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Role of Osteoprotegerin and Receptor Activator of Nuclear Factor-kB Ligand in Bone Loss Related to Advanced Chronic Obstructive Pulmonary Disease

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Chinese Medical Journal 2016年第14期129卷 1696-1703页

作者： Ludmila Ugay Evgenia Kochetkova vera nevzorova Yuliya Maistrovskaia Departement of Pulmonology Central Scientific Research Laboratory Pacific State Medical University Vladivostok 690950 Russian Federation

Background： Osteoporosis is a common complication of chronic obstructive pulmonary disease （COPD）. Recent clinical and biological researches have increasingly delineated the biomolecular pathways of bone metabolism regulation in COPD. We extended this work by examining the specific association and potential contribution of the osteoprotegerin （OPG）/receptor activator of nuclear factor-riB ligand （RANKL） axis to the pathogenesis of osteoporosis in advanced COPD. The aim of this study was to assess the relationships of serum OPG, RANKL, and tumor necrosis factor-alpha （TNF-a） with bone turnover in men with very severe COPD. Methods： Pulmonary function, T-score at the lumbar spine （LS） and femoral neck （FN）, serum OPG, RANKL, soluble receptor of tumor necrosis factor-alpha-1 and 11 （sTNFR-I, sTNFR-II）, osteocalcin （OC）, and β-CrossLaps （βCL） levels were measured in 45 men with very severe stage COPD and 36 male non-COPD volunteers. COPD patients and healthy controls were compared using all independent t-test and Mann-Whitney U-test. The Pearson coefficient was used to assess the relationships between variables. Results： OPG and OC were lower in male COPD patients than in control subjects whereas RANKL, serum ~CL, TN F-o~, and its receptors were higher. OPG directly correlated with forced expiratory volume in I s （FEVI） % predicted （r = 0.46, P 〈 0.005）, OC （r= 0.34, P 〈 0.05）, LS （I.= 0.56, P 〈 0.001 ）, and FN T-score （r= 0.47, P 〈 0.01 ）. In contrast, serum RANKL inversely associated with LS and FN T-score （r = -0.62, P 〈 0.001 and r = -0.48, P 〈 0.001 ） but directly correlated with [3CL （r = 0.48, P 〈 0.001 ）. In addition, OPG was inversely correlated with RANKL （r = -0.39, P 〈 0.01 ）, TNF-a （r = -0.56, P 〈 0.001 ）, and sTNFR-I （r = -0.40, P 〈 0.01 ）. Conelusion： Our results suggest that serum OPG and RANKL levels are inversely associated with bone loss in men with advanced stage COPD.

关键词： Chronic Obstructive Puhnonary Disease Osteoporosis Osteoprotegerin Receptor Activator of Nuclear Factor-KBLigand Tumor Necrosis Factor Receptors: Tumor Necrosis Factor-alpha

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