健康汉族男女性血清骨转换生化指标P1 NP和β－CTX浓度范围再分析

摘要

目的：根据健康汉族男女性血清Ⅰ型原胶原氨基端肽（ procollagen type 1 N－terminal propeptide， P1NP）和Ⅰ型胶原羧基端肽交联（βcross－linked C－telopeptide of type 1 collagen，β－CTX）浓度，按照不同年龄段进行分层再分析，建立简便的参考范围。方法纳入位于中国不同纬度5个城市的健康汉族受试者，采用化学发光法检测血清骨形成指标P1NP及骨吸收指标β－CTX浓度，并检测骨代谢调节激素甲状旁腺素（ parathyroid hormone， PTH）及25羟维生素D （25 hydroxy vitamin D，25OHD）水平。采用自动分析仪检测肝肾功能及血清钙、磷浓度。按照＜30岁；男性：30～50岁，女性：30岁～绝经前；男性：51～70岁，女性：绝经～70岁；＞70岁不同年龄段，分层分析男女性β－CTX和P1NP浓度范围。结果纳入健康受试者1436人，其中女性936人（65．18％），男性500人（34．82％）。受试者平均年龄（50．6±19．6）岁（15～110岁）。血清P1NP及β－CTX浓度呈非正态分布，总人群P1NP和β－CTX浓度中位数分别是49．36 ng／mL （95％ CI：18．79～155．55 ng／mL）及0．37 ng／mL （95％CI：0．11～0．90 ng／mL）。女性按30岁～绝经前作为正常参考人群，血清P1NP及β－CTX浓度范围95％CI分别为17．10～102．15及0．08～0．72 ng／mL；以30～50岁男性为正常参考人群，血清P1NP及β－CTX浓度95％CI分别是20．29～110．53及0．11～0．83 ng／mL。结论在健康汉族大样本男女性建立不同年龄段血清P1NP及β－CTX浓度的正常范围，30岁以下男女性及女性绝经后20年骨转换处于较高水平。%Objective To investigate the serum P1NP andβ-CTX reference range in healthy Chinese according to different age stratification from the previous study.Methods We included healthy volunteers in 5 Chinese cities at dif-ferent latitudes.Serum levels of procollagen type 1 N-terminal propeptide ( P1NP) , βcross-linked C-telopeptide of type 1 collagen (β-CTX), parathyroid hormone (PTH) and 25 hydroxy vitamin D (25OHD) were measured by chemilumi-nescence assay.Serum levels of calcium and phosphorus, hepatic and renal function were detected by automatic biochem-ical analyzer.Serum P1NP andβ-CTX levels were assessed by stratification of age and gender.Results A total of 1 436 subjects ( M∶F=500∶936) with average age of 50.6 ±19.6 (15-110) years were enrolled.They exhibited non-normally distributed P1NP andβ-CTX.The median P1NP and β-CTX levels were 49.36 (95% CI:18.79-155.55) ng/mL and 0.37 (95%CI: 0.11-0.90) ng/mL, respectively.In women between 30 years old to menopause, 95%confidence in-terval of serum P1NP andβ-CTX concentrations were 17.10-102.15 ng/mL and 0.08-0.72 ng/mL.In men between 30-50 years old, 95%confidence interval of serum P1NP andβ-CTX levels were 20.09-110.53 and 0.11-0.83 ng/mL. Conclusions We established reference ranges for serum P1NP and β-CTX in healthy Chinese individuals.Higher bone turnover level was found in women and men less than 30 years old and women within 20 years since menopause.