血清基质金属蛋白酶-13对绝经后骨质疏松骨密度和骨代谢的影响

Associations of Circulating Matrix Metalloproteinase-13 and Tissue Inhibitor of Matrix Metalloproteinase-1 Levels with Bone Mineral Density and Bone Metabolic Biomarker

目的:测定绝经后妇女血清基质金属蛋白酶-13(MMP-13)和抑制因子(TIMP-1)水平,并探讨其与骨密度数值和骨代谢指标的关系。方法:选取武汉地区120名48岁至65岁绝经后女性,用酶联免疫吸附试验(ELISA)测定血清MMP-13、TIMP-1以及雌二醇(E2)、骨保护蛋白(OPG)、骨保护蛋白配体(OPGL),Ⅰ型原胶原N端前肽(PINP)和Ⅰ型胶原交联C末端肽(CTX)的水平,计算TIMP-1/MMP-13比值,用双能X线吸收法(DEXA)测定腰椎正位,股骨颈,华氏区和大粗隆的骨密度(BMD)。同时,按照WHO标准将入选女性分为骨密度正常组、低骨量组和骨质疏松组。结果:①骨质疏松组中血清MMP-13的数值(44.25±1.21)μg/L高于正常组(27.08±1.41)μg/L(P<0.05),而TIMP-1的数值(134±116)μg/L低于正常组(146±130)μg/L。②骨质疏松组中血清MMP-13与骨密度、血清E2、OPGL数值存在明显负相关性(P<0.05),和OPG、PINP和CTX存在明显正相关性(P<0.05)。③低骨量组中MMP-13略高于骨质疏松组中数值,并且两者比较差异无统计学意义(P>0.05),但是明显高于正常组(P<0.05),同时与骨密度和E2、OPG、OPGL、PINP和CTX存在明显相关性(P<0.05)。结论:血清MMP-13和MMP-13/TIMP-1比值与绝经后骨质疏松症妇女和绝经后低骨量组妇女骨代谢指标具有关联性。血清MMP-13水平升高和MMP-13/TIMP-1比值升高可能为绝经后骨质疏松症和绝经后妇女早期骨代谢转换过程增快的表现。

Objective：To study the serum matrix metalloproteinase-13 （MMP-13） and tissue inhibitor of matrix metallopro-teinase-1 （TIMP-1） and detect the correlations of MMP-13 and TIMP-1 with bone metabolic markers and bone mineral den-sity （BMD） in aged postmenopausal Chinese women. Methods：The serum MMP-13, TIMP-1, E2, PINP, CTX, OPG and OPGL of 120 postmenopausal Chinese female volunteers were measured using ELISA methods. And the ratios of MMP-13 to TIMP-1 were calculated. BMD were measured using dual energy X-ray absorptiometry. Results： The serum levels of MMP-13 in osteoporosis patients were significantly higher than age-matched normal controls （44.25±1.21 μg/L VS 27.08 ± 1.41 μg/L, P〈0.05）. But the serum levels of TIMP-1 were lower than normal controls （134±116μg/L VS 146±130 μg/L, P〈0. 05）. In osteoporosis group, there were notable negative correlations between MMP-13 and BMD, OPGL, and E2 （P〉0.05）; and positive relations between MMP-13 and OPG, PINP, and CTX （P〈0.05）. In osteopenia group, the level of MMP-13 was as high as osteoporosis group, but was significantly higher than normal group （P〈0.05）. And the level of MMP-13 were significantly relative with BMD and metabolic biomarker （P〈0.05）. Conclusion：The serum MMP-13 and ratios of MMP-13/TIMP-1 are significantly correlated with bone metabolism marker. The increased of serum MMP-13 and the decreased of MMP-13/TIMP-1 ratio may predict as the concomitant state of high bone turnover, such as postm-enopausal osteoporosis and early stage of osteopenia.