中国老年学学会骨质疏松委员会骨代谢生化指标临床应用专家共识

Expert consensus of clinical application of the bone metabolic and biochemical markers,by Osteoporosis Committee of Chinese Gerontological Society

骨代谢生化指标包括:钙磷代谢调节指标、骨吸收标志物、骨形成标志物。骨代谢生化指标分别来源于骨、软骨、软组织、皮肤、肝、肾、小肠、血液及内分泌腺体等,是由成骨细胞或破骨细胞分泌的酶和激素,以及骨基质的胶原蛋白代谢产物或非胶原蛋白。骨代谢生化指标可及时反映骨转换状态,灵敏度高、特异性强,用于骨质疏松诊断分型、预测骨折风险、抗骨质疏松治疗疗效评价,以及代谢性骨病的鉴别诊断。并且在骨质疏松发病机制、骨质疏松药物的研究及流行病学研究方面具有重要临床意义。随着骨代谢生化指标检测技术逐渐成熟,临床应用日趋广泛,但不同来源的标本、不同方法、不同设备、不同试剂、人的不同年龄段、不同种族和不同性别等,检测结果存在差异。至今,骨代谢生化指标测定国内外尚无统一检测标准;为此,将骨代谢生化指标的生物学作用及临床意义、技术应用与质量控制,分别整理、凝炼成一篇为各位同仁可读、可用、可参考的文字材料。期待通过"共识"为推动临床骨代谢生化指标检测技术的提高,规范检测流程,建立科学的参考范围,使骨代谢生化指标在骨质疏松规范诊断、规范治疗、抗骨质疏松药物疗效评价及科研工作中发挥重要作用。

The bone metabolic and biochemical markers include calcium and phosphorus metabolic indicators, bone resorption markers, and bone formation markers.The bone metabolic and biochemical markers are derived from the bone, cartilage, soft tissue, skin, liver, kidney, small intestine, blood, endocrine glands, etc. They are enzymes and hormones secreted by osteoblasts or osteoclasts, and the metabolic products of collagen or non-collagen proteins from bone matrix.The bone metabolic and biochemical markers reflect the status of bone turnover promptly, with high sensitivity and specificity.They have been used in osteoporosis diagnosis, prediction of fracture risk, curative effect observation of drug treatment, and the differential diagnosis of metabolic bone disease.They have important application value in the research of the pathogenesis of osteoporosis, drugs for treatment of osteoporosis, and the epidemiological study.The clinical use of the bone metabolic and biochemical markers is getting popular due to the mature of the detection technology.However, the test results vary because of different source of the specimen, different methods, different equipment, different reagents, different ages, different races, and different gender.So far, there is no unified detection standard of bone metabolic and biochemical markers in the world.Therefore, we collect and summarize the biological role and clinical significance of bone metabolic and biochemical markers, application technology, and quality control in this paper, in order to provide a readable, applicable, and well referred material to colleagues.We look forward to promoting the detection technology for bone metabolic and biochemical markers in clinic, standardizing detection process, and establishing scientific reference range through the consensus, so that the bone metabolic and biochemical markers can play an important role in the standardization of osteoporosis diagnosis and treatment, anti-osteoporosis drug efficacy evaluation, and scientific research.