柠檬酸锶（Strontium Citrate）：在骨质疏松防治中的作用及临床价值

柠檬酸锶作为临床常用的有机锶补充剂，凭借高生物利用度与低胃肠道刺激性，成为骨质疏松防治的重要干预手段，其核心机制在于对骨代谢的双向调控。进入机体后，锶离子（Sr²⁺）可竞争性结合骨基质中的羟基磷灰石，形成结构更稳定的 “锶取代羟基磷灰石”，同时通过两条关键通路调节骨细胞功能：在破骨细胞层面，Sr²⁺下调核因子 κB 受体活化因子配体（RANKL）表达、上调骨保护素（OPG）水平，经 RANKL/OPG 通路抑制破骨细胞分化与活性，减少骨基质降解；在成骨细胞层面，其激活丝裂原活化蛋白激酶（MAPK）与 Wnt/β- 连环蛋白通路，促进成骨细胞增殖及骨钙素（OCN）、骨碱性磷酸酶（BALP）等成骨标志物分泌，加速新骨矿化。

临床研究证实其显著疗效：研究表明，绝经后骨质疏松女性每日口服 600mg 元素锶（以柠檬酸锶形式补充），持续 24个月后腰椎骨密度（BMD）提升，髋部 BMD 提升；对≥65岁患者的随访研究表明，该干预可使椎体骨折风险降低，非椎体骨折风险降低。此外，柠檬酸锶对双膦酸盐类药物不耐受患者具有良好适用性，常与维生素 D、钙联合使用，形成 “补充 - 调控 - 矿化” 的协同干预方案，既能提升骨密度，又能通过改善骨微结构增强骨强度，为绝经后女性、老年男性及糖皮质激素诱导的骨质疏松症（GIOP）患者提供安全有效的治疗选择，是当前骨质疏松综合管理中兼具疗效与安全性的一线干预剂。

柠檬酸锶（Strontium Citrate）：在骨质疏松防治中的作用及临床价值

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抗坏血酸锰Manganese Ascorbate、抗坏血酸亚铁Ferrous Ascorbate、赖氨酸甘氨酸镁Magnesium Lysinate Glycinate、甘氨酸谷氨酰胺镁Magnesium Glycinate Glutamine、柠檬酸苹果酸镁Magnesium Citrate Malate、柠檬酸锶Strontium Citrate、柠檬酸锰Manganese Citrate、柠檬酸铜Copper Citrate、天门冬氨酸锂Lithium Aspartate、牛磺酸硒Selenium Taurate.

Strontium Citrate: Role and Clinical Value in the Prevention and Treatment of Osteoporosis

As a commonly used organic strontium supplement in clinical practice, strontium citrate has become an important intervention for the prevention and treatment of osteoporosis due to its high bioavailability and low gastrointestinal irritation. Its core mechanism lies in the bidirectional regulation of bone metabolism. After entering the body, strontium ions (Sr²⁺) can competitively bind to hydroxyapatite in the bone matrix to form "strontium-substituted hydroxyapatite" with a more stable structure. Meanwhile, it regulates osteocyte function through two key pathways: On the osteoclast side, Sr²⁺ downregulates the expression of receptor activator of nuclear factor-κB ligand (RANKL) and upregulates the level of osteoprotegerin (OPG). Via the RANKL/OPG pathway, it inhibits the differentiation and activity of osteoclasts, thereby reducing bone matrix degradation. On the osteoblast side, it activates the mitogen-activated protein kinase (MAPK) pathway and the Wnt/β-catenin pathway, promotes the proliferation of osteoblasts and the secretion of osteogenic markers such as osteocalcin (OCN) and bone alkaline phosphatase (BALP), and accelerates the mineralization of new bone.

Clinical studies have confirmed its significant efficacy: studies show that postmenopausal women with osteoporosis who orally administer 600 mg of elemental strontium (supplemented in the form of strontium citrate) daily exhibit increased lumbar bone mineral density (BMD) and hip BMD after 24 consecutive months. Follow-up studies on patients aged ≥ 65 years indicate that this intervention can reduce the risk of vertebral fractures and non-vertebral fractures. In addition, strontium citrate is well-suited for patients intolerant to bisphosphonate drugs. It is often used in combination with vitamin D and calcium to form a "supplementation-regulation-mineralization" synergistic intervention regimen. This regimen not only increases BMD but also enhances bone strength by improving bone microstructure, providing a safe and effective treatment option for postmenopausal women, elderly men, and patients with glucocorticoid-induced osteoporosis (GIOP). It is currently a first-line intervention with both efficacy and safety in the comprehensive management of osteoporosis.

Strontium Citrate: Role and Clinical Value in the Prevention and Treatment of Osteoporosis

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Manganese Ascorbate, Ferrous Ascorbate, Magnesium Lysinate Glycinate, Magnesium Glycinate Glutamine, Magnesium Citrate Malate, Strontium Citrate, Manganese Citrate, Copper Citrate, Lithium Aspartate, Selenium Taurate.