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| 芳香化酶抑制剂的骨毒性研究进展 |
| Advances in osteotoxicity studies of aromatase inhibitors |
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| DOI：10.3969/j.issn.1006-7108.2026.05.020 |
| 中文关键词: 内分泌治疗 乳腺癌 骨质疏松 骨代谢 研究进展 |
| 英文关键词:endocrine therapy breast cancer osteoporosis bone metabolism research progress |
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| 中文摘要: |
| 芳香化酶抑制剂（aromatase inhibitors, AI）已成为绝经后激素受体阳性乳腺癌的标准治疗方案，但其引发的骨代谢失衡显著增加了骨折风险，影响患者生存质量。AI通过抑制雌激素合成，削弱成骨细胞活性并增强破骨细胞分化，导致骨质疏松的发生。研究表明，不同AI药物在骨毒性方面存在差异，同时患者基线特征、基因多态性等因素也影响其骨折风险。AI相关骨质疏松的管理策略应包括非药物干预（如运动和营养补充）以及药物治疗（如双膦酸盐和地舒单抗）。然而，现有研究在风险评估、基因机制解析及个体化治疗策略方面仍存不足，未来需通过多组学研究优化骨折风险预测模型，并改进临床筛查与干预流程，以提高AI相关骨毒性的防治水平。故本综述将从分析芳香化酶抑制剂对骨代谢的影响机制出发，探讨其诱导骨质疏松的分子机制及相关危险因素，并进一步说明当前预防与治疗策略，以期为优化乳腺癌患者的骨健康管理提供新的思路。 |
| 英文摘要: |
| Aromatase inhibitors (AIs) have become the standard treatment for the postmenopausal hormone receptor-positive breast cancer. However, AI-induced bone metabolism imbalance significantly increases fracture risk, affecting patients' quality of life. By inhibiting estrogen synthesis, AIs impair osteoblast activity and enhance osteoclast differentiation, leading to osteoporosis. Studies have shown that different AI agents exhibit varying degrees of bone toxicity, while patient baseline characteristics and genetic polymorphisms also influence fracture risk. The management of AI-associated osteoporosis should include non-pharmacological interventions (e.g., exercise and nutritional supplementation) and pharmacological treatments (e.g., bisphosphonates and denosumab). However, current research still lacks comprehensive risk assessment, genetic mechanism elucidation, and individualized treatment strategies. Future studies should leverage multi-omics approaches to optimize fracture risk prediction models and refine clinical screening and intervention protocols to improve the prevention and management of AI-related bone toxicity. This review aims to analyze the impact of AIs on bone metabolism, to explore the molecular mechanisms and risk factors underlying AI-induced osteoporosis, and to summarize current prevention and treatment strategies to provide new insights for optimizing bone health management in breast cancer patients. |
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