老年骨质疏松患者骨密度、骨代谢指标与25羟化维生素D_(3)相关性  

Correlation Between Bone Mineral Density,Bone Metabolism Index and 25 Hydroxyvitamin D_(3)in Elderly Patients with Osteoporosis

作　　者：李毅[1] 秦逸辉 余研 蔡累 冯茜[1] 钟素 许细萍 LI Yi;QIN Yihui;YU Yan;CAI Lei;FENG Qian;ZHONG Su;XU Xiping(The 73rd Group Army Hospital of the Chinese People's Liberation Army Cadre Ward,Xiamen 361003,China)

机构地区：[1]中国人民解放军陆军第73集团军医院干部病房,厦门361003

出　　处：《中国医药指南》2024年第5期50-53,共4页Guide of China Medicine

摘　　要：目的分析老年骨质疏松患者骨密度、骨代谢指标(骨形成标志物、骨吸收标志物)与25羟化维生素D_(3)(25-OH VitD_(3))的相关性,探讨25-OH VitD_(3)在老年骨质疏松患者筛查及治疗中临床价值。方法选择2022年1月至2023年1月本院收治的96例老年骨质疏松患者(骨质疏松组)及50例健康体检人员(健康组)作为研究对象,入组对象入院后均采用双能X线骨密度吸收仪测量骨密度(腰椎L_(1)~L_(4)、左侧股骨颈、左侧股骨上端),使用荧光免疫层析法测定血清25-OH VitD_(3),使用酶联免疫吸附法测定骨形成标志物(骨保护素、骨碱性磷酸酶、骨钙素、Ⅰ型前胶原氨基端前肽、甲状旁腺激素)和骨吸收标志物(β-胶原降解产物),比较骨质疏松组和健康组骨代谢指标、25-OH VitD_(3)水平差异,采用Person相关性分析骨密度、骨代谢指标与25-OH VitD_(3)相关性。结果骨质疏松组患者的腰椎L_(1)~L_(4)(0.76±0.12)g/cm^(2)、左侧股骨颈(0.60±0.10)g/cm^(2)、左侧股骨上端(0.65±0.13)g/cm^(2)的骨密度均明显低于对照组(1.22±0.15)g/cm^(2)、(0.94±0.13)g/cm^(2)、(1.02±0.11)g/cm^(2),均P<0.05。骨质疏松组患者骨保护素(2.85±0.30)ng/ml、骨碱性磷酸酶(15.08±1.58)U/L、骨钙素(4.02±0.58)ng/ml、Ⅰ型胶原氨基端前肽(967.55±103.24)pg/ml、甲状旁腺激素(49.84±1.58)ng/L、25-OH VitD_(3)(19.63±2.45)ng/ml均明显低于健康组[(4.66±0.45)ng/ml、(21.35±3.35)U/L、(6.04±0.68)ng/ml、(1306.12±108.65)Pg/ml、(57.37±1.45)ng/L、(25.66±2.28)ng/ml],β-胶原降解产物(0.83±0.15)ng/ml明显高于健康组(0.65±0.12)ng/ml,均P<0.05。经Person相关性分析显示,骨密度(r=0.702,P<0.05)、骨保护素(r=0.741,P<0.05)、骨碱性磷酸酶(r=0.741,均P<0.05)、骨钙素(r=0.742,P<0.05)、Ⅰ型胶原氨基端前肽(r=0.677,P<0.05)、甲状旁腺激素(r=0.762,P<0.05)与25-OH VitD_(3)呈正相关,β-胶原降解产物(r=-0.762,P<0.05)与25-OH VitD_(3)呈负相关。结论老年骨质疏松患者骨�Objective To analyze the correlation between bone mineral density,bone metabolism(bone formation markers,bone resorption markers)and vitamin 25 hydroxylated D_(3)in elderly patients with osteoporosis,and to explore the clinical value of vitamin 25 hydroxylated D_(3)in screening and treatment of elderly patients with osteoporosis.Methods A total of 96 elderly patients with osteoporosis(osteoporosis group)and 50 healthy physical examination personnel(healthy group)admitted to our hospital from January 2022 to January 2023 were selected as study subjects.Bone mineral density(lumbar L_(1)-L_(4),left femoral neck,left femur top)was measured by dual-energy X-ray absorptiometry after admission.25 hydroxylated vitamin D_(3)was determined by fluorescence immunochromatography,bone formation markers(osteoprotectin,bone alkaline phosphatase,osteocalcin,type I collagen amino terminal propeptide,parathyroid hormone)and bone resorption markers(β-collagen degradation products)were determined by enzyme linked immunosorbent assay.The differences of bone metabolism indexes and 25 hydroxyvitamin D_(3)levels between the osteoporosis group and the healthy group were compared,and the correlation between bone mineral density,bone metabolism indexes and 25 hydroxyvitamin D_(3)was analyzed by Person.Results The BMD of L_(1)-L_(4)(0.76±0.12)g/cm^(2),left femoral neck(0.60±0.10)g/cm^(2)and left femur upper end(0.65±0.13)g/cm^(2)in osteoporosis group were significantly lower than those of control group(1.22±0.15)g/cm^(2)and(0.94±0.13)g/cm^(2),(1.02±0.11)g/cm^(2),P<0.05.Osteoporotic group included(2.85±0.30)ng/ml,(15.08±1.58)U/L,(4.02±0.58)ng/ml,(967.55±103.24)Pg/ml,and(49.84±1.58)ng of parathyroid hormone/L,25 hydroxylated vitamin D_(3)(19.63±2.45)ng/ml was significantly lower than that in healthy group[(4.66±0.45)ng/ml,(21.35±3.35)U/L,(6.04±0.68)ng/ml,(1306.12±108.65)Pg/ml,(57.37±1.45)ng/L,(25.66±2.28)ng/ml],β-collagen degradation products(0.83±0.15)ng/ml were significantly higher than those in healthy group(0.65±0.12)

关 键 词：老年 骨质疏松 骨密度 骨代谢指标 25羟化维生素D_(3) 

分 类 号：R589.5[医药卫生—内分泌]