血清基质Gla蛋白与绝经后骨质疏松症的相关性

Relationship between serum matrix Gla protein and postmenopausal osteoporosis

目的探讨绝经后骨质疏松患者血清基质Gla蛋白(matrix Gla protein,MGP)与腰椎骨密度(bone mineral density,BMD)、骨代谢生化指标的相关性。方法 120例绝经后骨质疏松患者和60名健康的绝经后妇女,通过荧光适时定量聚合酶链反应检测血清MGP mRNA水平,化学发光检测血清Ⅰ型胶原羧基端肽(β-crosslinking telopeptide,β-CTX)、血清Ⅰ型前胶原N-端前肽(N-terminal propeptide of typeⅠcollagen,P1NP)、雌二醇(estradiol,E2)、甲状旁腺素(parathyroid hormone,PTH),双能X线法测定骨密度(bone mineral density,BMD)等。用独立样本t检验进行组间比较,用Spearman相关性分析法分析血清MGP mRNA与各变量的相关性。结果试验组的BMD、MGP mRNA水平[(0.780±0.075)g/m2和0.835±0.415]低于对照组[(0.976±0.071)g/m2他4.524±0.769],β-CTX、P1NP水平[(0.427±0067)和(48.50±4.43)mg/L]高于对照组[(.383±0.048)和(41.80±4.97)mg/L],差异均有统计学意义(P均=0.000)。绝经后骨质疏松患者血清MGP mRNA与BMD呈显著正相关(r=0.376,P=0.000),亦与E2(r=0.227,P=0.013)呈正相关,而与年龄、体质量指数(body mass index,BMI)、PTH、血钙(calcium,Ca)、磷(phosphorus,P)水平无明显相关。在健康绝经后妇女中,没有发现MGP mRNA与其他参数间的明显相关性。结论低血清MGP mRNA水平可能与绝经后骨质疏松的发病有关,雌激素参与对血清MGP的调控。

Objective To investigate the correlation between serum matrix Gla protein（ MGP） and lumbar spine bone mineral density（ BMD）,bone turnover markers in postmenopausal women. Methods One hundred and twenty postmenopausal osteoporosis women and 60 healthy postmenopausal women were enrolled. Serum MGP mRNA was determined by fluorescent real-time quantitative polymerase chain reaction. The serum levels of β-crosslinking telopeptide（ β-CTX）,N-terminal propeptide of type Ⅰ collagen（ P1NP）,estradiol（ E2） and parathyroid hormone（ PTH） were also determined in two groups. BMD was measured by dual energy X-ray absorptiometry（ DXA）. T test was used for group comparison and Spearman correlation analysis was used to estimate associations between MGP mRNA and other variables. Results There was statistical difference of MGP mRNA, BMD, β-CTX, P1 NP between osteoporosis group[0. 835 ± 0. 415,（ 0. 780 ± 0. 075） g/m^2,（ 0. 427 ± 0. 067） mg/L,and（ 48. 5 ± 4. 43） mg/L] and non-osteoporosis group [4. 524 ± 0. 769,（ 0. 976 ± 0. 071） g / m^2,（ 0. 383 ± 0. 048） mg/L,and（ 41. 80 ± 4. 97） mg/L] in female（ P 0. 05）. Compared with non-osteoporosis group,the levels of BMD and MGP mRNA in osteoporosis group were significantly lower while the levels of β-CTX and P1 NP were significantly higher than healthy women group. The level of serum MGP mRNA had a positive correlation with lumbar spine bone mineral density（ r = 0. 376,P = 0. 000） and estradiol level（ r = 0. 227,P = 0. 013） in postmenopausal osteoporosis women. No significant correlation was found between the serum MGP mRNA and age,BMI,β-CTX,P1 NP,Ca,P,PTH in two groups. Conclusions MGP may be involved in the pathogenesis of postmenopausal osteoporosis and E2 may influence the regulation of serum MGP level.