Onset of steroid-induced osteonecrosis in rabbits and its relationship to hyperlipaemia and increased free fatty acids
Onset of steroid-induced osteonecrosis in rabbits and its relationship to hyperlipaemia and increased free fatty acids
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DOI：
10.1093/rheumatology/keh721
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发表时间：
2005-10-01
期刊：
影响因子：
5.5
通讯作者：
Tomita, K
中科院分区：
文献类型：
--
作者：
Kabata, T;Kubo, T;Tomita, K
目标.明确类固醇治疗后骨坏死的起始时间及其与脂代谢异常的关系。采用5种不同的激素方案给家兔注射甲基强的松龙制备动物模型。由股骨近端内坏死灶的频率、大小或数量提示的单一急性缺血事件在各组之间没有差异。骨坏死的组织学证据首先发生在最初的类固醇给药后1-2周。与此同时，血清脂质显著异常升高，在最初的皮质激素治疗后持续1至2周。甘油三酯、总胆固醇和游离脂肪酸在所有组中均显著升高;这些脂质异常在骨坏死兔中显著存在，而在无骨坏死兔中不存在。本研究表明：（i）骨坏死在首次给予皮质激素后不久出现在家兔中，（ii）骨坏死在时间上与高脂血症和游离脂肪酸增加的发作相关。这支持骨内脂肪栓塞是骨坏死的一个原因。
Objectives. To clarify the initial onset time of osteonecrosis after the start of steroid treatment and its relation to the onset of abnormal lipid metabolism.Methods. Animal models were prepared by administering methylprednisolone to rabbits using five different steroid regimens.Results. A single, acute ischaemic event suggested by the frequency, size or number of necrotic foci within the proximal femur was not different among the groups. Histological evidence of osteonecrosis first occurred 1-2 weeks after initial steroid administration. At the same time there were significantly abnormal elevations in serum lipids, which persisted for between 1 and 2 weeks after the initial corticoid treatment. Triglycerides, total cholesterol and free fatty acids were markedly elevated in all groups; these lipid abnormalities were significantly present in the rabbits with osteonecrosis but not in the rabbits without osteonecrosis.Conclusions. This study shows that (i) osteonecrosis appears in rabbits shortly after corticoids are first administered, and (ii) osteonecrosis in rabbits is chronologically associated with the onset of hyperlipaemia and increased free fatty acids. This supports the occurrence of intraosseous fat embolism as a cause of osteonecrosis.