绝经后骨质疏松症相关骨代谢指标、细胞因子IGF-1的临床观察

The clinical observation of bone metabolic index and cytokine IGF-1 in postmenopausal osteoporosis patients

目的检测绝经后骨质疏松症(PMOP)患者体内的骨代谢指标、细胞因子的水平变化。为临床早期防治骨质疏松提供有力依据。方法选取长春地区45-69岁绝经后女性108例,按照WHO标准将入选女性分为骨密度正常者组46例,骨密度减低者组30例,骨质疏松组32例,双能X线吸收法DEXA测定2-4腰椎BMD;测定108例受试者血清雌二醇(E2)、胰岛素样生长因子-1(IGF-1)、骨碱性磷酸酶(BAP)及血清骨保护素(OPG)、核因子-k受体活化因子配体(RANKL)的水平,并进行相关性分析。结果 PMOP组、骨量减低组和正常对照组之间E2、OPG、RANKL、BAP、IGF-1差异均有统计学意义(P<0.05、P<0.01)。PMOP组BAP水平明显高于骨量减低组及正常对照组(P<0.01),E2水平明显低于骨量减低组(P<0.01)及正常对照组(P<0.05)。骨量减低组与正常对照组之间BAP和E2水平差异无统计学意义(P>0.05)。通过综合分析,E2与IGF-1呈显著正相关(r=0.562,P<0.01),与BAP呈负相关[r值分别为-0.15(P=0.034);RANKL与BAP呈正相关(r=0.224、P=0.036)。结论 E2、IGF-1、OPG、BAP、RANKL在PMOP临床诊治中有帮助,可作为其辅助指标。

Objective To examine levels of bone metabolic index and cytokine IGF-1 in postmenopausal women,and provide the reference for clinical early prevention of osteoporosis.Methods The levels of serum osteoprotegerin （OPG）,nuclear factor-k beta receptor activator ligand （RANKL）,bone alkaline phosphatase （BAP）,estradiol （E2）, cytokine IGF-1 were determined in 32 patients with PMOP,30patients with bone mass reducing and 46 subjects with normal bone mass（control group）.Partial correlation analysis was used for some of the indicators excluding age and E2,and the correlation was analyzed.Results A statistical significance in E2,OPG,RANKL,BAP and IGF- 1 levels was observed in patient groups and control group（P 〈0.05,P 〈0.01）.BAP levels of PMOP group were higher than those of bone mass reducing and control groups（P 〈0.01）.However,E2 levels were lower than those of bone mass reducing group（P 〈0.01）and control group（P 〈0.05）.There was no significant difference in E2 and BAP levels be-tween bone mass reducing group and control group（P 〉0.05）.IGF-1 with E2 showed a significant positive correlation （r=0.562 and ,P 〈0.01）,and IGF-1 was negatively correlated significantly with BAP（r=-0.15 and ,P =0.034）, there was a positive correlation between RANKL and BAP （r=0.224,P =0.036）.Conclusion The levels of BAP,E2 and IGF-1 may be indices of clinical diagnosis and treatment of PMOP.