老年男性骨代谢生化指标和骨密度的关系

Relationship between bone metabolic biochemical markers and bone mineral density in elderly male individuals

目的评估老年男性骨代谢生化指标和骨质疏松的关系。方法 97例老年男性,双能X线测量骨密度,根据测定的T score值将入组患者分为正常对照组(n=32)、骨量减少组(n=30)和骨质疏松组(n=35),同时测定血抗酒石酸酸性磷酶(TRACP5b)、骨源性碱性磷酸酶(BALP)、25-羟维生素D等水平。结果骨量减低组TRACP5b明显高于正常组[(4.2±0.6)vs(3.3±1.3)U/L,P<0.01],而骨质疏松组TRACP5b[(5.6±1.7)U/L]明显高于骨量减低组(P<0.01)骨质疏松组BALP显著高于骨量减少组[(8±5)vs(7±4)μg/L,P<0.05],但正常对照组[(7±8)μg/L]和骨量减低组之间BALP差异没有统计学意义(P>0.05)。25-羟维生素D在正常组、骨量减低组、骨质疏松组3组间无明显差异[(94±72),(119±146),(114±76)nmol/L,P>0.05]结论TRACP5b是反映老年人骨吸收较敏感的指标,有助于原发性骨质疏松的早期诊断。

Objective To evaluate the relationship between bone metabolic biochemical markers and bone mineral density （BMD） in elderly male individuals. Methods BMD of L2_4 and proximal femur was detected by dual-energy X-ray absorptiometry （DEXA） in 97 elderly male individuals, who were divided into healthy control group（n = 32）, osteopenia group（n = 30） and osteoporosis group（n = 35） according to the value of T score. Serum tartrate-resistant acid phosphatase 5b （TRACP5b）, bone-specific alkaline phosphatase （BALP） and 25-hydroxy vitamin D were measured in the subjects. Results The serum TRACP5b level was higher in osteoporosis group [（5.6 ± 1.7）U/L] than in osteopenia group [（4.2 ± 0.6）U/L, P 〈 0.01], and also higher in osteopenia group than in control group [（3.3 ± 1.3）U/L, P 〈 0.01]. The activity of serum BALP was higher in osteoporosis group than in osteopenia group [（8 ± 5） vs （7 =e 4） μg/L, P 〈 0.05], and was not siginificantly different between osteopenia group and control group [（7 ±8） μg/L, P 〉 0.05]. The serum 25-hydroxy vitamin D level was not significantly different among the three groups [（94 ± 72）, （119 ±146）, and （114 ±76） nmol/L, P 〉 0.05]. Conclusion TRACP5b is a sensitive parameter for the evaluation of osteoporosis in the eldrly males, and is helpful for the early diagnosis of primary osteoporosis.