骨代谢标志物与不同类型骨质疏松症的相关性研究

Correlation of bone metabolism markers and different types of osteoporosis

目的:比较不同类型骨质疏松症患者血清中骨代谢标志物的水平差异以及骨代谢标志物之间的相关性。方法:采用免疫电化学发光法检测2016年6月至2017年12月在我院确诊为骨质疏松无骨折患者134例,骨质疏松伴骨折患者118例,甲状旁腺功能亢进合并骨质疏松症患者126例和我院体检中心健康人群116例受试对象血清中I型前胶原氨基端延长肽(Procollagen type I N-terminal peptide,P1NP)、骨钙素(N-terminal midfragment of osteocalcin,N-MID)、I型胶原羧基端肽β特殊序列(βisomer of the C-terminal telopeptide of type I collagen,β-CrossLaps)、血清25羟维生素D(25-hydroxyvitamin D,25-OH(vit)D)、甲状旁腺素(Parathyroid hormone,PTH)的水平。结果:三种不同类型骨质疏松症患者血清中PINP及β-Crosslaps的水平均明显高于健康对照组(P<0.05),其中PTH增高性骨质疏松组增加最为明显;各组受试对象中女性患者血清25-OH(vit)D水平均明显低于同组男性患者(P<0.05),PINP、β-CrossLaps、N-MID的水平与同组男性患者相比均呈增加的趋势;Pearson相关性分析结果显示PTH与25-OH(vit)D呈负相关,PINP与N-MID,β-CrossLaps与N-MID,PINP与β-CrossLaps均呈正相关(P<0.05)。结论:分析骨代谢标志在不同类型骨质疏松症患者血清中的水平差异及骨代谢标志物之间的相关性,可合理评价骨组织的转换率,有利于早期发现骨代谢紊乱,能更有效地预防骨质疏松症的发生与发展,减少骨质疏松合并骨折的发生率。

Objective：To investigate the correlation between bone metabolism markers and different types of osteoporosis patients.Methods：Serum P1 NP,N-MID,β-CrossLaps,25-OH（vit）D and PTH levels in 134 cases of osteoporosis without fracture,118 cases of osteoporosis with fracture,126 cases of hyperparathyroidism combined with osteoporosis,and 116 healthy controls which were collected from June 2016 to December 2017 were measured by immune electrochemical luminescence method.Results：Levels of PINP andβ-CrossLaps in the three different types of osteoporosis groups were significantly higher than those of healthy controls（P〈0.05）,among which levels in the hyperparathyroidism combined with osteoporosis group were the most pronounced.The 25-OH（vit）D level in female patients of 4 groups were all significantly lower than those of male patients in the same group.（P〈0.05）.The levels of PINP,β-CrossLaps,and N-MID in female patients of 4 groups were all increased compared with male patients.Pearson correlation analysis results showed that PTH was negatively correlated with 25-OH（vit）D（P〈0.05）.PINP and N-MID,β-CrossLaps and N-MID,PINP andβ-CrossLaps were all positively correlated（P〈0.05）.Conclusion：Analysis of the correlation between levels of bone metabolic markers and different types of osteoporosis can help to evaluate the conversion rate of bone tissue,which may be helpful in the early detection of bone metabolic disorders.