女性年龄相关的骨形成指标变化与骨密度减少的关系  

Age-related changes of markers of bone formation and the relationship with bone mineral density decreasing rates in women

作　　者：王丹丹[1,2] 伍西羽[1,2] 廖二元[1,2] 张红[1,2] 罗湘杭[1,2] 戴如春[1,2] 盛志峰[1,2] 彭依群[1,2] 伍贤平[1,2] 

机构地区：[1]中南大学代谢内分泌研究所,长沙410011 [2]湘雅二医院内分泌科,长沙410011

出　　处：《中华内分泌代谢杂志》2013年第4期297-301,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 调查女性骨形成指标骨特异性碱性磷酸酶（BAP）、骨钙素和总碱性磷酸酶（TALP）与骨密度减少率之间的关系。方法 年龄横断面研究891名排除疾病和药物因素影响骨代谢的成年女性，年龄20-80岁。测量受试者腰椎、髋部和前臂远端骨密度与骨密度减少率，测定血清BAP、骨钙素和TALP，分析这些指标与骨密度减少率之间的关系。结果 骨形成指标与各骨骼部位骨密度减少率呈显著负相关，其中与骨钙素的负相关程度较好（r =-0.439和-0.519，均P〈0.01）。调整年龄和体重指数之后，这些指标与骨密度减少率的偏相关系数仍然有显著性意义。多元线性回归分析显示，骨形成指标对骨密度减少率是负性决定因素，其中骨钙素对各骨骼部位骨密度减少率的影响最大，可以分别解释骨密度减少率变异的19.2%～26.7%；BAP可以解释腰椎和前臂骨密度减少率变异的9.0%和0.8%，但对股骨颈和髋部骨密度减少率的影响被剔除；TALP可以解释骨密度减少率变异的0.6%-5.0%。结论 本研究揭示了女性骨形成指标与骨密度减少的关系，提示骨钙素可能是骨密度减少的重要预测因子，其增加可能与骨质疏松患病风险有关。Objective To investigate the relationship between bone formation markers, including bone-specific alkaline phosphatase（BAP）, osteocalcin, total alkaline phosphatase（TALP）, and bone mineral density decreasing rate（BDR）. Methods A cross-sectional study was made in 891 healthy adult women with ages ranging from 20 to 80 years old. Bone mineral density and BDR at posteroanterior spine, the left hip and the left forearm were measured. Levels of serum BAP, osteocalcin, and TALP were detected. The relationship between above bone formation markers and BDR was analysed. Results BDR at various skeletal sites had significant negative correlation with bone formation markers, especially for osteocalcin（r=-0.439 and -0.519, both P〈0.01）. After adjustment of age and body mass index, serum BAP, osteocalcin, and TALP, it still exhibited significant correlations with BDR. Stepwise multiple linear regression analysis showed that, bone formation markers were negative determinant factors of BDR, in which, serum osteocalcin was the most significant negative determinant of BDR, between 19.2% to 26.7% of the changes in BDR were determined by serum osteocalcin; 9.0% and 0.8% of the changes in BDR in spine and forearm, respectively, were determined by serum BAP, whereas its determining effect on femoral neck and total hip was excluded; only 0.6% to 5.0% of the changes in BDR were determined by serum TALP. Conclusion The study indicates the correlation between bone formation markers and bone mineral density decreaseing in women and suggests that, serum osteocalcin is the key determining factor of bone mineral density decreasing, the increase of which may be related with osteoporosis risk.

关 键 词：骨形成指标 骨特异性碱性磷酸酶 骨钙素 总碱性磷酸酶 骨密度减少率 

分 类 号：R580[医药卫生—内分泌]