维生素D缺乏性佝偻病患儿骨胶原标志物的检测及意义

Study on markers of bone collagen with vitamin D deficiency rickets children.

目的 研究维生素D(VitD)缺乏性佝偻病患儿骨胶原合成与分解的状况 ,探讨其与骨特异性骨碱性磷酸酶 (BALP)之间的相关性。方法 按照佝偻病临床诊断标准确定 2 0 0 1年 11月至 2 0 0 3年 1月河北医科大学附属二院及大同市第一人民医院儿科 14 8例研究对象 (佝偻病组 80例 ,对照组 6 8例 ) ,结合血清 2 5 羟维生素D(2 5 OHD)及BALP检测结果 ,经过两次筛查 ,明确最后研究对象为佝偻病组 4 3例 ,对照组 37例 ,用酶联免疫方法检测其血清I型前胶原羧基末端前肽 (PICP) ,I型胶原羧基末端交联 (crosslaps)水平。结果 佝偻病患儿血清PICP、crosslaps水平均高于正常组 ,且差异均有显著性意义。佝偻病组及正常组除血清BALP、PICP有正相关关系且有统计学意义 ,其他指标间均无相关性。结论 VitD缺乏性佝偻病患儿骨胶原的合成增强 ,并与骨碱性磷酸酶有相关性。PICP可否作为佝偻病早期诊断的指标需进一步研究。VitD缺乏性佝偻病患儿骨胶原的分解增强。佝偻病患儿骨胶原代谢处于高转换状态。

Objective To investigate the synthesis and degradation of bone collagen in vitamin D deficiency rickets children and to assess whether there are correlations among the synthesis and degradation of bone collagen,specific bone alkaline phosphatase as well.Methods The subjects (n=148)were screened by using the clinical diagnostic criteria,then we measured serum 25 OHD and bone alkaline phosphatase of them to set up biochemical criteria of BALP,and finally we defined subjects on 43 children aged 6～20 months with active vitamin D deficiency rickets,male 23,female 20; 37 healthy children aged 6～19 months were enrolled as sex and age matched controls.Biochemical markers of bone collagen synthesis PICP and bone collagen degradation (crosslaps) were measured by monocolony antibody ELISA and CrosslapTM one step ELISA,respectively; while 25 OHD and BALP were detected by radioimmunoassay and ELISA respectively.Results Mean serum PICP,crosslaps levels were significantly higher in rickets children than in controls.Serum PICP levels correlate positively and significantly with serum BALP levels statistically.Conclusion Both the synthesis and degradation of bone collagen in rickets children with vitamin D deficiency are increased significantly.Serum carboxyterminal propeptide of type 1 procollagen (PICP) is correlated positively with serum bone alkaline phosphatase(BALP) of all subjects in this study.Bone collagen metabolism in rickets children with vitamin D deficiency is in a high turnover state.