骨转换指标在儿科内分泌疾病的应用

Application of bone turnover markers in pediatric endocrine diseases

骨转换指标是骨转换(骨重建)过程中产生的代谢产物或酶类,可以反映破骨细胞和成骨细胞的总体活动状况。儿童中,骨转换指标与性别和年龄及青春期发育有密切关系。在有原发或继发骨质疏松的高危患儿中,骨转换指标的升高可能提示骨质疏松风险的增加,同时,该指标可以作为抗骨吸收药物治疗效果的监测指标。骨转换指标在代谢性骨病继发甲状旁腺功能亢进中呈现增高趋势,可能可以作为治疗后反应效果的指标。肥胖和糖尿病前期的患儿骨重建受到影响,可能危害远期的骨骼健康。然而,由于缺乏正常参考值数据,且存在结果不一致的现象,离临床应用有一定的差距。未来还需要更深入的研究探讨骨转换指标在儿科内分泌疾病中的应用。

Bone turnover markers(BTMs)are metabolites or enzymes produced during bone remodeling,usually considered as either bone formation or bone resorption markers.In children,BTMs are closely related to gender,age and pubertal status.Higher BTMs maybe associated with osteoporosis in children at high risk for primary or secondary osteoporosis.BTMs can be helpful to monitor treatment effects of drugs that have an effect on bone metabolism.The levels of BTMs increase among the children with secondary hyperparathyroidism of metabolic bone disease,also increase in obese and pre-diabetic children.Nowadays,BTMs are mainly used as reasearch tools,far from clinical applicaticn because of the inconsistent result.In the future,more studies are needed to explore the clinical application of these markers.