胶东半岛老年性骨质疏松症骨代谢生化指标与骨密度相关性研究

The correlation between biochemical markers of bone metabolism and bone mineral density in senile osteoporosis patients in Jiaodong Peninsula of Shandong

目的研究胶东半岛老年性骨质疏松症(OP)患者骨代谢生化指标与骨密度(BMD)的相关关系,探讨骨代谢生化指标对早期诊断OP的临床意义。方法采用双能X线骨密度仪(DEXA)对胶东半岛沿海地区多中心多阶段整群抽样297名40～89岁居民进行腰椎(L2-4)BMD测量。采用酶联免疫法(ELISA)分别测定血抗酒石酸酸性磷酸酶(TRAP-5b)、I型胶原C端肽(CTX)、骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)、降钙素(CT)、25-羟基维生素D[25(OH)D]以及血钙(Ca)和磷(P)并进行比较,应用SPSS 13.0软件进行统计分析。结果 OP患者各部位BMD明显低于正常组(均P<0.01)。老年男性BMD与骨形成和骨吸收指标呈现降低趋势。其中,OP组较对照组BGP、TRAP-5b和25(OH)D明显下降(P<0.05),而血CTX和BALP较对照组升高。老年女性血TRAP-5b、CTX、BALP和BGP在OP组显著升高(均P<0.01),而CT和25(OH)D明显降低。各组研究对象骨代谢生化标志物均有统计学意义。结论骨代谢生物指标作为OP的监测指标,比BMD更加灵敏、特异。能够早期反映患者骨代谢水平,对指导OP的早期预防及治疗有重要意义。

Objective To investigate the correlation between biochemical markers of bone metabolism and bone mineral density（BMD） in senile osteoporosis patients in Jiaodong Peninsula of Shandong and to explore the clinical value of biochemical markers of bone metabolism on the early diagnosis of primary osteoporosis. Methods BMD of the lumbar vertebrae 2-4 of 297 40-89 years old subjects in Jiaodong peninsula, sampled using the multi-center and multi-stage sampling method, was measured using dual energy X-ray absorptiometry （DEXA）. Serum TRAP-5b, CTX, BALP, BGP, CT, 25（OH） D, Ca, and P were detected using ELISA. SPSS 13.0 was used to analyze the data statistically. Results BMD of osteoporosis patients was significantly lower than that of the control patients. BMD and indexes of bone formation and absorption in senile males showed a decreasing trend. BGP, TRAP, and 25 （OH） D in senile males in osteoporosis group were significantly lower than those in non-osteoporosis ones （P 〈 0. 05 ）. Serum CTX and BALP of senile males in the osteoporosis group were significantly higher than those in the non-osteoporosis group. Serum TRAP-Sb, CTX, BALP, and BGP in females in osteoporosis group were significantly higher than those of the controls （P 〈0.01）. Serum CT and 25 （OH） D were significantly lower than those of the controls. The differences of all biochemical markers of bone metabolism were statistically significant. Conclusion The serum biochemical indexes of bone metabolism can be used as the monitor index of OP. The application of these indexes is more sensitive and specific than BMD. It can reflect the bone metabolism in the early stage, and has great significance in the prevention and treatment osteoporosis.