摘要
肌肉骨骼减少症(osteosarcopenia,OS)是一种多因素、多病因的退行性代谢综合征,其影响因素可能与衰老导致的机械、遗传、炎症因子、内分泌紊乱以及生活方式不规律相关。OS患者具有更高跌倒、骨折、活动障碍和死亡的风险,随着中国全球老龄化进程的加快,OS已经成为不容忽视的公共健康问题。近年来,国内外学者针对OS开展了大量的研究,但其发病机制仍不清楚。了解与OS相关的信号通路对进一步研究其发病机制和寻找治疗的新靶点具有重要意义。而运动作为现有效果强、持续性好的非药物治疗方式,能够增加老年人肌肉质量、提高骨密度、改善生活质量等,从而有效地预防和改善OS。本文主要就OS的流行病学、诊断标准、共同参与调节肌细胞与骨骼细胞代谢过程的相关信号通路(PI3K/Akt通路、Wnt/β-catenin通路、Notch通路、NF-κB通路),以及不同运动方式对OS的干预效果等方面进行综述,以期为临床治疗OS提供理论依据,提高老年疾病的预防能力。
Osteosarcopenia(OS)is a multifactorial,multiaetiologic degenerative metabolic syndrome in which sarcopenia coexists with osteoporosis,and its influences are related to aging-induced mechanics,genetics,inflammatory factors,endocrine disorders,and irregular lifestyles.With the accelerated aging process in our country,osteosarcopenia has become a public health problem that cannot be ignored,with a higher risk of falls,fractures,impaired mobility and death.In recent years,scholars at home and abroad have conducted a lot of research on osteosarcopenia,but their pathogenesis is still unclear.Understanding the signaling pathways associated with osteosarcopenia is of great significance for further research on the pathogenesis of these disorders and for finding new targets for treatment.Studies have shown that activation of the PI3K/Akt signaling pathway promotes osteoblast differentiation as well as skeletal muscle regeneration,indicating that inhibition of the PI3K/Akt signaling pathway is closely related to the development of osteosarcopenia.Muscle factor-mechanical stress interactions can maintain osteoblast viability by activating the Wnt/β-catenin signaling pathway,suggesting that Wnt signaling is important in muscle and bone crosstalk.The Notch signaling pathway also plays an important role in improving bone and muscle mass and function,but different researchers hold different views,which need to be further validated and refined in subsequent studies.Exercise,as an existing non-pharmacological treatment with strong and sustained effects on physical function and muscle strength,also significantly increases bone density in osteoporosis patients,which may be mainly due to the fact that exercise induces changes in the form and function of bones,in the form of muscular pulling and indirectly improves the bone mass,and changes in the bone strength can also change the number,shape as well as the function of the muscles.At the same time,the mechanism of different exercise modalities focuses on different aspects,and there are differences in exercise time,exercise intensity,and therapeutic effects in the implementation of interventions.Aerobic exercise can improve the quality of skeletal muscle and increase the expression of osteogenesis-related genes by stimulating mitochondrial biosynthesis,as well as improve the quality and strength of bones and muscles through the Wnt/β-catenin and PI3K/Akt signaling pathways,effectively preventing and controlling the occurrence of musculoskeletal disorders.High-intensity resistance exercise has a significant effect on improving the quality of muscles and bone mineral density,but older people with osteosarcopenia suffer from a decline in muscle quality and strength,and a decline in bone mineral density,which makes them very susceptible to fracture,so they should select the intensity of the training in a gradual and orderly manner,from small to large.What kind of exercise intensity and exercise modalities are most effective in improving the occurrence and development of osteosarcopenia needs to be further investigated.Therefore,this paper mainly reviews the epidemiology of osteosarcopenia,diagnostic criteria,the related signaling pathways(PI3K/Akt pathway,Wnt/β-catenin pathway,Notch pathway,NF-κB pathway)that jointly regulate the metabolic process of myocytes and skeletal cells,as well as the interventional effects of different exercise modes on osteosarcopenia,with the aim of providing theoretical bases for the clinical treatment of osteosarcopenia,as well as enhancing the preventive capacity of the disease in old age.
作者
靳丹
代新宇
刘淼
衣雪洁
高海宁
JIN Dan;DAI Xin-Yu;LIU Miao;YI Xue-Jie;GAO Hai-Ning(School of Sports Health,Shenyang Sport University,Shenyang 110102,China;Exercise and Health Research Center,Shenyang Sport University,Shenyang 110102,China)
出处
《生物化学与生物物理进展》
SCIE
CAS
CSCD
北大核心
2024年第5期1105-1118,共14页
Progress In Biochemistry and Biophysics
基金
国家自然科学基金(12072202)资助项目。
