青春期骨矿物含量与血清骨钙素及碱性磷酸酶的关系

Relationship between Bone Mineral Content and Serum Bone-Gla-Protein and Alkaline Phosphatase Levels in Puberty

目的 了解青少年骨矿物含量 (BMC)增长的特点及与性发育、体格发育的相关性。方法 选取 9～ 2 0岁健康青少年 ,采用单光子骨密度仪检测桡骨BMC ,放射免疫法测定血清骨钙素 (骨谷氨酸蛋白 )、雌二醇及睾酮水平 ,总碱性磷酸酶水平测定采用生化法 ,常规测定体格发育指标并评价性发育程度。结果 男、女性身高和体重增加最快的年龄分别为 1 1 .5～ 1 3 .7岁和 9.7～ 1 1 .3岁。BMC增长最快的年龄男性为 1 3 .7～ 1 6 .2岁 ,女性为1 1 .3～ 1 3 .7岁。骨量增长与性发育水平关系密切 ,不同性发育阶段BMC差异有显著性 (P <0 .0 1 )。血清骨钙素水平和总碱性磷酸酶随年龄增长的变化趋势一致 (r =0 .59,0 .63 ,P <0 .0 1 ) ,其高峰出现时间与身高增长速度高峰时间基本一致。结论 男、女性骨量在青春期出现明显的增长 ,与性发育关系密切。

Objective To study the characteristics of bone mineral content (BMC) accretion and the correlation with sex maturity and physical development in adolescents. Methods In 161 healthy children aged 9～20 years, the BMC and total alkaline phosphatase (TALP) level were measured using the single photon absorptiometer (SPA) and biochemical methods respectively; the serum levels of bone gla protein (BGP), estrogen and testosterone were determined using RIA; the height and weight were measured routinely and the sex maturity rating was assessed using the Tanner's criteria. Results The periods of peak height and weight velocity in boys and girls were 11.5 ～ 13.7 and 9.7 ～ 11.3 years respectively. The peak BMC accrual occurred in 13.7 ～ 16.2 and 11.3 ～ 13.7 years in boys and girls respectively. BMC accretion in females was earlier compared with males and revealed a significant decline after 16 years of age. The accretion of BMC was highly correlated with the sex maturity rating and there were significant differences in BMC between different pubertal stages (P< 0.01 ). The positive correlations between serum BGP and TALP levels and age were noted (r= 0.59 and r= 0.63 , respectively, both P< 0.01 ). The periods of peak serum BGP and ALP levels and peak height velocity (PHV) were coincident. Conclusions There is a close correlation between BMC accretion and sex maturity. There is an asynchrony between BMC accrual and physical development in puberty.