129例老年男性骨密度及血清25-OHD、PⅠNP、β-Crosslaps水平分析

ANALYSIS OF BONE MINERAL DENSITY AND SERUM 25-HYDROXY VITAMIN D,PROCOLLAGENⅠN-TERMINAL PEPTIDE,β-CROSSLAPS IN 129 ELDERLY MEN

目的 调查老年男性骨密度及25-羟维生素D（25-OHD）,Ⅰ型前胶原氨基端肽（PⅠNP）,β胶原降解产物（β-Crosslaps）水平,为老年男性骨质疏松的诊治提供依据。方法 记录129名60~90岁受试者的年龄、身高、体质量、BMI,测量其腰椎1-4、左侧股骨颈、Wards三角、大粗隆、左侧股骨上端的骨密度（BMD）,检测空腹血清25-OHD、PⅠNP,β-Crosslaps水平。根据骨密度水平将受试者分为骨量正常组（n=22）、骨量低下组（n=73）和骨质疏松组（n=34）。结果 骨量低下组及骨质疏松组的BMD均明显低于正常骨量组,骨质疏松组又明显低于骨量低下组（P〈0.05）。骨量低下组及骨质疏松组PⅠNP、β-Crosslaps均明显高于正常骨量组,骨质疏松组β-Crosslaps又明显高于骨量低下组（P〈0.05）。25-OHD水平在骨质疏松组有降低趋势,但差异无统计学意义（P〉0.05）。结论大部分老年男性存在骨量丢失及维生素D不足,其主要原因为高骨转换状态。

Objective To investigate the level of bone mineral density （BMD） and relevent index of bone metabolism , in order to provide the basis for clinical diagnosis and treatment of osteoporosis in elderly men. Methods The age,height,weight and body mass index （BMI） were recorded, and the level of serum 25OHD, procollagen I N- terminal peptide （ PINP）, and degradation metabolite of β collagen（β-crosslaps） in 129 subjects （aged 60-90） were measured . Their BMD of lumbar spine 1-4 （ L1-4 ） ,femoral neck （FN） ,trochanter,Ward＇s triangle and left upper femur were measured by dual-energy X-ray absorptiometry （DEXA）. The subjects were classified into 3 groups according to their BMD levels ： nonosteoporosis （ n = 22 ）, osteopenia （ n = 73 ）, and osteoporosis （ n = 34 ）. Results There was a signifcant decrease in BMD levels in ostepoenia and osteoporosis group compared with that in the nonosteoporosis group. Moreover, BMD level in osteoporosis group was significantly lower than that in osteope- nia group . P I NP and β-Crosslaps levels in osteoporosis and osteopenia group were significantly higher than that in nonosteoporosis group , and β-Crosslaps level in osteoporosis group was significantly higher than that in osteopenia group（P〈O. 05）. There was a declined tendency about the serum 25-OHD level in osteoporsis group（P〉O. 05 ）. Conclusion There was bone mass loss and vitamin D insuffiency in most of these elderly men, which may be related to the higher bone turnover state.