血清SM4D水平与绝经后骨质疏松症患者骨密度和骨代谢指标的相关性研究

Correlation between serum SM4D level and bone mineral density and bone metabolism indexes in postmenopausal osteoporosis patients

目的探讨绝经后骨质疏松症(postmenopausal osteoporosis,POP)患者血清4D同型二聚体(SM4D)水平与骨密度(bone mineral density,BMD)和骨转换指标的关系。方法通过双能X线吸收测定法对257例POP患者和90例健康对照者进行BMD测量。通过酶联免疫吸附测定法测定受试者血清SM4D、BAP、BGP和TRACP-5b水平。使用自动电化学发光系统测量I型血清交联N端肽(NTX)、25-羟基维生素D[25(OH)D]和骨钙素的N-mid片段水平(N-MID-OT)。结果与健康对照组相比,POP妇女的SM4D水平显著升高[(1.40±0.33)μg/L vs.(0.58±0.18)μg/L,P=0.006]。SM4D水平与血清TRACP-5b和NTX水平呈正相关,与腰椎和股骨颈BMD、血清BAP和BGP水平呈负相关。SM4D水平与年龄、体质量指数以及血清25(OH)D和N-MID-OT水平之间无相关性。腰椎和股骨颈骨密度(β=-0.354,P<0.001;β=-31.234,P<0.001)和血清BAP水平(β=0.127,P=0.019)是POP患者血清SM4D水平的独立预测因子。结论绝经后骨质疏松症女性SM4D与骨密度和骨转换指标密切相关。

Objective To investigate the association of serum semaphorin 4 D(SM4 D) levels with bone mineral density(BMD) and bone turnover markers in patients with postmenopausal osteoporosis(POP).Methods BMD was measured by dual-energy X-ray absorptiometry in 257 POP patients and 90 healthy controls.Serum SM4 D,BAP,BGP and TRACP-5 b levels were measured by enzyme linked immunosorbent assay.Serum cross linked N-telopeptides of type I(NTX),25-hydroxyvitamin D [(25(OH) D] and N-mid fragment of osteocalcin(N-MID-OT) levels were measured using automated electrochemiluminescence system.Results SM4 D level was significantly higher in POP women compared to healthy controls [(1.40±0.33) μg/L vs.(0.58±0.18) μg/L,P=0.006)].SM4 D level was positively correlated with serum TRACP-5 b and NTX levels and negatively correlated with BMD and serum BAP and BGP levels.There were no correlations between SM4 D level and age,body mass index,and serum 25(OH) D and N-MID-OT levels.BMD of lumbar spine and femoral neck(β=-0.354 P<0.001;β=-31.234,P<0.001) and serum BAP level(β=0.127 P=0.019) were the independent predictors of serum SM4 D level in POP patients.Conclusion The SM4 D and bone turnover indexes are closely related to bone density in postmenopausal women with osteoporosis.