Correlation Study And Analysis Of Prevention And Treatment Status Of Hcy And Bone Metabolic Diseases

Bone metabolic diseases are systemic bone metabolic diseases and important causes of high fracture and mortality rate of the elderly,bringing a heavy economic and social burden to the world.Homocysteine(Hcy),an intermediate metabolite of methionine,would induce Hyperhomocysteinemia(HHcy)when the fasting plasma concentration exceeds the normal range(15 ?mol/L)and is an independent risk factor for chronic diseases such as bone metabolic diseases.Studies have shown that HHcy is closely related to the occurrence and development of bone metabolic diseases,and a series of studies have been conducted on its mechanism and achieved certain results.These achienements was analyzed and the prevention and treatment measures of HHcy-related bone metabolic diseases was summarized in the review to provide a scientific basis for the target prevention and treatment in the later period.The comprehensive analysis of the mechanism of Hcy-induced chronic diseases shows that Hcy mainly induces atherosclerosis by disrupting the balance between procoagulant and anticoagulant factors in the vascular endothelium,causing endometrial damage and oxidative stress;cardiovascular disease by destroying elastin fibers,increasing collagen production and/or stimulating smooth muscle cell activity to increase arterial stiffness;Alzheimer's disease by promoting the expression of inflammatory factors and rapid proliferation of tumor cells and induces the occurrence of malignant tumors.The induction of chronic diseases by Hcy will increase the morbidity and mortality of bone metabolic diseases,thus the effective targeted prevention and treatment is necessary.The comprehensive analysis of the mechanism of Hcy-induced bone metabolic diseases shows that Hcy induces bone metabolic diseases through the following aspects.On the one hand,Hcy can inhibit osteoblast differentiation and promote apoptosis by promoting oxidative stress and mediating mitochondrial pathway and endoplasmic reticulum stress.On the other hand,Hcy can promote the increase of RANKL /OPG ratio through MAPK signaling pathway to enhance the activity and function of osteoclasts to promote bone resorption.The combination of these two aspects makes the bone reconstruction process shift to the direction of bone resorption.Hcy can also induce bone metabolic diseases by affecting the expression and activity of Lox,inhibiting enzymatic collagen cross-linking and increasing the production of nonenzymatic harmful cross-links such as pentose glycosides.At present,the mechanism by which Hcy inhibits osteoblast differentiation and enzymatic collagen cross-linking is not yet clear,and it needs to be studied in depth at the animal and the cellular level to provide an important reference for the targeted reversal of its negative effects.A comprehensive analysis of the effect of prevention and treatment of HHcy-related bone metabolic diseases was carried out and we found that conventional drugs have no effect on the HHcy-related bone metabolic diseases(calcium,tibolone,strontium salt,teriparatide)or no reports(vitamin D,calcitonin,abaloparatide,romamosozumab,DKK1 monoclonal antibody),or shows good effects but has obvious side effects(bisphosphonates)or the application is restricted by gender(SERMs).In addition,other substances(Liuwei Dihuang,statins and Na HS)have a certain control effect,while their research is still in the initial stage,so nutrition researchers are committed to finding safe and low-toxic phytochemicals that can effectively prevent HHcy-related bone metabolism diseases.The combined use of folic acid,vitamin B6 and B12 is a common measure for clinical prevention and treatment of HHcy-related bone metabolic diseases,but it has no good effect and will induce increased fracture rates and cancer rates in patients when taken for long-term.Resveratrol,curcumin and allicin can effectively prevent bone metabolism disorders and prevent Hcy-induced vascular toxicity and neurotoxicity.However,their preventive effects on HHcy-related bone metabolism diseases have not been reported.Tocotrienol(Tocotrienol,T3)has a good preventive effect on osteoporosis,which can effectively prevent HHcy induced by high methionine diet and effectively reverse oxidative stress.The results showed that 3 ?mol/L ?-T3 can effectively reduce increased activity of MC3T3-E1 cells 100 ?mol/L Hcy induced to the control level.Combined with the cell morphology observed,it is speculated that ?-T3 can effectively improve the inhibitory effect of Hcy on osteoblast differentiation,while the effects of ?-,?-and ?-T3 on HHcy-related bone metabolism diseases are yet to be studied.As a strong antioxidant,the promotion of T3 on bone formation and inhibition of bone resorption may be closely related to its strong antioxidant properties.Further research on the mechanism by which T3 improves HHcy-related bone metabolic diseases is of great significance for the development of functional factors for the prevention and treatment of HHcy-related bone metabolic diseases.