老年男性骨质疏松性髋部骨折患者血清IGF-1及骨转换生化指标水平的变化

Changes in serum levels of IGF-1 and bone turnover biocamical markers in elderly male patient with osteporotic hip fracture

目的:探讨老年男性骨疏松性髋部骨折患者血清胰岛素样生长因子-1(IGF-1)及骨转换生化指标水平的变化。方法:采用酶联免疫法测定68例老年男性骨质疏松性髋部骨折患者、50例老年男性骨质疏松患者和50例正常男性老年人血清胰岛素样生长因子-1(IGF-1)水平,采用电化学发光免疫分析法测定其血清Ⅰ型胶原氨基端前肽(PINP)、N-端骨钙素(N-MID)、β-胶原降解产物(β-CTX),采用双能ⅹ线骨密度仪分别测定正位腰椎(L2~L4)及左侧股骨颈骨密度(BMD)。结果:老年男性骨质疏松性髋部骨折患者腰椎、股骨颈BMD、血清IGF-1水平较老年男性骨质疏松患者和正常男性老年人明显降低(均P<0.01),老年男性骨质疏松性髋部骨折患者、老年男性骨质疏松患者血清PINP、N-MID水平较正常男性老年人明显降低(均P<0.01)。老年男性骨质疏松性髋部骨折患者血清β-CTX水平较老年男性骨质疏松患者和正常男性老年人明显升高(均P<0.01)。老年男性骨质疏松性髋部骨折患者血清IGF-1与患者腰椎、股骨颈BMD呈明显正相关(r=0.427,r=0.396,均P<0.01),血清IGF-1与患者血清PINP、N-MID成明显正相关(r=0.399,r=0.401,均P<0.01),与患者血清β-CTX呈明显负相关(r=-0.457,P<0.01)。结论:血清IGF-1水平降低在老年男性骨质疏松性髋部骨折的发病中可能发挥重要作用。测定患者血清IGF-1、PINP、N-MID、β-CTX水平可作为预测老年男性骨质疏松性骨折风险的参考指标。

Objective:To explore the changes in serum levels of insulin like groth factor-1(IGF-1)and bone turnover biocamical markers in elderly male patient with osteoporotic hip fracture.Methods:The serum level of IGF-1 was measured by using ELISA method.The serum levels of PINP,N-MID andβ-CTX were measured by using electrochemiluminescence immunoassay,and the BMD of lumber vertebrae2~4(L 2~4 and the neck of femur(Neck)were measured by using energy X-ray obsorptionetry in 68 elderly male patients with osteoporotic hip fracture,50 elderly male patients with osteoporosis,and 50 healthy elderly males.Result:The BMD of the lumber vertebrae 2~4 and the neck of femar and serum level of IGF-1 were significantly lower in the elderly male patients with osteoporotic hip fracture than those in elderly male patients with osteoporosis and health elderly males.The serum levels of PINP,N-MID were significantly lower in the elderly male patients with osteoporotic hip fracture than those in the elderly male patients with osteoporosis and health elderly males.The serum level ofβ-CTX was significantly higher in the elderly male patients with osteoporotic hip fracture than those in the elderly male patients with osteoprosis and health elderly males.A positive correlation was found between serum level of IGF-1 and BMD of the lumber 2~4 and the neck of femur and serum PINP and N-MID(r=0.427,r=0.396,r=0.399,r=0.401,all P﹤0.01).A negative correlation was found between levels of IGF-1 and serum levels ofβ-CTX(r=-0.457,P﹤0.01).Conclusion:The low serum concentration of IGF-1 might play an important role in the development of osteoporotic hip fracture in the elderly male patients.The detection of the serum levels of IGF-1,INPN,N-MID,β-CTX may be used as a reliable sign for premonitory osteoporotic hip fracture in elderly male.