硫辛酸辅助治疗对绝经后骨质疏松女性骨密度、骨代谢指标和炎症因子的影响

Effect of lipoic acid adjuvant therapy on bone mineral density,bone metabolic markers,and inflammatory factors in postmenopausal women with osteoporosis

目的评价硫辛酸(lipoic acid,LA)辅助治疗对绝经后骨质疏松妇女骨密度(bone mineral density,BMD)、骨代谢指标和炎症因子的影响。方法 100例绝经后骨质疏松症妇女(T评分<-2. 5)进行前瞻性登记,随机分配口服LA及阿仑膦酸钠(n=50),或仅接受阿仑膦酸钠(n=50)治疗,检测并比较右股骨颈和腰椎(L1-L4)骨密度的变化。同时观察治疗前后血清肿瘤坏死因子-α(TNF-α)、胰岛素样生长因子-1(IGF-1)和白细胞介素-6(IL-6)、骨钙素(osteocalcin,BGP)、Ⅰ型胶原交联的水平C-末端肽(CTX-1)、核因子кB受体激活因子配体(RANKL)和骨保护素(osteoprotegerin,OPG)的改变。结果 88例患者完成了为期一年的研究,LA组46例,对照组42例。与对照组相比,LA组的治疗有更好的BMD和血清TNF-α、IGF-1和IL-6、BGP、CTX-1、RANKL和OPG水平(P均<0. 05)。结论补充LA有助于增加阿仑膦酸钠增加绝经后骨质疏松妇女的疗效。

Objective To evaluate the effect of lipoic acid(LA) adjuvant therapy on bone mineral density(BMD),bone metabolism markers,and inflammatory factors in postmenopausal women with osteoporosis. Methods One hundred postmenopausal women with osteopenia(T-score <-2. 5) were prospectively enrolled and randomly assigned to receive oral LA and alendronate plus calcium and vitamin D3(n = 50),or alendronate plus calcium and vitamin D3(n = 50).BMD of the right femoral neck and lumbar vertebrae(L1-4) was detected and compared. The serum levels of tumor necrosis factor-α(TNF-α),insulin-like growth factor-1(IGF-1),interleukin-6(IL-6),osteocalcin(BGP),type Ⅰ collagen cross-linking C-terminal peptide(CTX-1),nuclear factor кB receptor activating factor ligand(RANKL),and osteoprotegerin(OPG) were observed. Results Eighty-eight patients completed the one-year study,including 46 cases in LA group and 42 cases in the control group. Compared to the control group,BMD and serum levels of TNF-α,IGF-1,IL-6,BGP,CTX-1,RANKL,and OPG in LA group had better result(all P<0. 05). Conclusion Supplementation of LA increases the efficacy of alendronate in postmenopausal women with osteoporosis.