骨化三醇联合特立帕肽治疗对绝经后骨质疏松症患者肠道菌群的影响

The effect of calcitriol combined with terlipide treatment on the gut microbiota of postmenopausal osteoporosis patients

摘要:

目的 探讨骨化三醇联合特立帕肽治疗对绝经后骨质疏松症患者肠道菌群的影响。方法 选取2021年3月—2023年9月在天津市宝坻区人民医院接受治疗的109例绝经后骨质疏松症患者为研究对象，按照随机数字表法分为治疗组55例（接受骨化三醇和特立帕肽联合治疗）与对照组54例（仅接受骨化三醇治疗）。所有患者治疗前后进行肠道菌群16S rRNA基因测序分析。观察两组治疗前后骨密度、骨转化标志物、肠道菌群、钙磷代谢指标及血清炎症因子的变化。结果 治疗组治疗前后腰椎、股骨颈及Ward's三角区域的骨密度的差值均高于对照组（P <0.05）。治疗组治疗前后骨钙素、tP1NP、PTH、25-羟基维生素D及β-CTx的差值均高于对照组（P < 0.05）。治疗组治疗前后双歧杆菌、乳酸杆菌及大肠杆菌的差值均高于对照组（P < 0.05）。治疗组治疗前后钙、磷及碱性磷酸酶的差值均高于对照组（P < 0.05）。治疗组治疗前后TNF-α、IL-6及IL-10的差值均高于对照组（P < 0.05）。结论 骨化三醇联合特立帕肽治疗可以显著改善绝经后骨质疏松症患者的肠道菌群，尤其是增加益生菌的比例，且有助于改善患者的骨密度。

Abstract:

Objective To investigate the effects of calcitriol combined with teriparatide on gut microbiota in postmenopausal osteoporosis patients.Methods A total of 109 postmenopausal osteoporosis patients treated at Baodi District People's Hospital from March 2021 to September 2023 were selected for the study. They were randomly divided into a treatment group (55 patients receiving combined therapy with calcitriol and teriparatide) and a control group (54 patients receiving only calcitriol). Pre- and post-treatment analyses of gut microbiota were performed using 16S rRNA gene sequencing. Changes in bone density, bone turnover markers, gut microbiota, calcium and phosphorus metabolism indicators, and serum inflammatory factors were observed in both groups.Results The bone density differences in the lumbar spine, femoral neck, and Ward's triangle area before and after treatment in the treatment group were higher than those in the control group (P <0.05). The difference in osteocalcin, tP1NP, PTH, 25-hydroxyvitamin D, and β - CTx before and after treatment in the treatment group was higher than that in the control group (P <0.05). The difference in Bifidobacterium, Lactobacillus, and Escherichia coli before and after treatment in the treatment group was higher than that in the control group (P <0.05). The difference in calcium, phosphorus, and alkaline phosphatase before and after treatment in the treatment group was higher than that in the control group (P <0.05). The difference in TNF - α, IL-6, and IL-10 in the treatment group was higher than that in the control group (P <0.05).Conclusion The combined application of calcitriol and teriparatide significantly enhances the gut microbiota, markedly increasing the proportion of beneficial bacteria, and effectively improves bone density in postmenopausal osteoporosis patients. This approach not only ameliorates clinical symptoms but also offers a comprehensive strategy for managing osteoporosis, reinforcing its therapeutic potential.