中老年女性骨代谢生化指标对早期骨质疏松症的临床诊断价值研究

Study on the value of biochemical markers of bone metabolism in clinical diagnosis of early osteoporosis among middle-aged and old women

目的通过分析中老年女性骨密度及骨代谢生化指标,观察其对于诊断骨质疏松症的临床价值。方法选取2014年3月-2017年3月在该院体检的162例中老年女性为研究对象,检测其腰椎L2-L4和左侧股骨近端(包括Neck、Troch、Ward三角区)骨密度以及血清中的骨钙素、碱性磷酸酶和尿中的吡啶啉(肌酐校正)。根据受检者不同的年龄段和骨密度对他们的骨代谢生化指标进行比较分析。结果中老年女性中患有骨质疏松的占51.2%;50~69岁的中老年女性血清中骨钙素和尿中吡啶啉(肌酐)的含量较高,超过70岁后则开始减少;不同年龄段的中老年女性血清中碱性磷酸酶的含量基本相同。骨质疏松组和骨量减少组的中老年女性血清中骨钙素含量和尿中吡啶啉(肌酐)含量高于正常组,但两组的血清中骨钙素含量和尿中吡啶啉(肌酐)含量基本相同,不同骨密度组的血清中碱性磷酸酶含量也基本相同。结论早期诊断骨质疏松症对减少中老年女性损害极其重要,而血清中的骨钙素、尿中的吡啶啉(肌酐)能够特异的反映骨吸收和形成,是诊断骨质疏松症的重要指标。

Objective To observe the clinical value of biochemical markers of female bone metabolism in clinical diagnosis of early osteoporosis by analyzing bone mineral density （BMD） and biochemical markers of bone metabolism in middle-aged and old women.Methods A total of 162 middle-aged and old women receiving physical examination in BENQ Medical Center from March 2014 to March 2017 were selected,BMD values of lumbar vertebra L2-L4 and left proximal femur （including Neck,Troch,Ward triangle）,serum osteocalcin and alkaline phosphatase,urinary pyridine （adjusted by creatinine） were detected.The biochemical markers of bone metabolism were compared and analyzed according to age and BMD.Results The incidence rate of osteoporosis was 51.2%.The levels of osteocalcin and urinary pyridine （adjusted by creatinine） in the women aged 50-69 years old were high,which decreased among the women more than 70 years old.The levels of serum alkaline phosphatase among middle-aged and old women in different age groups were basically the same.The levels of serum osteocalcin and urinary pyridine （adjusted by creatinine） in middle-aged and old women with osteoporosis and osteopenia were higher than those in middle-aged and old women with normal BMD.The levels of serum osteocalcin and urinary pyridine （adjusted by creatinine） in middle-aged and old women with osteoporosis and osteopenia were basically the same.The levels of serum alkaline phosphatase among middle-aged and old women in different BMD groups were basically the same.Conclusion Early diagnosis of osteoporosis is essential to reduce the damage to middle-aged and old women.Serum osteocalcin and urinary pyridine （adjusted by creatinine） can specifically reflect bone absorption and formation,which are important indicators for diagnosis of osteoporosis.