生长因子与老年性骨质疏松症相关性的临床研究

Relationship between elderly osteoporosis and transforming growth factor-beta-1, insulin-like growth factor-1 and epidermal growth factor

目的 观察老年性骨质疏松患者转化生长因子 β1 (TGF β1 )、胰岛素样生长因子 - 1(IGF 1) ,表皮生长因子 (EGF)血清水平以及与骨质疏松的相关性。方法 采用双能X线骨密度仪测量了 86例在本院老年病门诊和住院的老年人腰椎正位以及股骨颈、ward三角区、大粗隆部位的骨密度 (BMD) ,受试者均为老年男性 ,平均年龄为 6 9 97± 5 73岁 ,按照WHO推荐的诊断标准 ,参考中国人骨质疏松症建议诊断标准 (第二稿 ) ,将其分为非骨质疏松组 (NOP)、腰椎骨质疏松组 (OP1 )和股骨上段骨质疏松组 (OP2 ) ,测定所有受试者血清TGF β1 ,IGF 1,EGF水平。结果 腰椎骨质疏松组和股骨上段骨质疏松组血清IGF 1浓度值均低于非骨质疏松组 ((P <0 0 1) )。腰椎骨质疏松组血清TGF β1 浓度值与非骨质疏松组无明显差异 ((P >0 0 5 ) ) ,股骨上段骨质疏松组血清TGF β1 浓度值低于非骨质疏松组 (0 0 1<P <0 0 5 ) ,骨质疏松组血清EGF值与非骨质疏松组无差异 (P >0 5 )。腰椎骨密度值与血清IGF 1值呈正相关 (相关系数分别为 :0 2 12、0 32 5、0 2 2 8) ,腰椎骨密度值与血清TGF β1 值呈显著正相关 (相关系数分别为 :0 373、0 32 8、0 341、P <0 0 5 )。股骨颈、Ward三角、大粗隆的骨密度值与IGF 1和TGF β1

Objective To observe the changes of serum transforming growth factor-beta-1(TGF-β 1), insulin-like growth factor-1(IGF-1) and epidermal growth factor(EGF) in the elderly osteoporosis and the correlation between the bone mineral density and TGF-β 1, IGF-1 and EGF. Methods Bone mineral density of the lumbar spine and femur neck was measured with dual energy X-ray densitometer. 86 aged people were divided into three groups:non-osteoporotic group(NOP), lumbar spine osteoporotic group(OP 1), and femur neck osteoporotic group(OP 2). Serum TGF-β 1, IGF-1 and EGF levels were measured by enzyme-linked immunosorbent assay. Results IGF-1 level was much lower in groups OP 1 and OP 2 than those in group NOP( P <0 01). There was no significant difference in serum TGF-β 1 levels between the group OP 1 and group NOP.( P >0 05); in contrast, there was statistically significant difference in TGF-β 1 levels between the groups OP 2 and NOP(0 01< P <0 05). Serum EGF levels had no significant changes in the three groups( P >0 5). There was a positive correlation between BMD and TGF-β 1 and IGF-1. Conclusion TGF-β 1 and IGF-1 are considered as a main factor for maintaining bone mass. Decrease of their production rate in bone may cause osteoporosis. EGF plays an unimportant role in the pathogenesis of osteoporosis.