骨代谢生化指标测定在中老年骨质疏松症早期诊断中的应用研究

摘要

目的：探讨测定骨代谢生化指标在中老年骨质疏松症的早期诊断的应用价值。方法选择2012年10月至2013年10月在该院健康管理中心进行体检的241例中老年体检者，测定腰椎正位骨密度，根据不同骨密度分为正常骨量组（n＝66）、骨量减少组（n＝58）、骨质疏松组（n ＝63）、严重骨质疏松组（n ＝54），检测所有入选者的空腹血清中抗酒石酸酸性磷酸酶5b （TRACP5b）、骨特异性碱性磷酸酶（B-ALP）及胰岛素样生长因子-1（IGF-1）水平，对生化指标值分别进行统计分析。结果血清TRACP5b、B-ALP 及 IGF-1水平在4组间比较差异均有统计学意义（P ＜0.05）。骨量减少组、骨质疏松组、严重骨质疏松组别与正常骨量组比较，差异均有统计学意义（P ＜0.05）；血清 TRACP5b、B-ALP 的水平随着骨量的降低而升高（P ＜0.05），而血清IGF-1水平随着骨量的降低而降低（P ＜0.05）。结论检测血清 TRACP5b、B-ALP 及 IGF-1水平有助于中老年原发性骨质疏松症的早期诊断和治疗。%Objective To investigate the application value of determining the levels of biochemical indexes of bone metabolism in the early diagnosis of middle and old age osteoporosis.Methods 241 middle and old aged individuals undergoing the physical exami-nation in the health management center of our hospital from October 2012 to October 2013 were selected,determined the bone min-eral density(BMD)of the lumbar spine and divided into the normal bone mass group(n=66),osteopenia group(n=58),osteoporosis group(n= 63 )and severe osteoporosis group(n =54)according to the different BMD.The serum levels of bone-specific alkaline phosphatase(B-ALP),insulin-like growth factor-1(IGF-1)and tartrate-resistant acid phosphatase 5b(TRACP5b)were detected.The detection values of biochemical markers of bone metabolism in the four groups were statistically analyzed.Results There were sta-tistically significant differences in the serum levels of TRACP5b,B-ALP and IGF-1 among the four groups(P <0.05).The serum levels of TRACP5b,B-ALP and IGF-1 also had statistically significant differences between the osteopenia group,osteoporosis group and severe osteoporosis group with the normal bone mass group too(P <0.05);the serum levels of TRACP5b and B-ALP were in-creased with the decrease of bone mass(P <0.05),while the serum level of IGF-1 was decreased with the decrease of bone mass(P<0.05).Conclusion Detecting the serum levels of TRACP5b,B-ALP and IGF-1 is conducive to the early diagnosis of middle and old age primary osteoporosis.