健康汉族男女性血清骨转换生化指标P1NP和β-CTX浓度范围再分析  

Re-analysis of serum procollagen type 1 N-terminal propeptide andβ cross-linked C-telopeptide of type Ⅰ collagen concentrations in healthy men and women of Han nationality

作　　者：李梅[1] 章振林[2] 李艳[3] 邓伟民[4] 邓忠良[5] 胡莹莹[1] 吕芳[1] 徐苓[6] 夏维波[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内分泌科国家卫生和计划生育委员会内分泌重点实验室,北京100730 [2]上海交通大学第六人民医院骨质疏松科,上海200233 [3]湖北省人民医院检验科,武汉430060 [4]广州军区广州总医院老年科,广州510010 [5]重庆医科大学附属第二医院骨科,重庆400010 [6]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2016年第1期7-13,共7页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家科学技术重大课题(2008ZX09312-016);北京市自然科学基金(7121012)

摘　　要：目的根据健康汉族男女性血清Ⅰ型原胶原氨基端肽（procollagen type 1 N-terminal propeptide,P1NP）和Ⅰ型胶原羧基端肽交联（βcross-linked C-telopeptide of type 1 collagen,β-CTX）浓度,按照不同年龄段进行分层再分析,建立简便的参考范围。方法纳入位于中国不同纬度5个城市的健康汉族受试者,采用化学发光法检测血清骨形成指标P1NP及骨吸收指标β-CTX浓度,并检测骨代谢调节激素甲状旁腺素（parathyroid hormone,PTH）及25羟维生素D（25 hydroxy vitamin D,25OHD）水平。采用自动分析仪检测肝肾功能及血清钙、磷浓度。按照〈30岁;男性：30～50岁,女性：30岁～绝经前;男性：51～70岁,女性：绝经～70岁;〉70岁不同年龄段,分层分析男女性β-CTX和P1NP浓度范围。结果纳入健康受试者1 436人,其中女性936人（65.18%）,男性500人（34.82%）。受试者平均年龄（50.6±19.6）岁（15～110岁）。血清P1NP及β-CTX浓度呈非正态分布,总人群P1NP和β-CTX浓度中位数分别是49.36 ng/m L（95%CI：18.79～155.55 ng/m L）及0.37 ng/m L（95%CI：0.11～0.90 ng/m L）。女性按30岁～绝经前作为正常参考人群,血清P1NP及β-CTX浓度范围95%CI分别为17.10～102.15及0.08～0.72 ng/m L;以30～50岁男性为正常参考人群,血清P1NP及β-CTX浓度95%CI分别是20.29～110.53及0.11～0.83 ng/m L。结论在健康汉族大样本男女性建立不同年龄段血清P1NP及β-CTX浓度的正常范围,30岁以下男女性及女性绝经后20年骨转换处于较高水平。Objective To investigate the serum P1 NP and β-CTX reference range in healthy Chinese according to different age stratification from the previous study. Methods We included healthy volunteers in 5 Chinese cities at different latitudes. Serum levels of procollagen type 1 N-terminal propeptide（ P1NP）,β cross-linked C-telopeptide of type1 collagen（ β-CTX）,parathyroid hormone（ PTH） and 25 hydroxy vitamin D（ 25OHD） were measured by chemiluminescence assay. Serum levels of calcium and phosphorus,hepatic and renal function were detected by automatic biochemical analyzer. Serum P1 NP and β-CTX levels were assessed by stratification of age and gender. Results A total of 1 436subjects（ M∶ F = 500∶ 936） with average age of 50. 6 ± 19. 6（ 15- 110） years were enrolled. They exhibited non-normally distributed P1 NP and β-CTX. The median P1 NP and β-CTX levels were 49. 36（ 95% CI： 18. 79- 155. 55） ng / m L and0. 37（ 95% CI： 0. 11- 0. 90） ng / m L,respectively. In women between 30 years old to menopause,95% confidence interval of serum P1 NP and β-CTX concentrations were 17. 10- 102. 15 ng / m L and 0. 08- 0. 72 ng / m L. In men between30- 50 years old,95% confidence interval of serum P1 NP and β-CTX levels were 20. 09- 110. 53 and 0. 11- 0. 83 ng / m L.Conclusions We established reference ranges for serum P1 NP and β-CTX in healthy Chinese individuals. Higher bone turnover level was found in women and men less than 30 years old and women within 20 years since menopause.

关 键 词：骨转换生化指标 1型胶原羧基端肽交联 血清1型原胶原氨基端肽 

分 类 号：R681[医药卫生—骨科学]