绝经后妇女中骨质疏松患者血清钙磷、骨代谢指标与BMD的关系

Relationship between Serum Calcium,Phosphorus and Bone Metabolism Markers and BMD in Postmenopausal Women with Osteoporosis

目的探讨绝经后妇女骨质疏松患者血清钙磷、骨代谢指标与骨密度(BMD)的相关性。方法应用双能X线吸收法对86例绝经后妇女进行骨密度检查,根据骨密度分为骨质疏松组63例和正常组23例。分别检测两组血清Ca、P、β-胶原降解产物(β-CrossLaps)、N端骨钙素(N-MID osteocalcin)、Ⅰ型胶原N端前肽(PⅠNP)指标,并进行比较。进一步根据年龄分为4组:≤59岁3例设为A组,60～69岁10例设为B组,70～79岁36例设为C组,≥80岁37例设为D组,分析各组骨代谢指标与BMD的相关性。结果①骨质疏松组的年龄为(78.21±7.57)岁,高于正常组的(74.35±7.15)岁,BMD低于正常组(P<0.01);②骨质疏松组β-CrossLaps、N-MID、PINP三项指标均高于正常组,但差异无统计学意义(P>0.05),钙磷水平无明显差别(P>0.05);③β-CrossLaps在A组和C组与BMD呈负相关(r=-0.492、-0.035,P<0.05),在B组和D组呈现正相关(r=0.318、0.058,P<0.05);N-MID在各组均与BMD呈负相关(r=-0.972、-0.382、-0.001、-0.153,P<0.05);PINP在C组与BMD呈正相关(r=0.052,P<0.05),在A组、B组、D组与BMD呈负相关(r=-0.991、-0.515、-0.187,P<0.05);血清钙Ca在各组均与BMD呈正相关(r=0.362、0.307、0.105、0.137,P<0.05);P在A组、C组、D组与BMD呈负相关(r=-0.530、-0.047、-0.029,P<0.05),而在B组与BMD呈正相关(r=0.020,P<0.05)。结论β-CrossLaps、N-MID、PINP与BMD存在密切的关系,应联合用于骨质疏松症的诊治及病情监测。

Objective To investigate the correlation between serum calcium, phosphorus and bone metabolism markers and bone mineral density in postmenopausal women with osteoporosis. Methods A total of 86 postmenopausal women in our hospital were examined for bone mineral density by dual-energy X-ray absorptiometry. According to bone mineral density, 63 patients were divided into osteoporosis group and 23 patients in normal group.Serum Ca, P, β-collagen degradation products(β-CrossLaps), N-terminal osteocalcin(N-MID) and type I collagen N-terminal propeptide(PINP) were measured and compared. According to the age, the patients were divided into 4 groups: ≤59 years old, 3 cases were set to group A, 60 to 69 years old,10 cases were set to group B, 70 to 79 years old, 36 cases were set to group C, and ≥80 years old, 37 cases were set to group D. The correlation between bone metabolic markers and bone mineral density was analyzed. Results ①The age of osteoporosis group was(78.21±7.57) years old, higher than that of normal group(74±7.15) years old, bone mineral density was lower than normal group(P<0.01);②Osteoporosis group β-CrossLaps, N-MID and PINP were higher than the normal group, but the difference was not statistically significant(P >0.05). There was no significant difference in calcium and phosphorus levels(P>0.05). ③β-CrossLaps was negatively correlated with BMD in group A and C.(r=-0.492,-0.035, P<0.05), there was a positive correlation between group B and group D(r=0.318, 0.058, P<0.05);N-MID was negatively correlated with BMD in each group(r=-0.972,-0.382,-0.001,-0.153, P<0.05);PINP was positively correlated with BMD in group C(r=0.052, P<0.05), and negatively correlated with BMD in group A, B, and D( r=-0.991,-0.515,-0.187, P<0.05);serum calcium was positively correlated with BMD in each group(r=0.362, 0.307, 0.105, 0.137, P<0.05);P in group A,group C, group D was negatively correlated with BMD(r=-0.530,-0.047,-0.029, P<0.05), while there was a positive correlation between group B and BMD(r=0.020, P<0.05). Conclusion β-CrossLaps, N-MID, PINP and BMD are closely related and should be used in the diagnosis and treatment of osteoporosis and disease monitoring.