绝经后妇女椎体脆性骨折的双能X线骨密度仪评估及其与血清骨转化、骨代谢指标的关系

Dual-energy X-ray absorptiometry assessment of postmenopausal women with vertebral fragility fracture and its relationship with serum bone turnover and bone metabolism indexes

目的：研究绝经后妇女椎体脆性骨折双能 X 线骨密度测量结果与血清骨转化、骨代谢指标的关系。方法：选择2012年4月~2015年12月期间在复旦大学附属上海市第五人民医院接受 DXA 检查的158例绝经后妇女,根据骨密度测量结果分为骨质疏松组、骨量减少组、骨质正常组,根据胸腰椎正侧位片结果分为无椎体骨折组、胸椎骨折组、腰椎骨折组、胸腰椎骨折组,采集血清并测定骨转化和骨代谢指标。结果：胸椎骨折、胸腰椎骨折受试者的股骨颈、髋部、腰椎 L1~4骨密度显著低于无椎体骨折的受试者,腰椎骨折受试者的股骨颈、髋部、腰椎 L1~4骨密度与无椎体骨折的受试者无显著性差异；骨质疏松组、骨量减少组绝经后妇女血清中 PINP、ICTP、CTX、TRACP-5b、MMP13、OPG、OPN 含量显著高于骨量正常组,25（OH）D、BGP、ON 含量显著低于骨量正常组；骨质疏松组绝经后妇女血清中PINP、ICTP、CTX、TRACP-5b、MMP13、OPG、OPN 含量显著高于骨量减少组,25（OH）D、BGP、ON含量显著低于骨量减少组。结论：双能 X 线骨密度测定对绝经后妇女胸椎脆性骨折和胸腰椎脆性骨折的预测价值明确且与骨转化、骨代谢的改变密切相关。

Objective：To study the relationship between dual-energy X-ray bone mass density measurement results of postmenopausal women with vertebral fragility fracture and the serum bone turnover as well as bone metabolism indexes.Meth-ods：A total of 1 58 postmenopausal women who received DXA tests in our hospital between April 2012 and December 201 5 were selected,were divided into osteoporosis group,osteopenia group and normal bone mass group according to the bone min-eral density measurement results,and were divided into no vertebral fracture group,thoracic vertebral fracture group,lumbar vertebral fracture group and thoracolumbar vertebral fracture group according to the thoracolumbar vertebral anterioposterior and lateral film results,and serum was collected to determine bone turnover and bone metabolism indexes.Results：Femoral neck,hip and lumbar vertebra L1-4 bone mineral density of subjects with thoracic vertebral fracture and thoracolumbar verte-bral fracture were significantly lower than those of the subjects without vertebral fracture,and femoral neck,hip and lumbar vertebra L1-4 bone mineral density of subjects with lumbar vertebral fracture were not significantly different from those of the subjects without vertebral fracture;serum PINP,ICTP,CTX,TRACP-5b,MMP13,OPG and OPN content of osteoporosis group and osteopenia group were significantly higher than those of normal bone mass group while 25 （OH）D,BGP and ON content were significantly lower than those of normal bone mass group;serum PINP,ICTP,CTX,TRACP-5b,MMP13, OPG and OPN content of osteoporosis group were significantly higher than those of osteopenia group while 25 （OH）D,BGP and ON content were significantly lower than those of osteopenia group.Conclusions：Dual-energy X-ray bone densitometry has clear prediction value for postmenopausal women with thoracic vertebral fragility fracture and thoracolumbar vertebral fragility fracture,and is closely related to the changes of bone turnover and bone metabolism.