强直性脊柱炎患者骨代谢生化指标和RANKL-RANK-OPG系统表达之间的相关性  

Correlation of Bone Metabolic Indexes and Levels of RANKL-RANK-OPG System in Ankylosing Spondylitis Patients

作　　者：韦蓉梅 董丽平 吴红慧 徐燕群 张健清[2] 

机构地区：[1]广州市正骨医院检验科,广东广州510045 [2]广州市中山大学第一附属医院检验科,广东广州510045

出　　处：《现代生物医学进展》2013年第13期2528-2531,2546,共5页Progress in Modern Biomedicine

摘　　要：目的:考察强直性脊柱炎(ankylosing spondylitis,AS)患者骨代谢生化指标变化,并分析其与RNAKL-RANK-OPG系统表达之间的相关性。方法:研究对象为40名强直性脊柱炎男性患者,40名健康男性为对照组,记录强直性脊柱炎AS患者的病程,体重指数(body mass index,BMI),甲状旁腺素(parathyroid hormone,PTH),血钙,血磷,碱性磷酸酶(alkaline phosphatase,ALP)等临床指标,采用双能X线吸收法测定AS患者的骨密度(bone mineral density,BMD),利用免疫分析法检测血清中骨吸收指标骨钙素(bone glutamyl protein,BGP),I型强胶原羧基肽(carboxyterminal propeptide of type I procollagen,PICP),骨碱性磷酸酶(bone alkaline phosphatase,BALP),骨吸收指标抗酒石酸酸性磷酸酶(tartrate-resistant acid phosphatase,TRAP)及sRANKL,OPG的表达。分析骨代谢指标,RANKL-RANK-OPG与各项临床指标的相关性。结果:AS患者PICP,BALP,TRAP及sRANKL、OPG的表达较正常对照组存在明显的差异,具有统计学意义。不同部位的骨密度发生不同程度的骨量减少和骨质疏松,股骨颈、大转子、转子间和股骨颈分别为28%、45%、40%和50%,与骨代谢指标存在一定的相关性,TRAP与大转子的骨密度成负相关(r=-0.369,P=0.019),PICP与大转子的骨密度成正相关(r=0.391,P=0.013),BGP与转子间的骨密度成负相关(r=-0.419,P=0.009),sRANKL/OPG与腰椎密度均呈现负相关(r=-0.134,P=0.011)。骨代谢指标之间以及与临床指标也存在不同程度的相关性,sRANKL与OPG存在正相关(r=0.369,P=0.019)sRANKL/OPG与sRANKL、OPG存在负相关(r=-0.334,P=0.035;r=-0.983,P=0.000)。结论:AS患者骨代谢发生异常,骨吸收增强。RANKL-RANK-OPG系统失衡可能是AS骨量减少和伴随发生骨质疏松的机制之一。Objective： To test the bone metabolic indexes of ankylosing spondylitis（AS）,and to analyze the correlation of these data and RANKL-RANK-OPG system.Methods： 40 male AS patients and 40 normal males were studied.All the patients would be recorded about the clinical data,including course of disease,body mass index（BMI）,parathyroid hormone（PTH）,Ca,P of serum and alkaline phosphatase（ALP） and so on.Dual-energy X-ray absorptiometry was used to measure the bone mineral density（BMD）.Bone formation indexes BGP,PICP,BALP,bone absorption index TRAP and sRANKL,OPG were measured by ELISA.And then analyzed the relationship among these parameters.Results： There were differences in the levels of PICP,BALP,TRAP,sRANKL and OPG between AS group and control group.Different degrees of bone loss and osteoporosis appeared in different measurement sites,collum femoris 28 %,trochiter 45 %,intertrochianteric 40 % and lumbar 50 %,and the BMD had a certain correlation to the bone metabolic indexes,TRAP and BMD in trochiter r=-0.369,P=0.019,PICP and BMD in trochiter r=0.391,P=0.013,BGP and BMD in intertrochianteric r=-0.419,P=0.009,sRNAKL/OPG and lumbar r=-0.134,P=0.011.There were different levels of correlation between bone metabolic indexes and clinical data,sRANKL and OPG r=0.369,P=0.019,sRANKL/OPG,sRANKL,sRANKL/OPG and OPG r=-0.983,P=0.000.Conclusion： In AS patients,the bone＇s metabolism had changed and the absorption rate of bone had increased.The unbalance of RANKL-RANK-OPG system would be one of mechanisms of AS with bone loss and osteoporosis.

关 键 词：强直性脊柱炎 骨代谢 RANKL-RANK-OPG系统 骨质疏松 

分 类 号：R593.23[医药卫生—内科学]