骨形成与吸收过程中的代谢生化标记物

Metabolic biochemical makers in the progress of bone formation and absorption

目的:介绍近20年来国内外关于反映骨形成与吸收的代谢生化标记物的研究概况,以及对诊断代谢性骨病及分型、预测骨丢失和骨折的危险性、监测药物疗效的意义。资料来源:应用计算机检索Pubm ed网站1980年以来相关文章,限定文章语言种类为“English”,检索词为“biochem ical m arkers”,“boneturnover”,“osteoporosis”;应用计算机检索中文医学期刊网1980年以来相关文章,检索词为“骨代谢”,“标志物”。资料选择:对资料进行初审,选取目前常用的反映骨形成及吸收的生化标志物。纳入标准:①为骨基质成分。②由成骨细胞和破骨细胞活动而释放至血和尿中。③有明确的测量方法。④有临床指导意义。资料提炼:共收集到英文相关文献405篇,按上述标准纳入19篇;中文相关文献12篇,纳入2篇。其余文献均被排除。资料综合:21篇文章中10篇为机制方面的研究,3篇为测量方法研究,8篇为临床研究。共收集了10个相关指标,其中4个与骨形成相关,6个与骨吸收有关。结论:骨代谢的生化标志物是由成骨细胞和破骨细胞活动而释放至血和尿中的骨基质成分,可以反映整体骨转换率,对诊断代谢性骨病及分型、预测骨丢失和骨折的危险性、监测药物疗效等均有重要的意义。

OBJECTIVE; To introduce the general status of the studies about the biochemical makers that can reflect the progress of the bone formation and absorption at home and abroad in the recent 20 years, and the significances in diagnosing metabolic bone disease and typing, predicting risk of bone loss and fracture and monitoring the effect of drug. DATA SOURCES： The relevant articles were searched with computer in Pubmed website since 1980 published in English by using the keywords of “biochemical markers, bone turnover, osteoporosis”. Chinese relevant articles since 1980 were also retrieved in Chinese medical journal net, the keywords were“bone metabolism, biomarker”. STUDY SELECTION： The data were checked firstly, the articles concerning the biochemical makers reflecting the progress of the bone format＇ion and absorption were selected. Inclusive criteria： ① component of bone matrix;② released by osteoblast and osteoclast in the process of bone formation and absorption; ③ can be tested in exact methods; ④ of clinical instructive significance. DATA EXTRACTION： Totally 405 English articles and 12 Chinese articles were collected, and 19 English articles and 2 Chinese articles were selected, others were excluded. DATA SYNTHESIS： Of the 21 articles, 10 mechanism studies, 3 about testing method and 8 clinical studies. A total of 10 biomarkers were reviewed, in which 4 concerning with bone formation and 6 concerning bone absorption. CONCLUSION： The biochemical makers of bone metabolism are some components of bone matrix in blood and urine that are released by activation of the osteoblast and osteoclast. They can reflect the general bone turnover rate and are significant in diagnosing the metabolic bone disease, predicting the risk of the bone matrix loss or fractures, and monitoring the curative effects of the drugs.