25-羟基维生素D3在5060岁绝经后女性骨折中的变化

Changes of 25 hydroxy vitamin D_3 in postmenopausal women between 50 and 60 years of age with fractures

目的探讨在50~60岁绝经后女性骨折中骨代谢指标的变化。方法选择2014年7月~2015年6月因骨折在上海浦东新区公利医院骨科行手术治疗的50~60岁绝经后女性60例[平均年龄为(56.7±3.3)岁],按绝经后年限分为绝经后0~5年[平均年龄为(54.5±3.3)岁]和绝经后5~10年[平均年龄为(58.8±0.9)岁]两组,每组各30例。检测患者身高、体重及25-羟基维生素D3[25-(OH)D3]、骨碱性磷酸酶(BALP)、骨钙素(OC)、Ⅰ型胶原交联羧基末端肽(s-CTX)、Ⅰ型原胶原羧基末端肽(PICP)及尿Ⅰ型胶原氨基末端肽(u-NTX)等骨代谢指标。比较两组间一般情况、骨代谢指标的差异。结果血清25-(OH)D3水平在绝经后5~10年女性中较绝经后0~5年女性降低,差异有统计学意义(P<0.05);血清骨碱性磷酸酶、骨钙素、s-CTX、PICP及u-NTX水平在绝经后0~5年女性与5~10年女性差异无统计学意义(P>0.05)。结论血清25-(OH)D3随着绝经年限的增加而降低,50~60岁绝经后女性应及时补充维生素D3,预防和延缓骨折的发生。

Objective To investigate the changes of bone metabolism markers in postmenopausal women between 50 and 60 years of age with fractures. Methods From July 2014 to June 2015, in Shanghai Pudong New Area Gongli Hospital, 60 postmenopausal women between 50 and 60 years old [average age was(56.7 ±3.3) years] with fractures treated in were selected. The patients were divided into two groups by years after postmenopause, including 30 cases of0-5 years(average: 54.5±3.3) after postmenopause, 30 cases of 5-10 years [average age was(58.8±0.9) years] after postmenopause. All the patients were measured height, weight, and bone metabolism markers, including 25 hydroxy vitamin D3[25-(OH)D3], bone isoenzyme of alkaline phosphatase(BALP), Osteocalcin(OC), C-terminal crosslinking telopeptides of type Ⅰ collagen(u-NTX), type Ⅰ procollagen carboxy-terminal peptide(PICP) and N-terminal crosslinking telopeptides of type Ⅰ collagen(s-CTX). The differences in general and bone metabolism between the two groups were analyzed. Results Serum levels of 25-(OH)D3in 5-10 years after postmenopause group decreased significantly compared with 0-5 years after postmenopause group, the differences were statistically significant(P <0.05). There was no significant difference in serum BALP, OC, s-CTX, PICP, and u-NTX between 0-5 years postmenopause group and 5-10 years after postmenopause group, the differences were not statistically significant(P >0.05). Conclusion Serum levels of 25-(OH)D3decreased while the years after postmenopause increased.Postmenopausal women between 50 and 60 years old should promptly add vitamin D3 in order to prevent and delay the onset of fracture in postmenopausal women between 50 and 60 years old.