| Osteoporosis (OP) is a disease with decrease in generalized bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk. Pathologic change of OP is characterized by lowering bone mass of unit volume, insufficient formation of organic ingredient in bone matrix, secondary decrease of calcareous deposit. Epidemiology shows that OP and osteoporotic fracture are the most common senile disease. Hipbone fracture is the severest. In American, about 1.6 million people suffer from hipbone fracture every year. Therefore, with the complement of health service system, prolonging of population lifetime, OP as one of senile disease is paid more and more attention to.OP can be classified into three kinds. The first is primary OP including senile OP and postmenopausal OP. The second is secondary OP, induced by other diseases or drugs like diabetic OP (DOP), hyperthyroid OP, parathyroid OP, nephropathic OP and disuse OP etc. The third is idiopathetic OP, which is common in youth aged from 8 to14 or adult. More than half of the patients have family history and females are more than males among them. This thesis studies the DOP of secondary OP. At present with the increasing of diabetic mellitus (DM) incidence year after year, DOP is paid more and more attention to by civil and alien scholars. The incidence of DOP is different in many literatures. Nearly half of DM patients suffer from DOP, according to alien report. Base on domestic, the DOP incidence can reach to 66 percent, especially higher in female. There are more than fifteen million DM in our country , we canfigure out that DOP cases are not less than seven million according to Yan guo etc.The pathogenetic mechanisms of DOP are mainly as follow: ①The effect of DM on calcium-phosphorus metabolism. The osmotic diuresis excretes a lot of calcium ion, magnesium ion and phosphorus ion etc, and the calcium in bowel is not absorbed well, causing negative balance of calcium, lost of bone mass. Therefore, mineralization is descended. ②The effect of DM on bone metabolism. The increased bone absorption and decreased bone formation, that is the loss balance of bone formation and absorption are main manifestation in DM, which decrease mineral in bone and cause OP. One of the hot spots is to study the effect of AGEs on bone metabolism. ③There is a relationship between DOP and insufficiency of insulin, which can regulate bone growth and stimulate bone formation. On the surface of osteoblast(OB) there are insulin receptors. Insulin can stimulate them directly. ④Insulin like growth factors(IGF-1,IGF-2) are involved in the generation of DOP. IGFs are some kinds of polypeptide with similar structure as insulin. They exist in all tissues of mammal and play an important, widespread role in humankind as one kind of endocrine factors. Besides stimulating the proliferation and differentiation of cells and having insulin like effect, they are also involved in DM, and to some extent affect occurrence and development of OP.There are two OP types of conversion, high and low one, whose pathological progress depends on the structure and function of OB and OC. DOP belongs to low conversion type. The structure, quantity, and function of OB directly influence the generation and development of OP. The effect of peroxynitrite anion (ONOO-) on the apoptosis and function of OB is focused on, and the preventing mechanism of ZTKR on DOP is exploded in our study.There are few reports about the effect of ONOO- on bone metabolism in DOP. NO (nitic oxide) and O2。 (superoxide) can react quickly to produce ONOO-. L-Arg can be catalyzed by NOS to produce NO. And NOS can beclassified into three kinds, including nNOS (neuronal nitric oxide synthase), eNOS(endothelial nitric oxide synthase) and iNOS(inducible nitric oxide synthase). nNOS and eNOS called as cNOS can act under normal condition, but iNOS seldom act. iNOS can be induced by many body fluid factors, such as cytokines and endotoxin. If it is... |
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