绝经后妇女血清骨保护蛋白和基质金属蛋白酶-2水平与骨密度和骨代谢指标的关系

Relationships of Serum Osteoprotegerin and Matrix Metalloproteinase-2 Levels with Bone Metabolic Markers and Bone Mineral Density in Postmenopausal Women

目的：研究显示血清骨保护蛋白（OPG）和基质金属蛋白酶-2（MMP-2）在骨代谢中降解骨基质方面起到作用。本研究主要比较武汉地区的绝经后妇女的以上2项指标与骨密度和3个代谢指标的关系。方法：用酶联免疫吸附试验（ELISA）测定78名48～65岁绝经后妇女的血清OPG、MMP-2、血清骨碱性磷酸酶（BAP）和血清骨钙素（OC），用双能X线吸收法（DEXA）测定腰椎，股骨颈，Wards三角，大粗隆的骨密度。结果：（1）绝经后骨质疏松患者血清OPG和MMP-2水平均高于年龄匹配的正常对照组。（2）绝经后妇女血清OPG和MMP-2均与骨密度呈负相关。在校正年龄和体质指数后，血清MMP-2与股骨颈相关性消失。（3）血清OPG和MMP-2与骨钙素含量呈负相关。结论：绝经后骨质疏松妇女血清OPG、MMP-2与高骨转换代谢相关联，血清OPG与MMP-2水平升高可能为高骨代谢转换过程（如绝经后骨质疏松症）中的一种伴随表现。因此血清骨保护蛋白和基质金属蛋白酶-2可以作为绝经后骨质疏松妇女临床骨代谢的检测指标。

Objective：The serum osteoprotegerin （OPG） and the serum matrix metalloproteinase-2 （MMP-2） have been shown to play roles in bone metabolism by degrading the bone matrix. Present study was performed to compare above two with bone mineral density and three markers in postmenopausal women in Wuhan. Methods：The serum osteoprotegerin, matrix metalloproteinase-2, serum bone alkaline phosphates （BAP） and serum osteocalcin（OC） of 78 Chinese postmenopausal women aged 48～65 were measured by ELISA, Bone mineral density by dual energy X-ray absorptiometry. Results： （1） Serum osteoprotegerin and matrix metalloproteinase-2 concentrations were significantly higher in postmenopausal women with osteoporosis [all （127.6±6.25）ng/L; （1388±121）ttg/L] than those in age-matched normal controls [all （72.31±2.35） ng/L; （1126±141）μg/L （P〈0.01） ]. （2） Negative relationships were found between serum osteoprotegerin, matrix metalloproteinase-2 levels and bone mineral density in osteoporotic woman. Adjusted by the age and body mass index （BMI）, the correlation of matrix metalloproteinase-2 with bone mineral density of neck of femur disappeared. （3） Negative correlations in osteoporotic woman between osteoprotegerin, matrix metalloproteinase-2 levels and serum osteocalcin were found （all r = -0.216 ; r = - 0. 269, P 〈0.05） ; positive correlations between osteoprotegerin and serum bone alkaline phosphates were found （all r=0. 235 ; P 〈0.05）. Conclusions：There are significant correlations between serum osteoprotegerin, matrix metalloproteinase-2 levels and bone metabolism in high bone turnover of postmenopausal osteoporotic women respectively. The increases of serum osteoprotegerin and matrix metalloproteinase-2 appeared possibly as a concomitant event in high bone turnover state, such as postmenopausal osteoporosis. Therefore the serum osteoprotegerin and matrix metalloproteinase -2 could be the indicators to the bone metabolism in clinic of postmenopausal osteoporotic women.