Long - Term Use Of Glucocorticoid In Postmenopausal Osteoporosis Syndrome And Animal Experiment

Section One:the Chinese medicion syndrome and distribution of osteoporosis in postmenopausal women treated with glucocorticoidObjectiveTo study the distribution of Chinese medicine syndrome patterns of osteoporosis in postmenopausal women treated with glucocorticoid.MethodsWomen treated with glucocorticoid for more than 3 months for nephrotic syndrome, glomerulonephritis, glomerulosclerosis, systemic lupus erythematosus, rheumatoid arthritis, asthma, COPD, sicca syndrome or multiple myositis in Jan 1,2013 to Dec 31,2015 hospitalized in our hospital were Collected. Appropriate cases were included in the study according to the inclusion criteria and exclusion criteria. We analyszed the distribution of Chinese medicine syndrome patterns based on the clinical manifestations collectde by phone call following-up.Results83 patients were enrolled in the study. In order of largest proportion, it goes kidney-Yang deficiency in 33 cases, liver-kidney-Yin deficiency in 21cases, spleen-kidney-yang deficiency in 15 cases, stagnancy of both blood and qi in 8 cases and syndrome of deficiency of both yin and yang in 6 case.Conclusionkidney-Yang deficiency is the most common syndrome in patients with osteoporosis in postmenopausal women treated with glucocorticoid, followed closely by liver-kidney-Yin deficiency, spleen-kidney-yang deficiency, stagnancy of both blood and qi and syndrome of deficiency of both yin and yang.Section Two:The characteristic of osteoporosis on rat induced by ovariectomy with glucocorticoidObjectiveThis study investigated the difference of combined ovariectomy with dexamethasone treatment on rat in comparison with osteoporosis induced via ovariectomy or dexamethasone alone, and analysis of the associated mechanism.MethodsFifty-two female Sprague-Dawley rats (3 months old) were randomly divided into four groups:age-matched control group(CON group); those receiving a dexamethasone (0.3 mg/kg/d) injection alone (DEXA group); those undergoing bilateral ovariectomy (OVX group); and those subjected to both ovariectomy and dexamethasone (0.3 mg/kg/d) injection after one week(OVX-DEXA group). Animals were euthanized at the end of the 4th week, the 8th week, or the 12th week. Bone mineral density, bone microarchitecture, biomechanical properties of vertebrae, and serum levels of estrogen, amino-terminal propeptide of type I collagen (PINP), and β-C-telopeptide of type I collagen (β-CTX) and the mRNA expression of Runx2, OPG, Sclerostin, cathepsink were measured.ResultsBone mineral content and bone mineral density were markedly lower in the OVX-DEXA group and DEXA group compared with the OVX group. The lowest Trabecular number (Tb. N) and the highest trabecular separation (Tb. Sp, mm) was observed in the OVX-DEXA group. The OVX-DEXA group showed lower compressive strength and energy absorption capacity compared with the OVX groups at the 12th week. Estradiol level was lowest in the OVX-DEXA group while PINP and β-CTX level in serum were higher than OVX group at the 12th week. The expression of Runx2, OPG were down-regulated whereas the expression of Cathepsin k was up-regulated in the DEXA, OVX, and OVX-DEXA groups compared with CON groups. The expression of sclerostin were up-regulated in the OVX-DEXA group compared with the DEXA and OVX groups.ConclusionOvariectomy combined with dexamethasone induced more serious osteoporosis in the rat lumbar spine than either ovariectomy or dexamethasone alone.