胰岛素样生长因子与血液透析患者骨质疏松症关系的研究

Study on Relationship between Insulin-like Growth Factor-1 and Osteoporosis in Hemodialysis Patients

目的:探讨血胰岛素样生长因子-1(IGF-1)与血液透析患者骨密度的关系及其在骨质疏松症诊断中的作用。方法:45例骨量异常(骨量减少或骨质疏松)血液透析患者分别检测透析前血IGF-1、Ⅰ型前胶原氨基端前肽(PINP)、Ⅰ型胶原C末端肽(CTX)等生化指标,统计所有患者的骨密度值。15例骨量正常血液透析患者作为对照组。结果:透析患者骨量异常组血IGF-1水平显著低于骨量正常对照组(P<0.001),而且早在骨量减少阶段就已显示出差异性(P<0.05),血PINP、CTX显著高于骨量正常对照组(P<0.001)。血清IGF-1水平与患者髋部的骨密度正相关(P<0.001),与PINP、CTX负相关(P<0.001),但与腰椎骨密度值无相关性。结论:IGF-1做为新型骨代谢生化标志物,其水平在血液透析患者中与骨密度变化相平行,对透析患者骨量变化的监测和骨质疏松症的早期诊断具有重要的临床价值。

Objective：To investigate the relationship between insulin-like growth factor-1 （IGF-1）and the bone mineral density of hemodialysis patients,and to investigate the value of IGF-1 in early diagnosis of osteoporosis.Methods：Forty-five abnormal bone mass cases （osteopenia or osteoporosis） were measured serological IGF-1 Procollagen type Ⅰ N-terminal propeptide（PINP）and C-terminal telopeptide of type Ⅰ collagen（CTX） before dialysis respectively,and the bone mineral density of those were also statistically processed.Fifteen normal bone mass cases were set as the control group.Results：The levels of IGF-1 in the abnormal bone mass group were significantly decreased than those in control group since early in osteopenia stage.The levels of serological PINP and CTX were significantly increased.There were positive correlations between IGF-1 and bone mineral density of hip,negative correlations between IGF-1 and PINP CTX respectively,but no correlations between IGF-1 and bone mineral density of lumbar.Conclusion：As new biochemical markers of bone metabolism,the levels of serological IGF-1 in hemodialysis patients were parallel to bone mineral density.There were important clinical value about serological IGF-1 in monitoring the bone mass variation of hemodialysis patients and early diagnosis of osteoporosis.