血清中Sclerostin、RANKL及OPG在老年股骨转子间骨折早期的含量改变及其临床意义

Changes of serum sclerostin,RANKL,and OPG at the early stage of femoral intertrochanteric fractures in senile patients and their clinical significance

目的观察正常成年男女、老年男女及低外力作用下发生髋部骨折的老年男女血清中sclerostin、RANKL及OPG的含量变化并分析其临床意义。方法收集正常成年男女、老年男女及在2010年10月至2011年10月我院收治的低外力作用下发生股骨转子间骨折的老年患者血清样本。采用酶联免疫吸附实验(ELISA)检测各血清样本中sclerostin、RANKL及OPG的水平。数据均以均数±标准差表示。采用SPSS13.0对数据进行统计分析。结果正常成年组(A组):sclerostin 76.6±10.5 pmol/l、RANKL 0.58±0.18 ng/ml、OPG 17.3±4.6 pmol/l;正常老年组(B组):sclerostin 102.0±12.3 pmol/l、RANKL 0.25±0.12 ng/ml、OPG 12.1±3.5 pmol/l;老年骨折组(C组):sclerostin 90.8±11.0 pmol/l、RANKL 0.23±0.13 ng/ml、OPG 11.7±3.5 pmol/l。结论由以上结果经统计分析后得出,sclerostin,RANKL及OPG在不同年龄层次其表达水平具有明显差异,与年龄有相关性。在老年骨折的早期阶段(骨折后3天内)血清中sclerostin的含量已出现显著变化。而RANKL及OPG的含量在骨折早期阶段并无明显改变。由此我们认为,骨折早期血清sclerostin的水平下降在促进骨折愈合的过程中可能起到一定作用,通过人为干涉抑制sclerostin的水平对预防老年髋部骨折可能存在一定的价值。

Objective To observe the changes of serum sclerostin, RANKL, and OPG in normal adults, normal senile people, and senile people who had hip fractures with a low external force, and their clinical significance. Methods Serum specimen of normal adults, normal senile patients, and senile people who had femoral intertrochanteric fractures with a low external force from October 2010 to October 2011, were collected. Serum sclerostin, RANKL, and OPG were measured using enzyme-linked immunosorbent assay （ELISA）. Results were expressed as mean ± SE. Statistical analysis was conducted using a SPSS17.0 software. Results Normal adult group （group A） ： sclerostin （76.6 ± 10.5 pmol/1） , RANKL （0.58±0. 18 ng/ml） , OPG （17. 3 ±4. 6 pmol/1） ; Normal senile group （group B）： sclerostin （102.0 ±12.3 pmol/1）, RANKL （0.25 ±0. 12 ng/ml）, OPG （12. 1 ±3.5 pmol/1） ; Senile fracture group （group C） ： sclerostin （90. 8 ±11.0 pmol/1）, RANKL （0.23 ±0.13 ng/ml）, OPG （11.7 ±3.5 pmol/1）. Conclusion According to statistical analysis of above results, expression of sclerostin, RANKL, and OPG is distinctly different at different stage of age, and it is correlated with age. The serum expression of sclerostin has already apparently changed at the early stage of the senile fractures （within 3 days after fractures ）. No significant changes areobserved in the expression of OPG and RANKL at the early stage of the fracture. Thus, we believe that the decline of serum sclerostin level at the early stage of the fracture may play a key role in the healing process. It may be of great value to prevent senile hip fractures by intervening of serum sclerostin.