胶东半岛健康成年人群骨代谢生化指标与骨密度相关性研究

摘要

目的 研究胶东半岛健康成年人群腰椎(L2-L4)骨密度(BMD)与抗酒石酸酸性磷酸酶(TRAP5b)、Ⅰ型胶原C端肽(CTX)、骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)、降钙素(CT)、25-羟基维生素D[25(OH)D]、血清钙(Ca)和磷(P)的相关关系.方法 采用双能X线骨密度仪(DXA)对胶东半岛沿海地区多中心多阶段整群抽样436名21～89岁居民进行BMD测量;采用美国Thermo公司酶标免疫分析仪和HITACHI日立7600-20全自动生化分析仪检测骨代谢指标.将436例受试者按不同性别,每10岁为1个年龄段分组;应用SPSS 13.0分析软件进行统计分析.结果 21～49岁人群TRAP-5b、CTX、BALP、BGP等指标性别间不存在差异;50～89岁人群性别间差异显著,女性高于男性.TRAP-5b、CTX与BMD负相关;女性BALP、BGP在50～69年龄段明显升高,与BMD负相关,70岁以后开始下降.25(OH)D与BMD正相关;CT降低出现在60～89岁年龄段,与BMD显著正相关.血清Ca和P无明显差异.结论 骨代谢指标测定是监测骨量变化及骨质疏松早期诊断的重要技术手段.不同年龄女性骨形成/骨吸收标志物比率不同,绝经后女性骨代谢呈现高转换状态.%Objective To investigate the relationship between bone mineral density (BMD) and serum levels of bone metabolism index including tartrate-resistant acid phosphatase (TRAP-5b) , collagen type Ⅰ carboxy-terminal peptide (CTX), bone alkaline phosphatase ( BALP), bone Gla protein (BGP),calcitonin (CT) , and 25-OH-vitamin D (25-OH-D) in healthy adults in Jiaodong Peninsula of Shandong.Methods Using dual-energy X-ray absorptiometry (DEXA) equipment, BMD was measured among 436 normal people (207 men and 229 women, aged 21-89 years old) in Jiaodong peninsula with a multi-center,multi-staging sampling method.The bone metabolism index was measured using a ELISA analyzer ( USA Thermo) and an automatic biochemical analyzer (HITACHI 7600-20).The 436 subjects were divided into different gender groups with each ten-year of age.SPSS 13.0 software was used for data analysis.Results The levels of TRAP-5b, CTX-1, BALP, and BGP were not significantly different between the two genders in the 21-49 year group.Those were different in the 50-89 year group, being higher in the female than in the male.TRAP-5b and CTX were negatively correlated with BMD.BALP and BGP increased in the 50-69 year group in females, and they were negatively correlated with BMD.The values decreased after 70 years old.25-OH-D was positively correlated with BMD.CT decreased in the 60-89 year age group, and it was positively correlated with BMD.Serum Ca and P were no significant difference.Conclusion The measurement of bone metabolism index provided a significant technical method for monitoring bone mass and early diagnosis of osteoporosis.The ratio of bone formation markers and bone resorption markers was different females of different age.Bone turnover increased in the postmenopausal women.