To investigate the intervention effect of calcitriol on closed lumbar compression fracture based on PI3K/Akt/mTOR signaling pathway
Objective To investigate the intervention effect of calcitriol on closed lumbar compression frac-ture based on PI3K/Akt/mTOR signaling pathway.Methods 150 patients with closed lumbar vertebral compression fractures admitted to our hospital from January 2020 to September 2022 were randomly divided into a blank group,a control group,and an observation group in a 1∶1∶1 ratio,with 50 patients in each group.All three groups were treat-ed with bed rest,use of a reset pad,hard board bed,lumbar and dorsal muscle training,and oral vitamin D calci-um chewable tablets(specification 750 mg×60 s),2 tablets/time,1 dose/day treatment,blank group oral placebo capsules,1 capsule/time,1 dose/day;The control group received oral administration of alpha calciferol(specifica-tion 0.25 μg×20 s),2 capsules/time,1 time/day;Observation group takes orally calcitriol capsules(specification 0.25 μg×1O s),1 capsule/time,1 dose/day;Each group lasted for 12 weeks.Evaluate the Oswesty Dysfunction In-dex(ODI)and pain Visual Analog Scale(VAS)before and after treatment,detect protein expression in the PI3K/Akt/mTOR pathway,and detect bone metabolism indicators such as serum calcium,serum phosphorus,bone densi-ty,osteocalcin,alkaline phosphatase(ALP),bone density regulated protein(OPG),and RANK ligand(RANKL).Results Before treatment,VAS,ODI,bone mineral density,bone metabolism indexes,PI3K,Akt and mTOR pro-tein expression levels were not statistically significant in three groups(P＞0.05).After 12 weeks of treatment,VAS score and ODI index of control group and observation group were significantly decreased compared with blank group,bone mineral density,serum phosphorus,ALP,osteocalcin and OPG were increased,and the protein expression levels of serum calcium,RANKL,PI3K,Akt and mTOR were decreased,with statistical significance(P＜0.05).Com-pared with the control group,VAS score and ODI index in observation group were decreased,bone mineral density,serum phosphorus,ALP,osteocalcin and OPG were increased,and serum calcium,RANKL,PI3K,Akt and mTOR protein expression levels were decreased,with statistical significance(P＜0.05).Conclusion Calcitriol may activate the PI3K/Akt/mTOR signaling pathway by bidirectional regulation of PI3K/Akt/mTOR pathway,on the one hand increasing OPG,ALP and BGP levels,so as to reduce osteoclast generation and promote fracture healing.On the other hand,it can reduce the expression of PI3K/Akt protein,inhibit the PI3K/Akt/mTOR signaling pathway,and reduce the inflammatory reaction caused by fracture.
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