中老年女性骨密度和骨代谢生化指标关系的研究

The study on bone mineral density and bone metabolic markers in middle-aged and old women

目的：了解中老年女性骨密度和骨代谢生化指标随年龄变化的特点，分析骨代谢生化指标在骨质疏松症早期诊断中的价值。方法：测定162例中老年女性腰椎正位骨密度，同时检测所有受检者空腹血清骨钙素、血清碱性磷酸酶及晨尿吡啶啉，尿吡啶啉用肌酐校正。按年龄段和不同骨密度组对骨代谢生化指标值分别进行统计分析。结果：骨质疏松在中老年女性中普遍存在，发病率很高，达51．2％。骨代谢指标按年龄分析，中老年女性骨钙素和尿吡啶啉／肌酐在50～69岁时明显升高。70岁以后又趋于下降。而血清碱性磷酸酶各年龄段无显著性差异。按骨密度分析，中老年女性骨质疏松组和骨量减低组的骨钙素和尿吡啶啉／肌酐均明显高于正常组。而骨质疏松组和骨量减低组的骨钙素和尿吡啶啉／肌酐值无显著性差异。各骨密度组的血清碱性磷酸酶无显著性差异。结论：骨质疏松症是1种危害极大的疾病，在中老年女性中患病率很高，因此早期诊断尤为重要。血清骨钙素、尿吡啶啉／肌酐分别是反映骨形成和骨吸收特异性和敏感性较高的指标，有助于原发性骨质疏松症的早期诊断。

Objective： To discuss the characters of the bone mineral density （ BMD ） and bone metabolic markers of middle - aged and old women along with the change of age and the value in early diagnosis of Osteoporosis with bone metabolic markers. Methods： To test the bone mineral density （BMD） of anterior - posterior lumbar spines and fasting serum bone gla protein （ BGP）, serum alkaline phospha- tase （ALP） and urinary pyridinoline （PYD） of 162 women. Then to statistic biochemical criterion value in each age stage and different BMD groups respectively. Results： The osteoporosis was common in middle - age and old women and the morbidity rate was high （51.2% ）. Middle - aged and old senile women＇s BGP and PYD/Cr significantly risked from 50 years old to 69 years old, and they shown the lowering trend after 70 years old. But serum ALP was in the normal range, there was no obvious difference in each age stage. BGP and PYD/Cr of middle - aged and old senile women in osteoporosis group and less bone mass group were significantly higher than that of normal group without obvious difference for BGP and PYD/Cr of osteoporosis group and less bone mass group. There were no significant differences with serum ALP in each group. Conclusion： Osteoporosis is a tremendously harmful disease with high morbidity rate for middle - aged and old women, thus the early diagnosis is particularly important. The serum BGP and PYD/Cr is the higher marker with singularity and sensitivity for giving expression to bone formation and bone resorption, prior to the change of BMD. Therefore, to test serum BGP and PYD/Cr contributes to the early diagnosis of primary osteoporosis.