骨转换标志物在老年女性骨质疏松症患者静脉滴注唑来膦酸后骨密度变化预测中的价值

Value of serum bone turnover markers for predicting changing trend of bone mineral density in elderly osteoporosis women after zoledronic acid infusion

目的了解血清骨转换标志物(BTMs)在预测老年女性骨质疏松症(OP)患者静脉滴注唑来膦酸后骨密度(BMD)变化中的价值。方法予100例老年女性OP患者静脉滴注唑来膦酸5 mg,在治疗前、治疗12月末分别检测血清Ⅰ型胶原C-末端肽交联(CTX)、Ⅰ型原胶原N-端前肽(P1NP)水平和股骨颈骨密度(FNBMD)、总髋部骨密度(THBMD)和腰椎1-4骨密度(LSBMD)值。比较治疗前后血清BTMs和BMD的差异,并分析治疗前血清BTMs水平和BMD变化值(△BMD)的相关性。结果与治疗前比较,治疗12月末患者血清CTX和P1NP均显著下降(P <0.01), FNBMD、 THBMD和LSBMD均显著增加(P <0.01)。治疗前血清CTX水平与△FNBMD (r=0.248, P <0.05)、△THBMD (r=0.345,P <0.01)呈正相关,血清P1NP水平与△FNBMD (r=0.302, P <0.01)、△THBMD (r=0.266, P <0.05)呈正相关,而血清CTX和P1NP与△LSBMD均无明显相关(P> 0.05)。结论血清BTMs对老年女性OP患者静脉滴注唑来膦酸后BMD增高有一定的预测价值,其中血清CTX、 P1NP越高,患者股骨颈和总髋部BMD上升越明显。

AIM To investigate the value of serum bone turnover markers(BTMs)for predicting change of bone mineral density(BMD)in elderly osteoporosis women after zoledronic acid infusion.METHODS A total of 100 elderly osteoporosis women were recruited into the study and were intravenously administrated with zoledronic acid 5 mg.All subjects underwent serum BTMs(carboxy-terminal cross-linking telopeptide of type 1 collagen(CTX)and procollagen type 1 amino-terminal propeptide(P1NP))and BMD(femoral neck bone mineral density(FNBMD),total hip bone mineral density(THBMD),and lumbar spine bone mineral density(LSBMD))measurement right before and 12 months after zoledronic acid treatment.The differences in serum BTMs and BMD,and the relationships between serum BTMs and the changes of BMD(△BMD)were analyzed.RESULTS Compared with those before treatment,serum CTX and P1NP decreased(all P<0.01),while FNBMD,THBMD and LSBMD increased(all P<0.01)12 months after a single dosing of zoledronic acid.Serum CTX was positively associated with△FNBMD(r=0.248,P<0.05)and△THBMD(r=0.345,P<0.01),and P1NP was positively associated with△FNBMD(r=0.302,P<0.01)and△THBMD(r=0.266,P<0.05).While CTX and P1NP were not associated with△LSBMD(all P>0.05).CONCLUSION Serum BTMs have predictive value in increase of BMD in elderly osteoporosis women after zoledronic acid infusion.FNBMD and THBMD would increase more obviously in elderly osteoporosis women with high BTMs than those with low ones.