骨科就诊人群血清维生素D与骨代谢标志物水平相关性分析

Correlation between serum vitamin D and bone metabolism markers in orthopedic patients

目的探究骨科就诊患者维生素D在体内经25羟化酶催化合成的血清25-羟维生素D[25-hydroxy vitamin D,25(OH)D]与骨代谢生化标志物水平之间的关系。方法回顾性分析3015例就诊于北京医院的骨科患者的血清25-羟维生素D、总I型前胶原氨基端肽(total procollagen type 1 amino-terminal propeptide,tP1NP)、N-MID骨钙素(osteocalcin,OCN)、I型胶原羧基端肽β特殊序列(β-isomerized C-terminal telopeptides,β-CTX),按患者血清25羟维生素D不同水平分组,比较各骨代谢生化标志物在不同组别间的差异及25羟维生素D与各标志物的相关性,并了解不同季节因素对这一相关性的影响。结果按血清25(OH)D水平分为四组:维生素D严重缺乏组、维生素D缺乏组、维生素D不足组、维生素D充足组。tP1NP与β-CTX水平随血清25(OH)D水平升高而逐渐降低,且β-CTX水平在不同25(OH)D组别间差异均有显著性(P<0.05)。相关分析显示,tP1NP、β-CTX与血清25(OH)D水平均呈负相关(r=-0.109,P<0.05;r=-0.185,P<0.05)。冬春季与夏秋季血清25(OH)D与骨代谢标志物关系符合这一规律。结论骨科就诊患者血清25羟维生素D水平与骨代谢生化标志物tP1NP、β-CTX水平呈负相关,且不受季节因素影响,反映骨吸收状态的β-CTX与维生素D水平相关性更为密切。

Objective To investigate the relationship between serum Vitamin D and bone metabolism markers in orthopedic patients.Method 25-hydroxy Vitamin D[25(OH)D],total procollagen type 1 amino-terminal propeptide(tP1 NP),osteocalcin(OCN),andβ-Crosslaps(β-CTX)in serum were measured in 3015 orthopedic patients by electrochemiluminescence immunoassay.The patients were divided into four groups by different levels of 25(OH)D.The differences of bone metabolism markers among different groups were compared.The correlations between 25(OH)D and bone metabolism markers(tP1 NP,OCN,β-CTX)were evaluated.The seasonal factor was investigated for the relationships.Result The markers of tP1 NP andβ-CTX were negatively correlated with serum 25(OH)D levels(r=-0.109,P<0.05;r=-0.185,P<0.05).Theβ-CTX levels were significant different among four groups defined by 25(OH)D levels(P<0.05).The relationship between serum 25(OH)D and bone metabolism markers were same in different seasons.Conclusion The serum 25(OH)D level was negatively correlated with bone metabolism markers of tP1 NP andβ-CTX in orthopedic patients of one single center.The correlation was not affected by seasonal factors.Furthermore a more close association between 25(OH)D and the bone resorption markerβ-CTX was observed.