十堰地区健康人群骨代谢标志物参考范围的建立

Establishment of reference interval of normal people's bone metabolism marker in Shiyan City

目的建立十堰地区健康人群骨代谢相关标志物β-胶原特殊序列(β-crossLaps)、总Ⅰ型前胶原氨基端延长肽(total procollagen type1 amino-terminal propeptide,tP1NP)和人N端中段骨钙素(N-MID Osteocalcin,N-MID-OT)参考区间。方法选择2010年3月至2010年10月来我院体检的年龄范围在30～79岁的健康体检人员215名,按性别、年龄进行分组,所有人员均经骨密度仪测量,按诊断标准排除骨质疏松症等相关疾病。采集清晨空腹血清,使用罗氏电化学全自动免疫分析仪检测tP1NP、β-crossLaps、N-MID-OT水平。结果 tP1NP有随年龄增高而浓度递增的变化趋势,特别是女性在50～59岁组明显增高,与30～39及40～49岁组比较,P<0.01。从年龄因素上分析,这可能与女性的绝经期有关。而β-crossLaps在男、女血清中的含量也是随年龄增大而逐渐升高,只是与最低年龄组比较,男性血清浓度的升高趋于平缓,而女性在50～59岁组开始增幅明显,P<0.05;N-MID-OT在男女组中有明显随年龄增长而逐渐下降的变化规律,这与性激素的减少有着直接的影响。因此我们按性别将年龄进行分组,设立了相应的参考区间。结论本实验室建立的3项血清骨转换标志物的参考区间与试剂厂家提供的有差异,建议各实验室建立各自的参考区间。

Objective To found the reference interval of normal people’ bone metabolism marker in Shiyan：special β-collagtaxy（β-crossLaps）,total procollagen type 1 amino-terminal propeptide（tP1NP）,N-MID Osteocalcin.Methods 215 normal healthy subjects in the age of 30-79 years old were included,who came for general checkup in our hospital from March to October,2010.They were randomly grouped by sex and age.All of them underwent bone density test and those with osteoporosis were excluded according to the diagnostic code.Fasting serum was collected in the morning analysed for tP1NP,β-crossLaps,N-MID by Luo’s electrochemistry auto-immune analysor.Results The concentration of tP1NP has progressive tendency with the age advancing,expecially in female’s group in the age between 50 and 59,compared with the group between 30-39 and 40-49 of age（P〈0.01）.From the age factor,it maybe concerned with the female’s critique age.The β-crossLaps’ concentration gradually went up with the age advancing in their serum.But compared with the lowest age group,males’serum concentration increased gently,but females in age group between 50-59 increased obviously（P〈0.05）;The N-MID osteocalcin regularly declined with the advancing age in gender group.So we set up corresponding reference interval according to defference age groups by gender.Conclusions The three bone metabolism markers of reference interval vary with the different agents produced by different companies,we suggest every laboratory should set up respective reference interval of their own.