中老年妇女骨转换生化指标和骨密度的变化  

Changes of biochemical markers of bone turnover and bone mineral density in mid- and old.aged women

作　　者：刘红[1] 廖二元[1] 伍贤平[1] 张红[1] 谢辉[1] 曹行之[1] 

机构地区：[1]中南大学湘雅二医院代谢内分泌研究所,长沙410011

出　　处：《中华内分泌代谢杂志》2009年第2期164-167,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：卫生部临床学科重点项目（2001035427）

摘　　要：目的探讨中老年妇女骨转换生化指标与骨密度随绝经的变化。方法408名符合条件40～80岁的女性志愿者，同一时间段留取血清和晨尿，统一用酶免方法测定血清骨碱性磷酸酶（BAP）、骨钙素和尿Ⅰ型胶原氨基末端肽（uNTX）；用双能X线骨密度仪测定前后位腰椎1-4（L1-4）、左侧股骨颈的骨密度。结果（1）BAP、骨钙素和uNTX与年龄、孕次、生育次数和绝经年限呈正相关（均P〈0．01）；L1-4和股骨颈部位的骨密度与年龄、孕次、生育次数和绝经年限呈负相关（均P〈0．01）。（2）40～55岁绝经后妇女BAP、骨密度和uNTX水平均较绝经前妇女高（P〈0．01），而绝经后妇女的L1-4、股骨颈部位的骨密度均低于绝经前妇女（P〈0．01）。（3）绝经年限1～5年组、6～10年组、11～15年组和≥16年组的BAP、骨钙素和uNTX均较绝经前组增高（P〈0．01），尤其在绝经后前5年迅速升高，而L1-4、股骨颈部位的骨密度则急剧降低。（4）骨质疏松组和低骨量组BAP、骨钙素和uNTX浓度均高于骨量正常组（P〈0．05）。结论妇女绝经后骨密度降低，骨质疏松的发生与高骨代谢转换率有关。因此监测骨转换生化指标有助于绝经后骨质疏松症的早期防治。Objective To study the changes of biochemical markers of bone turnover and bone mineral density （BMD） in mid- and old-aged women. Methods A total of 408 female volunteers aged 40 to 86 years were enrolled. Serum bone alkaline phosphatase （BAP）, osteocaltin and urine type Ⅰ collagen N-telopeptide （uNTX） were measured using ELISA, and BMD at anteroposterior lumbar spine 1-4 （L1-4） and femoral neck （FN） was detected by dual energy X-ray absorptiometry （QDR4500A）. Results （ 1 ） Serum BAP, osteocahin and uNTX levels were positively correlated with age, parity, number of births and duration of menopause （all P〈0.01 ） , while BMD at L1-4 and FN were negatively correlated with age, parity, number of births and duration of menopause （all P〈0.01 ）. （2） In subjects aged 40 to 55 years, levels of serum BAP, osteocaltin and uNTX significantly increased in postmenopausal women compared with premenopausal women, whereas BMD at L1-4 and FN decreased （all P〈0.01 ）. （3） The levels of the bone biomarkers increased rapidly, but those of BMD at both sites decreased abruptly within five years after menopause （all P〈0.01 ）. （4） Serum BAP, osteocaltin and uNTX values in women with osteoporosis and osteopenia were lower than those in normal BMD women （ all P〈0.05）. Conclusion Increased bone biomarker levels in postmenopausal women are associated with a decreased BMD value and increased risk factors for osteoporosis. Measurment of the biochemical markers of bone turnover seems to be helpful for early diagnosis and prevention of osteoporosis.

关 键 词：骨转换生化指标 骨密度 绝经 

分 类 号：R580[医药卫生—内分泌]