绝经后骨质疏松症患者血清几丁质酶壳三糖苷酶、血管活性肠肽水平与骨密度及骨代谢标志物的相关性研究  

Correlation between Serum Levels of Chitotriosidase1, Vasoactive Intestinal Peptide and Bone Mineral Density and Bone Turnover Indicators in Postmenopausal Osteoporosis Patients

作　　者：黄燕红 黄丽玲[2] 雷美红[1] 林小英 李哲立 HUANG Yan-hong;HUANG Li-ling;LEI Mei-hong;LIN Xiao-ying;LI Zhe-li(Department of Endocrinology and Rheumatology,909 Hospital of Joint Service Support Force of PLA/Southeast Hospital Affiliated to Xiamen University,Fujian Zhangzhou 360000,China;Department of Obstetrics and Gynecology,909 Hospital of Joint Service Support Force of PLA/Southeast Hospital Affiliated to Xiamen University,Fujian Zhangzhou 360000,China)

机构地区：[1]解放军联勤保障部队第909医院/厦门大学附属东南医院内分泌风湿科,福建漳州360000 [2]解放军联勤保障部队第909医院/厦门大学附属东南医院妇产科,福建漳州360000

出　　处：《现代检验医学杂志》2022年第2期179-183,189,共6页Journal of Modern Laboratory Medicine

基　　金：2017年省卫生计生科技人才培养项目资助(2017CXB0128)。

摘　　要：目的 探讨绝经后骨质疏松症(postmenopausalosteoporosis,PMOP)患者血清几丁质酶壳三糖苷酶1(Chitortiosidase1,CHIT1),血管活性肠肽(vasoactiveintestinalpeptide,VIP)水平与骨密度及骨代谢标志物的相关性。方法 纳入厦门大学附属东南医院2017年12月~2020年12月收治的PMOP患者60例为PMOP组,取同期于医院体检的绝经后妇女60例为对照组,比较两组血清CHIT1和VIP水平、腰椎L1-4和股骨颈的骨密度、甲状旁腺素(parathyroidhormone,PTH)、I型羧基端交联端肽胶原(typeIcollagecross-linked-telopeptide,CTX)和I型前胶原氨基端前肽(procollagenIN-terminalpeptide,PINP)水平,分析上述指标的相关性,观察PMOP发生的影响因素。结果 PMOP组血清CHIT1(9.64±2.25),CTX(0.52±0.13mg/L),PINP(60.84±23.51mg/L)水平高于对照组(5.83±1.26nmol/mol/h,0.25±0.07mg/L,39.83±12.52mg/L),血清VIP(161.32±27.86pg/ml),PTH(10.49±2.52pmol/L)水平以及腰椎L1-4(0.74±0.13g/cm^(2)),股骨颈的骨密度(0.62±0.0.14g/cm^(2))低于对照组(302.61±43.92pg/ml,15.19±4.64pmol/L,1.19±0.16g/cm^(2),0.88±0.12g/cm^(2)),差异均有统计学意义(t=6.110~21.042,均P=0.000)。PMOP患者血清CHIT1水平与血清PTH,腰椎L1-4,股骨颈的骨密度呈负相关(r=-0.327,-0.479,-0.485,均P<0.05),与血清CTX,PINP水平呈正相关(r=0.482,0.423,均P<0.05),血清VIP水平与血清PTH,腰椎L1-4,股骨颈的骨密度呈正相关(r=0.515,0.482,0.535,均P=0.000),与血清CTX,PINP水平呈负相关(r=-0.414,-0.386,均P<0.05)。Logistic回归分析提示,CHIT1>7.73nmol/mol/h是PMOP发生的危险因素,而VIP>231.97pg/ml,腰椎L1-4骨密度>0.97g/cm2是预防PMOP发生的保护性因素(P<0.05)。结论 PMOP患者血清CHIT1水平增高,而VIP水平降低,且二者均与腰椎L_(1-4),股骨颈骨密度以及骨代谢标志物有相关性,临床有望将二者作为评估PMOP病情的辅助指标。Objective To explore the correlation between serum levels of chitotriosidase1 (CHIT1) and vasoactive intestinal peptide (VIP), bone metabolic markers and bone turnover indicators in postmenopausal osteoporosis (PMOP) patients. Methods60 PMOP patients admitted to the Southeast Hospital of Xiamen University from December 2017 to December 2020 were included in the PMOP group, and 60 postmenopausal women who received physical examination in the hospital during the same period were selected as the control group. The levels of serum CHIT1, VIP, lumbar L1-4, bone mineral density of femoral neck,parathyroid hormone (PTH), type I collage cross-linked-telopeptide(CTX) and procollagen Ⅰ N-terminal peptide(PINP)were compared between the two groups. The correlation of the above indexes were analyzed, and the influencing factors of PMOP were observed. Results The levels of serum CHIT1(9.64±2.25nmol/mol/h), CTX(0.52±0.13mg/L) and PINP(60.84±23.51mg/L) in the PMOP group were higher than those in the control group(5.83±1.26nmol/mol/h, 0.25±0.07mg/L, 39.83±12.52mg/L). The levels of serum VIP(161.32±27.86pg/ml), PTH(10.49±2.52pmol/L) and bone mineral density of lumbar spine L1-4(0.74±0.13g/cm^(2)), femoral neck (0.62±0.0.14g/cm^(2)) were lower than those in the control group(302.61±43.92pg/ml, 15.19±4.64pmol/L, 1.19±0.16g/cm^(2), 0.88±0.12g/cm^(2)), the differences were statistically significant (t=6.110~21.042, all P=0.000). Serum CHIT1 levels in PMOP patients were negatively correlated with serum PTH and bone mineral density of lumbar spine L1-4, femoral neck(r=-0.327, -0.479, -0.485, all P < 0.05), and positively correlated with serum CTX and PINP levels(r=0.482, 0.423, all P < 0.05). Serum VIP levels were positively correlated with serum PTH and bone mineral density of lumbar spine L1-4, femoral neck(r=0.515, 0.482, 0.535, all P=0.000), and negatively correlated with serum CTX and PINP levels (r=-0.414, -0.386, all P < 0.05). Logistic regression showed that CHIT1 > 7.73nmol / mol / h was a risk factor for PMOP,

关 键 词：绝经后骨质疏松症 几丁质酶壳三糖苷酶 血管活性肠肽 骨密度 骨代谢 

分 类 号：R591.44[医药卫生—内科学] R446.11[医药卫生—临床医学]