| 摘要: |
| 骨质疏松症(OP)是一种全球流行的骨骼疾病,给社会带来沉重的健康与经济负担。同型半胱氨酸(Hcy)作为一种含硫氨基酸代谢中间产物,其血浆水平升高(即高同型半胱氨酸血症,HHcy)已被确立为心脑血管疾病的独立危险因素。近年来,研究视野扩展至骨骼系统,发现HHcy与骨密度降低、骨代谢紊乱及骨折风险增加密切相关,但其具体作用机制及临床意义仍存争议。本文旨在系统综述Hcy与骨质疏松关联的研究进展。首先,梳理流行病学证据,阐明Hcy水平与骨密度及骨折风险之间的复杂关系。其次,深入探讨其分子与细胞生物学机制,重点分析Hcy通过诱发氧化应激、炎症反应及干扰特定信号通路等途径,破坏骨代谢平衡的核心作用。此外,文章综述了遗传多态性(如MTHFR基因)及B族维生素状态在此关联中的影响,并评估了通过营养(补充叶酸、维生素B12等)及药物干预降低Hcy水平以防治骨质疏松的潜力与挑战。本综述旨在为深入理解Hcy在骨质疏松发病中的作用提供全面视角,并为开发新的防治策略提供理论依据。 |
| 关键词: 同型半胱氨酸 高同型半胱氨酸血症 骨质疏松 骨代谢 骨密度 骨折风险 |
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| Research Progress on Homocysteine in Osteoporosis |
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Tongji University
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| Abstract: |
| Abstract:? Osteoporosis (OP) is a globally prevalent skeletal disease, imposing a substantial health and economic burden on society. Homocysteine (Hcy), a sulfur-containing amino acid metabolic intermediate, has been established as an independent risk factor for cardiovascular and cerebrovascular diseases when its plasma levels are elevated (i.e., hyperhomocysteinemia, HHcy). In recent years, the research focus has expanded to the skeletal system, revealing that HHcy is closely associated with decreased bone mineral density, disordered bone metabolism, and increased fracture risk. However, its specific mechanisms of action and clinical significance remain controversial. This article aims to systematically review the research progress on the association between Hcy and osteoporosis. Firstly, it synthesizes epidemiological evidence to clarify the complex relationship between Hcy levels, bone mineral density, and fracture risk. Secondly, it delves into the molecular and cellular biological mechanisms, focusing on analyzing the core role of Hcy in disrupting bone metabolic homeostasis through pathways such as inducing oxidative stress, inflammatory responses, and interfering with specific signaling pathways. Furthermore, the article reviews the influence of genetic polymorphisms (e.g., the MTHFR gene) and B-vitamin status on this association, and evaluates the potential and challenges of preventing and treating osteoporosis by lowering Hcy levels through nutritional (e.g., folic acid, vitamin B12 supplementation) and pharmacological interventions. This review aims to provide a comprehensive perspective for a deeper understanding of the role of Hcy in the pathogenesis of osteoporosis and to offer a theoretical basis for developing new prevention and treatment strategies. |
| Key words: Homocysteine ：Hyperhomocysteinemia ：Osteoporosis ：Bone Metabolism ：Bone Mineral Density ：Fracture Risk |
