益生菌制剂对绝经后骨质减少女性患者骨骼状态的改善作用

Effect of probiotics for the improvement of skeletal status in postmenopausal women with osteopenia

目的研究益生菌制剂对绝经后骨质减少女性患者骨骼状态的改善作用。方法选择2016年4月—2018年4月在本院就诊的绝经女性478例,其中骨质疏松患者103例。将患者分为对照组和益生菌组,两组患者均连续治疗6个月,定期进行随访。检测患者治疗前后骨密度(BMD)、骨代谢指标、骨折情况、肠道微生物情况。结果 治疗后益生菌组患者Ⅰ型胶原吡啶交联终肽(CTX)、骨特异性碱性磷酸酶(BALP)均明显低于对照组治疗后水平(CTX:P=0.004;BALP:P=0.011)和益生菌治疗前水平(CTX:P=0.008;BALP:P=0.024)。对照组治疗前后丰度排列前三位的微生物均为Bacteroides plebeius,布氏瘤胃球菌(Ruminococcus bromii),普拉梭菌(Faecalibacterium prausnitzii);益生菌组治疗前后丰度排列前三位的微生物均为Bacteroides plebeius,普拉梭菌(Faecalibacterium prausnitzii),布氏瘤胃球菌(Ruminococcus bromii)。结果显示益生菌组患者治疗后肠道甲醇拟无枝酸菌(Amycolatopsis methanolica),Burkholderia oklahomensis,Streptomyces turgidiscabies,Verrucosispora maris检出率明显低于治疗前(P=0.009,0.012,0.005,0.007)。结论益生菌可以改善骨代谢,对绝经后骨质减少女性具有骨保护作用,其机制可能与益生菌对肠道微生物分布的影响有关。

Objective To explore the effect of probiotics on the skeletal state of postmenopausal women with osteopenia.Methods A total of 478 postmenopausal women in our hospital from April 2016 to April 2018 were enrolled,including 103 patients with osteoporosis.The patients were divided into the control group or the probiotic group.Both groups were treated continuously for 6 months and were followed up regularly.Bone mineral density,bone metabolic markers,fractures and intestinal microbiota were measured before and after treatment.Results After treatment,the levels of type I collagen crosslinked C-terminal peptide(CTX)and bone-specific alkaline phosphatase(BALP)in the probiotic group significantly reduced and were significantly lower than those in the control group.The top 3 microorganisms in the control group before vs after treatment were Bacteroides plebeius(77.12% vs 75.94%),Ruminococcus bromii(13.29% vs 13.58%)and Faecalibacterium prausnitzii(12.46% vs 11.92%).The top 3 microorganisms in the probiotic group before vs after treatment were Bacteroides plebeius(76.62% vs 77.98%),Faecalibacterium prausnitzii(15.73% vs 16.14%)and Ruminococcus bromii(14.80% vs 14.68%).The detection rates of Amycolatopsis methanolica,Burkholderia oklahomensis,Streptomyces turgidiscabies and Verrucosispora maris in the probiotic group were significantly lower after treatment(P=0.009,0.012,0.005,0.007).Conclusion Probiotics can improve bone metabolism and have a protective effect for postmenopausal women with osteopenia,the mechanisms of which may be related to their effects on the abundance of intestinal microbes.