重组人甲状旁腺素（1—34）治疗绝经后骨质疏松症妇女血清骨硬化蛋白水平的变化  

Changes in serum sclerostin in post-menopausal women with osteoporosis treated with recombinant human parathyroid hormone（1-34）

作　　者：蔡婧[1] 周婷婷[1] 郭常辉[1] 杜姝姗[1] 

机构地区：[1]重庆医科大学附属第二医院内分泌科,400010

出　　处：《中华内分泌代谢杂志》2013年第7期575-578,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的了解绝经后妇女血清骨硬化蛋白（sclerostin，SO）水平差异以及予以PTH治疗前后s0水平的变化，进一步探讨s0与雌二醇、骨密度等指标的相关性。方法选择绝经后妇女95例，根据骨密度测量结果分为正常对照组（41例）和骨质疏松组（54例），测量受试者体重指数、血清碱性磷酸酶（ALP）、雌二醇、血钙、磷、s0等。骨质疏松组予以重组人甲状旁腺素（1—34）[rhPTH（1．34）]20μg／d皮下注射，同时口服钙片500mg／d，分别于治疗6个月、12个月时检测受试者血钙、磷、骨密度、血清ALP、雌二醇及s0等指标，并进行统计学分析。结果（1）治疗前骨质疏松组血清sO含量显著高于正常对照组（P〈0．05），s0与雌二醇、骨密度呈负相关，与年龄、绝经年限呈正相关（P〈0．05）；（2）经rhPTH（1．34）治疗6个月和治疗12个月时骨质疏松组血清s0水平较治疗前逐渐下降（P〈0．01）。结论绝经后骨质疏松患者血清s0较正常对照组增高，与雌二醇、骨密度密切相关，经rhPTH（1．34）治疗后血清s0水平逐渐下降，提示s0可能参与了绝经后骨质疏松的发生发展。Objective To investigate changes in serum sclerostin （SO） in postmenopausal women before and after treatment with recombinant human parathyroid hormone （1-34） [ rhPTH （ 1-34 ） ], and to explore the relationship of serum SO with estradiol （ E2 ）, and bone mineral density （BMD）. Methods Ninety-five postmenopausal women were divided into normal BMD group （ n = 41 ） and osteoporosis group （ n = 54）. Body mass index, alkaline phosphatase （ALP）, serum E, calcium, phosphate, and SO were determined in both groups. The patients in osteoporosis group were treated with rhPTH （1-34） 20 μg/d by subcutaneous injection and oral calcium 500 mg/d for 12 months. Serum calcium, serum phosphate, BMD, serum ALP, serum E2, and sclerostin were determined in osteoporosis group by 6 months and 12 months of treatment. Results （ 1 ） Serum level of SO in osteoporosis group was raised significantly as compared with normal BMD group （P 〈 0. 05 ）; E2 and BMD were negatively correlated with SO; age and postmenopausal years were positively correlated with SO （ P 〈 0.05 ）. （ 2 ） Serum SO was reduced gradually with treatment of rhPTH （ 1-34 ） by 6 months and 12 months （ P 〈 0.05 ）. Conclusions Serum SO was increased in postmenopausal women, which was related to E2 and BMD, and was reduced gradually with treatment of rhPTH （1-34）. SO may participate in the development of postmenopausal osteoporosis.

关 键 词：重组人甲状旁腺素(1-34) 骨硬化蛋白 骨质疏松 绝经后 

分 类 号：R580[医药卫生—内分泌]