绝经后女性血清骨代谢指标与骨质疏松的相关性分析

Correlation analysis of serum bone metabolism indicators and osteoporosis in postmenopausal women

目的探讨绝经后女性血清4项骨代谢指标(25-羟基维生素D、β胶原特殊序列、总Ⅰ型胶原前肽和骨钙素)对骨质疏松的辅助诊断价值。方法收集2019年1-12月于广州医科大学附属第二医院骨科门诊就诊的209例50岁以上绝经女性血清4项骨代谢指标及骨密度(BMD)的检测数据,根据临床诊断将其分为对照组49例、骨量减少组67例、骨质疏松组93例,对各组的检测数据进行统计分析。结果骨质疏松组50~<65岁患者4项骨代谢指标水平与对照组和骨量减少组比较,差异均有统计学意义(P<0.05)。Pearson相关分析显示,25-羟基维生素D与β胶原特殊序列、总Ⅰ型胶原前肽和骨钙素分别呈负相关(r=-2.89、-2.88、-2.55,P<0.05);总Ⅰ型胶原前肽与β胶原特殊序列呈正相关(r=0.756,P<0.05);总Ⅰ型胶原前肽与骨钙素呈正相关(r=0.786,P<0.05);β胶原特殊序列与骨钙素呈正相关(r=0.774,P<0.05)。结论对绝经后女性进行4项血清骨标志物的检测,有助于全面并合理地评价患者近期骨代谢情况,辅助临床诊断骨质疏松,特别是对于50~<65岁女性患者应积极干预,延缓骨质疏松的进展。

Objective To investigate the value of four bone metabolism indicators(25-hydroxy vitamin D,β-collagen special sequence,total typeⅠcollagen propeptide and osteocalcin)in the auxiliary diagnosis of osteoporosis for postmenopausal women.Methods From January to December in 2019,209 postmenopausal women over 50 years old were enrolled in the study from the Department of Orthopedics of Second Affiliated Hospital of Guangzhou Medical University.According to the clinical diagnosis,they were divided into control group(49 cases),osteopenia group(67 cases)and osteoporosis group(93 cases).The test data of each group were statistically analyzed.Results Compared with the control group and osteopenia group,there were significant differences in the levels of the four bone metabolism indicators in 50-<65 year-old patients of osteoporosis group(P<0.05).Pearson correlation analysis showed that 25-hydroxy vitamin D level was negatively correlated withβ-collagen special sequence,total typeⅠprocollagen and osteocalcin(r=-2.89,-2.88,-2.55,P<0.05).There was a positive correlation between total typeⅠprocollagen andβ-collagen special sequence(r=0.756,P<0.05),total typeⅠprocollagen and osteocalcin(r=0.786,P<0.05);β-collagen special sequence and osteocalcin(r=0.774,P<0.05).Conclusion The detection of four serum bone markers in postmenopausal women is helpful to comprehensively and reasonably evaluate the recent bone metabolism of patients and assist clinical diagnosis of osteoporosis.Especially for women aged 50-<65,active intervention should be taken to delay the progress of osteoporosis.