同型半胱氨酸水平与骨密度及骨转化标志物的相关性分析

Association of homocysteine levels with bone mineral density and bone turnover markers

目的分析不同水平的血浆同型半胱氨酸(Hcy)与骨密度及骨转化标志物的相关性,进一步探讨Hcy在骨质疏松发生中的作用及其潜在临床价值。方法收集2013年3月至2014年5月临汾市人民医院体检中心体检者中120例,根据骨密度分组:骨质疏松组40例,骨量减少组40例,正常骨量组40例;并以血浆Hcy检测结果分组:高Hcy组66例,正常Hcy组54例。观察患者的血脂、体质指数(BMI)、丙氨酸氨基转移酶(ALT)等相关临床指标,并分析Hcy与骨密度(脊柱及髋部平均值)及骨转化标志物I型前胶原N末端前肽(PINP)、抗酒石酸酸性磷酸酶(TRAP)的关系。结果 (1)骨质疏松组Hcy明显高于骨量正常组(P<0.05),骨量减少组Hcy与骨量正常组比较差异无统计学意义(P>0.05)。(2)高Hcy组PINP值低于正常Hcy组(P<0.01)。(3)高Hcy组TRAP值高于正常Hcy组(P<0.01)。血浆Hcy水平与骨密度值呈负相关(r=-0.404,P<0.01),与PINP呈负相关(r=-0.404,P<0.01),与TRAP呈正相关(r=0.908,P<0.01)。结论血浆Hcy水平与骨密度及骨转化标志物均存在明显相关性。

Objective To analyze the correlations of plasma homocysteine （Hcy） with bone mineral density （ BMD ） and bone turnover markers to further explore the role of homocysteine in pathogenesis of osteoporosis and its potential clinical value. Methods A total of 120 subjects, examinated in the medical center of Linfen People＇s Hospital between March 2013 and May 2014 ,were enrolled in this study. According to BMD value, the patients were divided into three groups （n = 40 each） ：osteoporosis group, osteopenia group and normal bone mass group. According to Hcy value, the patients were di- vided into high-Hcy group （ n = 66） and normal-Hcy group （ n = 54）. The related clinical data including blood lipid pro- file, body mass index （BMI） and alanine aminotransferase （ALT）were observed, and the associations of Hcy with BMD （the average value of spine and hipes） and bone turnover markers including procollagen I N-terminal peptide （PINP） and tartrate resistant acid phosphatase （TRAP） were analyzed. Results Hcy level in osteoporosis group increased significantly compared with normal bone mass group （ P 〈 0.05 ）, while there was no significant difference in Hcy levels between osteope- nia group and normal bone mass group（P 〉0.05）. The PINP value decreased significantly and the TRAP value increased significantly in high-Hcy group compared with normal-Hcy group（ all P 〈 0.01 ）. Plasma Hcy level was negatively correlated with BMD and PINP （ all r = - 0.404, all P 〈 0.01 ） and was positively correlated with TRAP（ r = 0. 908, P 〈 0.01 ）. Con- clusion Hcy level is correlated with BMD and bone turnover markers.