Study On The Relationship Between Gut Health And Bone Mass In Postmenopausal Women

Objectives:Postmenopausal osteoporosis can cause osteoporotic fractures in postmenopausal women,leading to a reduced quality of life for patients and imposing a huge financial burden on patients and their families.As the main digestive organ and the main immune system of the human body,gut and gut health is crucial.Gut health is defined as the absence of gastrointestinal symptoms(such as abdominal pain,diarrhea,and other gastrointestinal symptoms),diseases(such as inflammatory bowel disease,colon cancer),and other adverse local conditions(such as increased intestinal permeability,mucosal inflammation,deficiency/excess of short-chain fatty acids).Recent studies have shown a strong relationship between gut health and bone mass.Therefore,this study wanted to investigate the relationship between gut health-gastrointestinal symptoms/gastrointestinal diseases and bone mass in postmenopausal women through a case-control study,to understand the factors influencing bone density,and to provide a relevant theoretical basis for the formation of a gut-focused care program for postmenopausal patients with osteoporosis.At the same time,the deep relationship and mechanism between gut health-the poor local condition(such as intestinal permeability,inflammation level,gut microbiota)and postmenopausal osteoporosis will be further explored through animal experiments to provide further evidence base and theoretical basis for gut health care in postmenopausal patients with osteoporosis.Methods:In a case-control study,110 postmenopausal women were recruited and divided into the normal group(NL group),the osteopenia group(PMO group)and osteoporosis group(OP group)according to their bone mineral density.General information,gastrointestinal symptom rating scale,short form 12,and bone mineral density were collected from postmenopausal women.Also,stool was collected from patients.Multi-factor ANOVA andχ~2 test were used to compare the differences between the three groups.Correlation analysis was used to analyze the relationship between gastrointestinal symptoms and bone mass in postmenopausal women,multiple linear regression to analyze the factors influencing bone mass.In the animal experiments,to investigate the deep relationship and mechanism between gut health-the poor local condition(such as intestinal permeability,inflammation level,gut microbiota)and postmenopausal osteoporosis,differences in bone mass,intestinal permeability,inflammation levels and gut microbiota were observed by comparing normal female mice with model-making mice(post-ovariectomized mice).In addition,changes in bone mass,intestinal permeability,inflammation levels and gut microbiota were also observed by giving fecal microbiota transplantation intervention.Results:The results of the case-control study showed that(1)there were significant differences in age,education,dietary habits,exercise habits,history of gastrointestinal surgery/gastrointestinal diseases,gastrointestinal symptoms,quality of life,and bone mineral density between the NL and PMO groups and the OP group.(2)Gastrointestinal symptoms in postmenopausal women were negatively associated with bone mineral density,and quality of life was positively associated with bone mineral density.(3)Age,body mass index,history of gastrointestinal surgery/gastrointestinal diseases,dietary habits,gastrointestinal symptoms and quality of life in postmenopausal women effectively predicted bone mineral density of patients.The results of the animal experiments showed that(1)estrogen deficiency induced a decrease in bone mass,an increase in intestinal permeability,an increase in the level of inflammation and a disturbance of gut microbiota.(2)The fecal microbiota transplantation(healthy population or healthy mice)to modeling mice could promote the restoration and reconstruction of intestinal microecology,and the bone mass of modeling mice was significantly increased.(3)The fecal microbiota transplantation(postmenopausal osteoporotic population or postmenopausal osteoporotic mice)to normal female mice induced a disruption of intestinal microecology and decrease in bone mass.Conclusion:Age,body mass index,dietary habits,history of gastrointestinal surgery/gastrointestinal disease,gastrointestinal symptoms and quality of life in postmenopausal women significantly predict changes in bone mineral density.There is a correlation between gut health and bone mineral density in postmenopausal women.By restoring gut health and promoting the reconstruction of intestinal microecology,the disease progression of postmenopausal osteoporosis can be effectively delayed.