Higher Glucocorticoid Secretion in the Physiological Range Is Associated With Lower Bone Strength at the Proximal Radius in Healthy Children: Importance of Protein Intake Adjustment
Higher Glucocorticoid Secretion in the Physiological Range Is Associated With Lower Bone Strength at the Proximal Radius in Healthy Children: Importance of Protein Intake Adjustment
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健康儿童生理范围内较高的糖皮质激素分泌与近端半径较低的骨强度相关：蛋白质摄入量调整的重要性
DOI：
10.1002/jbmr.2347
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发表时间：
2015
影响因子：
6.2
通讯作者：
Remer T
中科院分区：
文献类型：
--
作者：
Sánchez-Guijo A;Hartmann MF;Schönau E;Esche J;Wudy SA;Remer T
生理范围内较高的糖皮质激素（GCs）分泌是否已经影响健康儿童的骨骼状况尚不清楚。由于膳食蛋白质摄入影响骨骼和GCs，我们在特别控制蛋白质摄入后，研究了健康非肥胖儿童尿液中糖皮质激素状态和皮质骨的关系。外周定量计算机断层扫描（pQCT）测量前臂近端骨参数。研究对象（n= 175,87名男性，年龄6至18岁）在24小时内采集了两次尿液样本：第一次在骨测量前1年采集，第二次在骨测量时采集。采用质谱法测定尿GC主要代谢物，并汇总评估肾上腺GC日分泌量（∑C21）。总结尿游离皮质醇（UFF）和可的松（UFE）来评估潜在的生物活性游离gc （UFF + UFE）。在控制了几个协变量，特别是尿氮（蛋白质摄入的生物标志物）后，皮质醇分泌∑C21与所有分析的pQCT骨质量测量值呈负相关。∑C21还预测了更大的骨膜内周长和更低的骨膜周长，解释了更小的皮质面积和更低的强度-应变-指数（SSI）（连同更低的骨密度）。UFF + UFE、UFE本身和尿代谢物11β -羟基类固醇脱氢酶1型（11β - HSD1）活性与BMD和骨矿物质含量呈相应的负相关（p< 0.05），但与SSI和骨几何变量无关。综上所述，较高的GC水平，即使在生理范围内，似乎已经在生长过程中对骨的建模和重塑产生负面影响。我们的生理数据也表明可的松作为骨细胞11β - HSD1分泌皮质醇的直接来源。©2014美国骨与矿物研究学会。
Whether higher production of glucocorticoids (GCs) within the physiological range may already be affecting bone status in healthy children is unknown. Because dietary protein intake affects both bone and GCs, we examined the association of urinary measures of glucocorticoid status and cortical bone in healthy non‐obese children, after particularly controlling for protein intake. Proximal forearm bone parameters were measured by peripheral quantitative computed tomography (pQCT). Subjects studied (n= 175, 87 males, aged 6 to 18 years) had two 24‐hour urine samples collected: the first sample at 1 year before bone measurement, and the second sample at the time of bone measurement. Major urinary GC metabolites were measured by mass spectrometry and summed to assess daily adrenal GC secretion (∑C21). Urinary free cortisol (UFF) and cortisone (UFE) were summed to assess potentially bioactive free GCs (UFF + UFE). After controlling for several covariates and especially urinary nitrogen (the biomarker of protein intake) cortisol secretion ∑C21 was inversely associated with all analyzed pQCT measures of bone quality. ∑C21 also predicted a higher endosteal and lower periosteal circumference, explaining both a smaller cortical area and (together with lower BMD) a lower strength‐strain‐index (SSI). UFF + UFE, UFE itself, and a urinary metabolite‐estimate of 11beta‐hydroxysteroid dehydrogenase type1 (11beta‐HSD1) activity showed corresponding reciprocal associations (p< 0.05) with BMD and bone mineral content, but not with SSI and bone geometry variables. In conclusion, higher GC levels, even within the physiological range, appear to exert negative influences on bone modeling and remodeling already during growth. Our physiological data also suggest a relevant role of cortisone as the direct source for intracrine‐generated cortisol by bone cell 11beta‐HSD1. © 2014 American Society for Bone and Mineral Research.
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影响因子：
6.2
作者：
Remer, T;Boye, KR;Wudy, SA
通讯作者：
Wudy, SA
影响因子：
5.8
作者：
DUNN, JF;NISULA, BC;RODBARD, D
通讯作者：
RODBARD, D
绝经后妇女骨矿物质含量与临床、激素和生化参数的关系
影响因子：
2.6
作者：
B. Acar;T. Uslu;A. Topuz;E. Osma;T. Erçal;C. Posacı;Y. Erata;A. Mumcu
通讯作者：
A. Mumcu
神经性厌食症的骨丢失及其机制的评估
影响因子：
4.2
作者：
I. Legroux;J. Vignau;M. D'herbomez;F. Collier;X. Marchandise;B. Duquesnoy;B. Cortet
通讯作者：
B. Cortet
在正常生理范围内长期较高的尿钙排泄预示着具有较高潜在肾酸负荷的健康儿童的近端桡骨骨状态受损。
影响因子：
4.1
作者：
Lijie Shi;L. Libuda;E. Schönau;L. Frassetto;T. Remer
通讯作者：
T. Remer