骨髓脂肪异常浸润与老年骨质疏松的关系

Relationship between abnormal infiltration of bone marrow fat and senile osteoporosis

骨质疏松及由此导致的骨折在老年人中普遍存在,骨髓脂肪的异常浸润在老年骨质疏松的发生和发展中起着关键作用。部分原因可能是骨髓脂肪细胞和成骨细胞具有共同的前体细胞,且在衰老条件下,氧化应激水平增加,使其朝着更有利于脂肪细胞生成的方向分化。此外,骨髓脂肪是一种内分泌器官,可以通过分泌具有脂毒性的游离脂肪酸(主要是棕榈酸)抑制成骨细胞的分化,促进其发生脂性凋亡及过度自噬使骨形成减少,也能诱导破骨细胞分化使骨吸收增加。因此,骨髓脂肪可能成为治疗老年骨质疏松新的潜在靶点。本文就老年骨质疏松骨髓脂肪异常浸润的可能机制及其对骨代谢的可能影响,以及调节骨髓脂肪细胞的量和功能对老年骨质疏松的治疗作用进行梳理,旨在扩宽对老年骨质疏松的理解,探索新的治疗方向。

Osteoporosis and its induced fractures are common in the elderly,and abnormal infiltration of bone marrow fat plays a key role in the occurrence and development of senile osteoporosis.It may be partially caused by that bone marrow adipocytes and osteoblasts have common precursor cells,and increased oxidative stress with aging promotes their differentiation which is more conducive to adipogenesis.In addition,bone marrow fat is an endocrine organ,which can inhibit the differentiation of osteoblasts and promote their lipoapoptosis and excessive autophagy by secreting free lipotoxic fatty acids(mainly palmitic acids),thus reducing bone formation,as well as can induce osteoclast differentiation and correspondingly increase bone resorption.Therefore,bone marrow fat may become a new potential target for the treatment of senile osteoporosis.In this paper,the possible mechanism of abnormal infiltration of bone marrow fat in senile osteoporosis and its possible effect on bone metabolism in senile osteoporosis,as well as the therapeutic effect of regulating the amount and function of bone marrow adipocytes on senile osteoporosis were reviewed,aiming to broaden our understanding of senile osteoporosis and explore new direction for treatment.