及TNFα-血清蛋白含量明显升高（P〈0.05）。相关性分析显示PBMC中ERα、ERβmRNA表达与血清E2水平、腰椎BMD呈显著正相关性（P〈0.05）,PBMC中IL-6、TNFα-、RANKL、RANKmRNA表达与血清E2水平、腰椎BMD呈显著负相关性（P〈0.05）。结论：绝经后妇女雌激素水平下降伴随着外周血免疫细胞雌激素受体转录水平下降,同时,炎性骨吸收调控因子和溶骨性细胞因子表达升高,这种变化可能在绝经后骨丢失中发挥重要作用。

Objective：To analyze the expression of bone metabolism-related factors in peripheral blood monocytes of menopausal women.Methods：30 cases of postmenopausal women and 30 cases of premenopausal women were selected in this study.The serum estradiol（E2） was assessed by electrochemiluminescence immunoassay.Peripheral blood monocytes（PBMC） were isolated and ERα,ERβ,IL-6,TNF-α,RANKL,RANKmRNA were detected by RT-PCR.IL-6 and TNF-α protein contents were assessed by ELISA.Bone mineral density（BMD）of lumbar vertebrae 2-4 was measured with dual energy X ray absorptiometry.Results：Compared with premenopausal women,E2,BMD,ERα,ERβmRNA of postmenopausal women were decreased obviously（P0.05）.However,the mRNA expression of IL-6,TNF-α,RANKL and RANK in PBMC of postmenopausal women were increased（P0.05）.Meanwhile,the protein contents of IL-6 and TNFα were increased（P0.05）.ERα,ERβmRNA in PBMC were positively correlated with serum E2 level and BMD（P0.05）.IL-6 and TNF-α,RANKL,RANK mRNA in PBMC were negatively correlated with serum E2 level and BMD（P0.05）.Conclusion：E2 level of postmenopausal women were decreased,and the expression of ERα,ERβ mRNA in PBMC were decreased synchronously.However,the expression of inflammatory bone metabolism-related factors and osteolytic factors were up-regulated at the same time.These changes may be attributable to the bone loss after menopause.