血清骨代谢指标和Klotho蛋白在骨质疏松患者血清中的表达及意义

Expression and significance of serum bone metabolism index and Klotho protein in patients with osteoporosis

目的:探讨血清骨代谢指标和Klotho蛋白在骨质疏松患者血清中的表达变化及意义。方法:收集167例骨质疏松患者为研究对象,另将同期在本院行健康体检且自愿参与本研究的83例健康者作为对照组。采用X线骨密度仪测定两组的骨密度;采用酶联免疫吸附法检测血清I型前胶原氨基端肽、I型胶原羧基端肽β特殊序列、骨钙素氨基中分子片段、骨特异性碱性磷酸酶、Klotho蛋白水平;比较两组骨密度值、血清骨代谢指标及Klotho蛋白表达水平的差异性,并分析Klotho蛋白、骨代谢指标、骨密度值之间的相关性。结果:骨质疏松组患者的骨密度和T值均明显低于健康对照组,差异均有统计学意义(P<0.05)。骨质疏松组患者I型前胶原氨基端肽、骨特异性碱性磷酸酶、骨钙素氨基中分子片段、Klotho蛋白水平较对照组明显降低,差异有统计学意义(P<0.05),但I型胶原羧基端肽β特殊序列水平较对照组明显升高,差异有统计学意义(P<0.05)。骨质疏松患者的血清Klotho蛋白水平与血清I型前胶原氨基端肽、骨特异性碱性磷酸酶、骨钙素氨基中分子片段水平及骨密度和T值呈正相关(P<0.05),与血清I型胶原羧基端肽β特殊序列水平呈负相关(P<0.05)。结论:骨质疏松患者血清骨代谢指标明显改变,血清Klotho蛋白水平明显降低,且骨代谢指标、Klotho蛋白、骨密度值之间的存在相关性,表明血清骨代谢指标和Klotho蛋白可作为临床诊断骨质疏松的辅助指标,有助于骨质疏松的临床诊治评估。

Objective:To investigate the changes and significance of serum bone metabolism index and Klotho protein expression in osteoporosis patients.Methods:167 cases of osteoporosis were included in this study.In addition,83 healthy people who had physical examination in our hospital and participated in the study voluntarily in the same period were taken as the control group.Bone mineral density was measured by X-ray absorptiometry.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of amino terminal peptide of procollagen I,special sequence of carboxy terminal peptideβof collagen I,middle molecular fragment of osteocalcin amino group,bone specific alkaline phosphatase and Klotho protein.The differences of bone mineral density,bone metabolism index and Klotho protein expression between the two groups were compared.The correlation among Klotho protein,bone metabolism index and bone mineral density was analyzed.Results:The bone mineral density and T value of osteoporosis group were significantly lower than those of healthy control group(P<0.05).The level of amino terminal peptide,bone specific alkaline phosphatase,osteocalcin amino molecule fragment and Klotho protein in osteoporosis group was significantly lower than that in healthy control group(P<0.05),but the level of special sequence of carboxy terminal peptideβin collagen I was significantly higher than that in healthy control group(P<0.05).The level of serum Klotho protein was positively correlated with the level of amino terminal peptide of type I procollagen,bone specific alkaline phosphatase,middle molecular segment of osteocalcin amino,bone density and T value(P<0.05),and negatively correlated with the level of specific sequence of carboxy terminal peptideβof type I collagen(P<0.05).Conclusion:The level of serum Klotho protein is significantly decreased in patients with osteoporosis,and there is a significant correlation among the indexes of bone metabolism,Klotho protein and BMD,which indicates that the indexes of serum bone metabolism and Klotho protein can be used as auxiliary indexes for clinical diagnosis of osteoporosis,and also contribute to the clinical diagnosis and evaluation of osteoporosis.