自然绝经后女性骨代谢标记物与骨密度的关系研究

Relationship between bone metabolism markers and bone mineral density in postmenopausal women

目的:探讨自然绝经后女性骨代谢标记物:Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PINP)和β-胶原降解产物(βcross-linked C-telopeptide of typeⅠcollagen,β-CTX)与骨密度(bone mineral density,BMD)的关系。方法:选取147名45~72岁自然绝经2年以上的妇女为研究对象。使用双能X射线吸收测定法(dualenergy X-ray absorptiometry,DXA)测量BMD,并检测血清β-CTX与PINP水平。研究对象按BMD分为骨量正常组(n=55)、骨量减少组(n=56)、骨质疏松组(n=36),比较3组间PINP、β-CTX的差异;腰椎BMD、髋部BMD与一般资料的相关性;β-CTX与PINP、腰椎BMD与髋部BMD的相关性。结果:3组β-CTX水平比较,差异有统计学意义(P<0.05),而PINP比较无明显差异(P>0.05);腰椎BMD与年龄、绝经年龄、身高、体质量、BMI有相关性(P<0.05);髋部BMD与绝经年龄、身高、体质量、BMI、β-CTX有相关性(P<0.05);β-CTX与PINP有相关性(P<0.05),腰椎BMD与髋部BMD有相关性(P<0.05)。结论:骨吸收与骨形成处于高代谢状态,骨质疏松人群骨量流失可能较快。BMD值较PINP、β-CTX更能反映骨量的高低。

Objective:To investigate the relationship between N-terminal propeptide of typeⅠprecollagen(PINP),βcross-linked C-telopeptide of typeⅠcollagen(β-CTX)and bone mineral density(BMD)in postmenopausal women.Methods:A total of 147 women aged 45-72 years with natural menopause were selected.Dualenergy X-ray absorptiometry(DXA)was used to measure BMD,andβ-CTX and PINP were detected.All 147 women were divided into normal bone mass group(n=55),osteopenia group(n=56),osteoporosis group(n=36)according to the BMD.The differences in PINP,β-CTX among the three groups,correlation between BMD of lumbar spine,BMD of hip and general data,β-CTX and PINP were analyzed.The correlation between lumbar BMD and hip BMD were compared.Results:There were significant differences inβ-CTX among the three groups(P<0.05),but no significant difference in PINP(P>0.05).BMD of lumbar spine was related to age,menopausal age,height,weight,and body mass index(BMI)(P<0.05),hip BMD was related to menopausal age,height,weight,BMI,β-CTX(P<0.05),β-CTX was related to PINP(P<0.05),there was a correlation between lumbar BMD and hip BMD(P<0.05).Conclusion:Bone resorption and bone formation are in a high metabolic state,and bone loss may be faster in osteoporosis populations.BMD value can reflect the level of bone mass more than PINP andβ-CTX.