新型骨代谢标志物在骨质疏松症中的研究进展  

Research progress of novel bone turnover markers in osteoporosis

作　　者：冯晓霁 周文杰 张静 张益多 余星南 于凡 Feng Xiaoji;Zhou Wenjie;Zhang Jing;Zhang Yiduo;Yu Xingnan;Yu Fan(Department of Laboratory Medicine,West China Second University Hospital,Sichuan University Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu610041,China)

机构地区：[1]四川大学华西第二医院医学检验科,出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《中华预防医学杂志》2024年第12期2045-2055,共11页Chinese Journal of Preventive Medicine

基　　金：四川省科技厅重点研发项目(2023YFS0218)。

摘　　要：骨骼具有代谢活性,由破骨细胞和成骨细胞介导的骨吸收和骨形成维持稳态。通过测量骨代谢标志物,可以反映整体骨代谢状态和全身骨组织的动态变化。传统的骨代谢标志物包括碱性磷酸酶、骨特异性碱性磷酸酶、1型原胶原氨基端前肽、1型原胶原羧基端前肽、骨钙素、1型胶原交联羧基端肽(CTX)及其亚型β-CTX、1型胶原交联氨基端肽等,在临床实践中已广泛应用,但在稳定性、诊断可靠性、特异性反映骨骼部位等方面仍然存在局限。近年来微小RNA、C-X-C样趋化因子配体12、凝溶胶蛋白、膜联蛋白A2、硬化蛋白、Dickkopf相关蛋白1、柠檬酸盐等新型骨代谢标志物得到了广泛关注。本文旨在阐述新型骨代谢标志物的产生及作用机制、检测手段以及在骨质疏松症中的诊断价值和应用前景,以期为骨质疏松症的预防、诊断和治疗提供新的思路。Bones possess metabolic activity,with their homeostasis maintained by bone resorption and bone formation mediated by osteoclasts and osteoblasts.By measuring bone metabolism markers,the overall state of bone metabolism and dynamic changes in systemic bone tissue can be reflected.Traditional bone turnover markers,including alkaline phosphatase,bonespecific alkaline phosphatase,procollagen type 1 N-terminal propeptide,procollagen type 1 C-terminal propeptide,osteocalcin,c-terminal telopeptides of type 1 collagen(CTX)and its subtypeβ-CTX,n-terminal telopeptides of type 1 collagen,have been widely used in clinical practice but still have limitations in terms of stability,diagnostic reliability,and specific reflection of bone sites.Recently,novel bone turnover markers like microRNA,C-X-C chemokine ligand 12,Gelsolin,Annexin A2,sclerostin,Dickkopf-related protein 1,and citrate have garnered significant attention.This article endeavors to conduct a review of the production,mechanism of action,detection methods,diagnostic value,and application prospects of new bone turnover markers in osteoporosis,thereby offering novel ideas for the prevention,diagnosis,and treatment of osteoporosis.

关 键 词：骨代谢 生物标志物 微小RNA 骨质疏松症 

分 类 号：R580[医药卫生—内分泌]