Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis
Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis
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DOI：
10.1007/s00264-015-2742-6
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发表时间：
2015-06-01
影响因子：
2.7
通讯作者：
Zarzycki, Daniel
中科院分区：
文献类型：
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作者：
Kulis, Aleksandra;Gozdzialska, Anna;Zarzycki, Daniel
目的为了验证青少年特发性脊柱侧凸（AIS）的病因学与性成熟过程之间的潜在联系，我们测定了受此疾病影响的绝经前后女孩的雌激素浓度。AIS主要发生在青春期女孩中，是最常见的错误姿势之一。因此，它被认为是AIS的多因素病理机制涉及显着缺乏oestrogens.Methods诊断AIS的基础上，体格检查和X线片分析。用ELISA法测定FSH、LH、雌激素、孕酮、骨钙素和RANKL的浓度。用动力学方法测定碱性磷酸酶（AP）活性。该研究包括月经前期和月经后期的AIS女孩和相应组的脊柱侧凸的自由controls.Results在月经前期脊柱侧凸女孩，FSH，LH和雌二醇的水平较低;孕酮，雌酮和雌三醇的水平较高;和雌酮和雌三醇的浓度是相似的相比，月经前期的控制。与对照组相比，在患有AIS的月经前期青少年中观察到更高水平的RANKL、骨钙素和AP。与对照组相比，绝经后脊柱侧凸女孩的FSH、LH、雌二醇和孕酮浓度较低，雌酮略低，雌三醇无差异。RANKL、骨钙素和AP水平在绝经后脊柱侧凸青少年中显著高于对照组（P <0.05）。雌二醇的测定可能对AIS相关脊柱病变的筛查具有诊断价值。
Purpose In order to verify the potential association between the aetiopathogenesis of adolescent idiopathic scoliosis (AIS) and the process of sexual maturation, we determined the concentrations of oestrogens in pre- and postmenarcheal girls affected by this condition. AIS, occurring mostly in pubescent girls, is one of the most frequent forms of faulty posture. Therefore, it was assumed that the multifactorial pathomechanism of AIS involves significant deficiency of oestrogens.Methods The diagnosis of AIS was established on the basis of physical examination and analyses of radiograms. Concentrations of FSH, LH, oestrogens, progesterone, osteocalcin and RANKL were determined by ELISA. The activity of alkaline phosphatase (AP) was measured by kinetic method. The study included pre- and postmenarcheal girls with AIS and corresponding groups of scoliosis-free controls.Results In premenarcheal scoliotic girls, the levels of FSH, LH and oestradiol were lower; the levels of progesterone, oestrone and oestriol were higher; and the concentrations of oestrone and oestriol were similar compared to premenarcheal controls. Higher levels of RANKL, osteocalcin and AP were observed in premenarcheal adolescents with AIS compared to controls. The concentrations of FSH, LH, oestradiol, and progesterone in postmenarcheal girls with scoliosis were lower, oestrone were slightly lower and oestriol did not differ compared with the control group. Significantly higher levels of RANKL, osteocalcin and AP were observed in postmenarcheal scoliotic adolescents compared with controls.Conclusions There is an interdependence between the concentration of oestradiol and development of scoliosis. Determination of estradiol may have diagnostic value in the screening of spinal pathologies associated with AIS.