绝经后骨质疏松症患者血清甲状旁腺素和25羟维生素D及骨代谢标志物与骨密度的相关性

Correlation Between Serum Parathyroid Hormone 25-Hydroxyvitamin D Bone Metabolism Markers and Bone Mineral Density in Patients with Postmenopausal Osteoporosis

目的:探讨绝经后骨质疏松症患者血清甲状旁腺素(PTH)、25羟维生素D[25(OH)D3]、骨代谢标志物的水平与骨密度的相关性。方法:选取我院2019年7月至2021年6月收治的绝经后骨质疏松症患者108例作为观察组,同期来我院体检正常绝经妇女108例作为对照组。检测观察组及对照组PTH、25(OH)D3、骨代谢标志物的水平,并分析与骨密度的相关性。结果:两组PTH、25(OH)D3水平对比:观察组PTH与对照组相比(P>0.05);观察组25(OH)D3低于对照组(P<0.01);两组骨代谢标志物水平对比:观察组Ⅰ型前胶原氨基末端前肽、β-胶联降解产物、骨碱性磷酸酶及骨钙素均高于对照组(P<0.01);不同部位骨密度指标对比:观察组全髋骨、股骨颈及腰L1~4骨密度均低于对照组(P<0.01);绝经后骨质疏松症患者骨密度值与甲状旁腺素、25羟维生素D呈正相关(P<0.01),与年龄、Ⅰ型前胶原氨基末端前肽、β-胶联降解产物、骨碱性磷酸酶及骨钙素呈负相关(P<0.01)。结论:绝经后的骨质疏松患者的骨密度与血清25羟维生素D水平、骨代谢标志物有关。

Objective:To investigate the correlation between levels of serum parathyroid hormone(PTH),25-hydroxyvitamin D[25(OH)D3]and bone metabolism markers and bone mineral density in patients with postmenopausal osteoporosis.Methods:108 patients with postmenopausal osteoporosis admitted to the hospital between July 2019 and June 2021 were selected as observation group,and another 108 normal menopausal women undergoing physical examination during the same period were included in control group.The levels of PTH,25(OH)D3 and bone metabolism markers were detected between observation group and control group,and their correlation with bone mineral density was analyzed.Results:Comparison of levels of PTH and 25(OH)D3 showed that compared with control group,there was no statistical significance in the level of PTH in observation group(P>0.05),and the level of 25(OH)D3 was lower(P<0.01).In terms of levels of bone metabolism markers in the two groups,the levels of N-terminal propeptide of type I procollagen,β-cross-linked C-terminal telopeptide of type I collagen,bone alkaline phosphatase,and osteocalcin were higher in observation group than those in control group(P<0.01).Comparison of bone mineral densities of different parts showed that the bone mineral densities of total hip bone,femoral neck and lumbar L1-4 in observation group were lower compared to control group(P<0.01).The bone mineral density of patients with postmenopausal osteoporosis was positively correlated with parathyroid hormone and 25-hydroxyvitamin D(P<0.01),and was negatively correlated with age,N-terminal propeptide of type I procollagen,β-cross-linked C-terminal telopeptide of type I collagen,bone alkaline phosphatase and osteocalcin(P<0.01).Conclusion:The bone mineral density in patients with postmenopausal osteoporosis is related to serum 25-hydroxyvitamin D and bone metabolism markers.