糖皮质激素诱导骨质疏松机制的研究探究进展-新.pdf

国际内分泌代谢杂志2006 年 3 月第 26 卷第 2 期 　Intern J Endocrinol Metab ,March 2006 ,Vol 26 ,No . 2 ·135 · 糖皮质激素诱导骨质疏松机制的研究进展 刘尚全 　陈名道 　　【摘要】　骨吸收增加是糖皮质激素诱导骨质疏松的原因之一 ,但近年来的研究证实糖皮质激素 β 通过 Wnt 、丝裂原活化蛋白激酶 、转化生长因子 等信号途径抑制成骨细胞的增殖 、分化 ;刺激 cas pase3 表达而促进成骨细胞凋亡 ;抑制胶原合成相关基因的表达而减少胶原合成 , 同时促进基质胶原 β 蛋白酶的表达 ,促进胶原分解 ;激活 11 羟类固醇脱氢酶 ,促进非活性和活性类固醇之间的转化 ,增强 糖皮质激素的作用 ,影响成骨细胞的增殖 、分化及其功能 ,从而使骨形成减少导致骨质疏松 。 【关键词】　糖皮质激素 ;骨质疏松 ;成骨细胞 ;骨形成 Progress in glucocorticoidinduced osteoporosis 　LI U S hangquan , CHEN Mingdao. Ruij in Hosp ital , School of Medicine , S hanghai J iaotong University , S hanghai Institute of Endocrine and Metabolic Disease , S hanghai 200025 , China 【Abstract 】　The increase of bone absorption is one reason of glucocorticoid induced osteoporosis. However , recent studies show that glucocorticoid can inhibit the proliferation and differentiation of osteoblasts through Wnt , transforming growth factor signal pathways , increase the apoptosis of osteoblasts by stimulating the expression of caspase3 , decrease collagen synthesis by inhibiting the expression of genes relateted to collagen synthesis and in crease collagen degradation by stimulating the expression of matrix metalloproteinase , catalyze inactive steroid into active one by activating 11betahydroxysteroid dehydrogenase and therefore enlarge the effect of glucocorticoid. Through these ways , glucocorticoid can reduce the bone formation and hence lead to osteoporosis. 【Key words】　Glucocorticoid ;Osteoporosis ;Osteoblast ;Bone formation ( ) Intern J Endocrinol Metab , 2006 , 26 :135- 137 ( 　　糖皮质激素在临床广泛应用的同时亦可引起骨