血清亮氨酸氨基肽酶和胃泌素-17与胃病继发骨质疏松症的关系

The relationships between serum leucine amino peptide enzyme and Gastrin-17 and gastric disease secondary osteoporosis

目的探讨血清亮氨酸氨基肽酶(LAP)和胃泌素-17(G-17)与胃病继发骨质疏松症(OP)的关系。方法选择2012—2017年南京市高淳人民医院收治的310例行胃镜检查且其余检查结果完整的受检者,其中胃黏膜正常或显示轻度非萎缩性胃炎140例(正常对照组)、萎缩性胃炎108例(萎缩性胃炎组)、胃癌62例(胃癌组),另选同期在本院行胃切除手术的46例患者作为胃切除组。收集所有受检者的LAP、G-17、谷氨酰转肽酶(GGT)、血清钙检测结果,对LAP和G-17进行Pearson相关性分析。分析3组LAP、G-17异常数与OP发病率之间的关系。结果正常对照组、萎缩性胃炎组、胃癌组、胃切除组的血清钙和G-17呈逐步下降的趋势〔血清钙(mmol/L):2.26±0.30、2.20±0.24、2.02±0.20、1.82±0.22,G-17(pmol/L):10.23±3.07、7.57±2.14、3.30±1.39、0.38±0.12〕,GGT和LAP呈逐步上升趋势〔GGT(U/L):38±10、39±11、40±11、40±12,LAP(U/L):30.2±10.0、46.2±10.3、58.6±10.2、70.3±11.0〕;胃癌组和胃切除组与正常对照组比较差异均有统计学意义(均P<0.05),各组间GGT比较差异均无统计学意义(均P>0.05)。LAP、G-17升高例数占比与OP患病例数呈同步上升趋势。LAP与G-17呈高度负相关(r=-0.875,P<0.05)。结论随胃病严重程度的增加,血清LAP逐步升高。对于胃病患者,在排除肝脏受损情况后,LAP异常升高应考虑OP的可能。

Objective To investigate the relationships between serum leucine amino peptide enzyme (LAP) and Gastrin-17 (G-17) and secondary osteoporosis (OP) of gastric disease. Methods Three hundred and ten patients who were admitted to Nanjing Gaochun People's Hospital in 2012-2017 for gastroscopic examination with their rest examination results completed were selected as the subjects in this study;among them, there were 140 cases with normal gastric mucosa or mild non-atrophic gastritis (normal control group), 108 cases of atrophic gastritis (atrophic gastritis group) and 62 cases of gastric cancer (gastric cancer group). In addition, 46 patients having undergone gastric resections were selected as a gastric resection group. The results of LAP, G-17, GGT and serum calcium test of all subjects were collected, Pearson correlation analyses were performed on LAP and G-17. The relationship between the abnormal number of LAP and G-17 and the incidence of OP was analyzed. Results The levels of serum calcium, GGT and G-17 respectively in the sequence of normal control group, atrophic gastritis, gastric cancer group and gastric resection group showed a decreasing trend in serum calcium and G-17 [serum calcium (mmol/L): 2.26±0.30, 2.20±0.24, 2.02±0.20, 1.82±0.22, G-17 (pmol/L): 10.23±3.07, 7.57±2.14, 3.30±1.39, 0.38±0.12], while GGT and LAP presented a gradually elevation trend [GGT (U/L): 38±10, 39±11, 40±11, 40±12, LAP (U/L): 30.2±10.0, 46.2±10.3, 58.6±10.2, 70.3±11.0]. The differences were statistically significant between gastric cancer group and normal control group, as well as gastrectomy group and normal control group (all P < 0.05), and there were no statistically significant differences in GGT between various groups (all P > 0.05). The proportions of the numbers of cases with LAP and G-17 elevation and the proportion of the number of OP cases increased gradually. LAP is highly negatively correlated with G-17 (r =-0.875, P < 0.05). Conclusions With the increase of the severity of gastric disease, the serum LAP increases gradually. For patients with stomach problems, after liver damage has been ruled out when abnormal elevation of the LAP is discovered, the possibility of OP presence should be considered.