停經後婦女合併骨質疏鬆症週邊血液最終糖化產物、骨橋蛋白與雌激素之表現

Levels of circulating advanced glycation end-products, osteopontin and estrogen in menopausal women with osteoporosis

楊登和(Deng-Ho Yang)

指導教授 ： 魏正宗 ； 鄭雅文

中山醫學大學/醫學院/醫學研究所/博士(2014年)

https://doi.org/10.6834/CSMU.2014.00051

摘要

在老化與糖尿病的過程中，最終糖化產物可以在不同的器官與組織中堆積；在罹患骨質疏鬆症的患者也可以見到在骨骼之中有最終糖化產物濃度上升的情形，此研究的目的在評估骨質疏鬆症的患者其週邊血液的最終糖化產物的濃度是否與疾病有關。本研究針對82位停經後骨質疏鬆或骨質缺乏的婦女、16位骨質缺乏的年輕女性及43位無骨質疏鬆或骨質缺乏的健康婦女，評估其骨密度、週邊血液最終糖化產物濃度及骨質疏鬆症相關的生物標記。結果顯示在骨質疏鬆或骨質缺乏的組別相較對照組有較高的血清最終糖化產物濃度(P < 0.0001)。血清最終糖化產物濃度與腰椎骨密度之間也具統計上的負相關(與腰椎骨密度，r = -0.249，P = 0.028；與腰椎T-score，r = -0.261，P = 0.021)。當婦女有較高的最終糖化產物濃度時(> 8.12 U/mL)，血清最終糖化產物濃度高者會有5.34倍腰椎骨質缺乏的風險與3.31倍髖骨骨質缺乏的風險。最終糖化產物濃度的上升和骨質的缺乏有相關性，且血清最終糖化產物濃度是一個會進展成骨質疏鬆症的危險因子；本研究結果認為血清最終糖化產物濃度可用來評估並追踨骨質疏鬆症的嚴重度及進展性，針對最終糖化產物的標靶治療可以是一個用來治療原發性或次發性骨質疏鬆症的嶄新方式。

關鍵字

最終糖化產物 ； 骨質疏鬆症 ； 骨質缺乏 ； 生物標記

並列摘要

Advanced glycation end-products (AGEs) can accumulate in organs and tissues during ageing and diabetes. Increased levels of serum AGEs are found in the bone tissue of patients with osteoporosis. The purpose of this study was to evaluate circulating AGEs in patients with osteoporosis. We evaluated plasma AGEs, osteoporosis-related biomarkers, and bone mass in 82 menopausal women with osteoporosis or osteopenia, 16 young women with osteopenia, and 43 healthy women without osteoporosis or osteopenia. Higher levels of serum AGEs were found in the osteoporosis or osteopenia group compared to healthy women (P < 0.0001). A negative correlation was observed between serum AGEs and lumbar spine bone density (BMD of lumbar spine, r = -0.249, P = 0.028; T-score of lumbar spine, r = -0.261, P = 0.021). Women with an increased level of serum AGEs (> 8.12 U/mL) had a 5.34-fold risk of osteopenia regarding lumbar spine T-score and a 3.31-fold risk of osteopenia regarding the hip T-score. Serum AGEs could be used to monitor the severity and progression of osteoporosis. An increased serum level of AGEs was associated with impaired bone formation and was a risk factor for the development of osteoporosis. Targeting AGEs may represent a novel therapeutic approach for primary or secondary osteoporosis.

並列關鍵字

advanced glycation end-products ； osteopenia ； osteoporosis ； biomarker

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