脂–骨代谢轴在骨质疏松症中的研究进展

Research Progress of the Lipid-Bone Metabolism Axis in Osteoporosis

摘要: 本文以一种全面且深入探讨的方式进行综述，提出了以“脂–骨代谢轴”为名的全新范式，此范式着重强调了胆固醇这一关键物质对于骨稳态而言是处于核心地位的调控者；与此同时，对脂质代谢与骨稳态之间所存在的交互机制予以了阐明，而这一阐明工作实则是为骨质疏松症在防治方面能够获得多维度视角，从而提供了不可或缺的理论基础。首先进行旨在解析分子机制方面内容，着重对以APOA1、LDL-C等为代表的脂蛋白与脂肪因子为骨重塑调控目的所涉及的诸如SREBP2-IRF7、Wnt/β-catenin等这些信号通路加以探讨；其次针对血脂异常跟骨质疏松之间在流行病学层面存在的关联以及此关联在诊断与预后领域具备的价值实施分析。本综述原旨在达成构建一套名为“脂代谢–骨稳态”的精准防治体系之目标，然而面对高脂血症与骨质疏松共病时诊疗方面存在的严峻挑战，其努力方向被设定为提供坚实理论依据以尝试妥善处理此困境。

Abstract: This article conducts a comprehensive and in-depth review and proposes a brand-new paradigm named the “lipid-bone Metabolism Axis”, which emphasizes that cholesterol, a key substance, is a central regulator for bone homeostasis. Meanwhile, the interaction mechanism between lipid metabolism and bone homeostasis has been clarified. This clarification work actually provides an indispensable theoretical basis for obtaining a multi-dimensional perspective in the prevention and treatment of osteoporosis. Firstly, the content aimed at analyzing the molecular mechanism is carried out, with a focus on exploring signaling pathways such as SREBP2-IRF7 and Wnt/β-catenin involved in the regulation of bone remodeling by lipoproteins and adipokines represented by APOA1 and LDL-C. Secondly, an analysis was conducted on the epidemiological association between dyslipidemia and osteoporosis, as well as the value of this association in the fields of diagnosis and prognosis. This review was originally intended to achieve the goal of establishing a precise prevention and treatment system named “Lipid Metabolism-bone Homeostasis”. However, in the face of the severe challenges in diagnosis and treatment when hyperlipidemia and osteoporosis coexist, its efforts were set to provide a solid theoretical basis in an attempt to properly handle this predicament.