初发系统性红斑狼疮患者雌激素受体表达及与骨量异常的关系

Relationship between the expression of estrogen receptor and bone mineral density in patients with initial systemic lupus erythematosus

目的探讨初发系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者的骨量情况,研究其雌激素受体α(ER-α)和雌激素受体β(ER-β)的表达水平及与骨量之间的关系,为临床防治SLE患者骨质疏松提供依据。方法收集未用激素治疗的初发SLE患者临床资料,采用双能X线检测受检者腰椎(L1-4)和股骨近端的骨密度(bone mineral density,BMD),运用实时定量PCR法检测外周血淋巴细胞ER-α和ER-β的表达水平。结果初发SLE患者骨密度明显低于正常对照组(P<0.05),骨量减少的发生率明显增高;初发SLE患者ER-β基因mRNA表达水平高于正常对照组(P<0.01),但骨量减少组和骨量正常组之间的无显著差异(P>0.05)。ER-α表达水平在初发SLE组和正常对照组之间的无显著差异(P>0.05)。ER-α和ER-β表达水平与SLE患者骨量间不存在相关性(r=0.028,P=0.862;r=0.134,P=0.398)。结论 SLE患者较正常人群更容易出现骨量减少;SLE患者体内ERβ基因表达增高,但与其骨量减少之间无明显相关性。

Objective To investigate the bone mineral density （ BMD ） in patients with initial systemic lupus erythematosus （ SLE） , to study its relationship with the expression of two kinds of estrogen receptors （ ER-αand ER-β） , and to provide basis for the prevention and treatment of osteoporosis in patients with SLE.Methods The clinical data of patients with initial SLE without hormone therapy were collected.BMD of the lumbar vertebrae （ L1-4 ） and the left proximal femur （ the femoral neck） were detected using dual X-ray absorptiometry.The gene expression levels of ER-αand ER-βin lymphocytes in peripheral blood were determined using real-time PCR.Results BMD in patients with initial SLE was significantly lower than that in normal controls, and frequency of bone loss was also significantly higher （ P〈0.05 ） .The gene expression of ER-βin patients with initial SLE was higher than that in normal controls （ P〈0.01 ） , while no significant difference between osteopenia group and normal bone mass group was observed （ P〉0.05 ） .The expression of ER-αin patients with initial SLE showed no significant difference comparing with that in normal controls （P〉0.05）.And no correlations between the expression levels of ER （ER-αand ER-β） and bone mass in patients with initial SLE were observed （r=0.028, P=0.862;r=0.134, P=0.398）.Conclusion Patients with initial SLE are more likely to have lower BMD than normal controls.The expression of ER-βmRNA in SLE patients increases, but the increase is not correlated with the bone loss.