Chronic Psychological Stress as a Risk Factor of Osteoporosis
Chronic Psychological Stress as a Risk Factor of Osteoporosis
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DOI：
10.7888/juoeh.37.245
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发表时间：
2015-12-01
期刊：
影响因子：
--
通讯作者：
Kubo, Kin-Ya
中科院分区：
文献类型：
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作者：
Azuma, Kagaku;Adachi, Yasuhiro;Kubo, Kin-Ya
骨质疏松症是最常见的代谢性骨骼疾病，其特点是骨量减少和骨质量恶化，导致骨折风险增加。随着人口老龄化，骨质疏松性骨折成为重要的公共卫生问题。生物体不断受到影响生理过程的各种压力刺激。最近的研究表明，慢性心理压力通过多种信号通路是骨质疏松症的危险因素。本文旨在综述慢性心理应激与骨质疏松症关系的最新进展。越来越多的证据证实中枢神经系统，尤其是下丘脑在骨代谢调节中的生理重要性。动物和人体研究均表明，慢性心理压力通过影响下丘脑-垂体-肾上腺皮质（HPA）轴、交感神经系统以及其他内分泌、免疫因素，导致骨量减少和骨质量恶化。主动咀嚼被证明是一种有效的压力应对行为，可以减弱压力引起的神经内分泌反应并改善压力引起的骨质流失。因此，主动咀嚼可能是预防和/或治疗慢性压力相关骨质疏松症的有效方法。我们还讨论了慢性压力、咀嚼和骨质疏松症之间相互作用的几种潜在机制。慢性应激会激活HPA轴和交感神经系统，抑制性腺激素和生长激素的分泌，增加炎症细胞因子，最终通过抑制骨形成和刺激骨吸收而导致骨质流失。
Osteoporosis, the most common metabolic skeletal disease, is characterized by decreased bone mass and deteriorated bone quality, leading to increased fracture risk. With the aging of the population, osteoporotic fracture is an important public health issue. Organisms are constantly exposed to various stressful stimuli that affect physiological processes. Recent studies showed that chronic psychological stress is a risk factor for osteoporosis by various signaling pathways. The purpose of this article is to review the recent progress of the association between chronic psychological stress and osteoporosis. Increasing evidence confirms the physiological importance of the central nervous system, especially the hypothalamus, in the regulation of bone metabolism. Both animal and human studies indicate that chronic psychological stress induces a decrease of bone mass and deterioration of bone quality by influencing the hypothalamic-pituitary-adrenocortical (HPA) axis, sympathetic nervous system, and other endocrine, immune factors. Active mastication, proven to be an effective stress-coping behavior, can attenuate stress-induced neuroendocrine responses and ameliorate stress-induced bone loss. Therefore, active mastication may represent a useful approach in preventing and/or treating chronic stress-associated osteoporosis. We also discuss several potential mechanisms involved in the interaction between chronic stress, mastication and osteoporosis. Chronic stress activates the HPA axis and sympathetic nervous system, suppresses the secretion of gonadal hormone and growth hormone, and increases inflammatory cytokines, eventually leading to bone loss by inhibiting bone formation and stimulating bone resorption.