老年骨质疏松症患者骨代谢标志物及骨密度相关性分析  

Correlation analysis of bone metabolism markers and bone density in elderly patients with osteoporosis

作　　者：王璐[1] 黄华 彭超 杨玉涛 蒋光芬 WANG Lu;HUANG Hua;PENG Chao;YANG Yutao;JIANG Guangfen(Beijing Jishuitan Hospital Guizhou Hospital Guiyang,Guizhou 550014;Guiyang First People's Hospital Guiyang,Guizhou 550002;Third Affiliated Hospital of Guizhou University of TCM Guiyang,Guizhou 550003;Guizhou Provincial Workers'Hospital Guiyang,Guizhou 550025)

机构地区：[1]北京积水潭医院贵州医院,贵州贵阳550014 [2]贵阳市第一人民医院,贵州贵阳550002 [3]贵州中医药大学第二附属医院,贵州贵阳550003 [4]贵州省职工医院,贵州贵阳550025

出　　处：《智慧健康》2025年第1期33-36,共4页Smart Healthcare

摘　　要：目的探索老年骨质疏松患者骨代谢指标变化与骨密度的关系。方法采用回顾性研究方法,选取2022年4月—2024年9月就诊于北京积水潭医院贵州医院骨内三病区住院的48例老年骨质疏松患者为研究主体,将其纳入骨质疏松组。另外,选取同期住院且年龄差异不显著的骨量正常和减少人群48例纳入无骨质疏松组。检测患者骨密度,并检测两组患者空腹Ⅰ型前胶原氨基末端前肽(PINP)、N端骨钙素中段分子(N-MID)、β-Ⅰ型胶原交联羧基末端肽(β-CTX)、甲状旁腺激素(PTH)和25羟基维生D水平。通过统计学方法比较分析年龄、性别、BMI等与骨代谢指标的相关性。结果骨质疏松症组女性多于男性,体重及BMI水平低于无骨质疏松组,差异有统计学意义(P<0.05)。骨质疏松症组骨密度的水平明显低于无骨质疏松组,N-MID的水平高于无骨质疏松组,差异有统计学意义(P<0.05),两组血清25-OH-VD、β-CTX、Toal-P1NP、PTH比较,差异无统计学意义(P>0.05)。骨质疏松组及无骨质疏松组中男女骨密度和骨代谢指标对比,差异均无统计学意义(P>0.05)。结论骨代谢指标可及时反映骨转换状态,具有灵敏度高、特异性强等特点,结合临床骨密度测定,有利于骨质疏松症诊断分型、代谢性骨病的鉴别诊断、预测骨折风险、抗骨质疏松治疗及疗效评价。Objective To observe the correlation between changes in bone metabolism indicators and bone density in elderly patients with osteoporosis.Methods Using retrospective research method,48 elderly patients with osteoporosis who were hospitalized in the third orthopedic ward of Guizhou Hospital in beijing jishuitan hospital from April 2022 to September 2024 were selected as the research subjects and included in the osteoporosis group.In addition,48 patients with normal and decreased bone mass who were hospitalized in the same period and had no significant age difference were selected and included in the osteoporosis-free group.The bone mineral density (BMD) of the patients in the contralateral side was examined,and the levels of fasting procollagen type I N-terminal propeptide (PINP),N-terminal osteocalcin (N-MID),β-type I collagen cross-linked carboxy-terminal peptide (β-CTX),parathyroid hormone (PTH) and 25-hydroxy vitamin D were detected in the two groups.The correlation between age,sex,BMI and bone metabolism index was compared and analyzed by statistical method.Results There were more women than men in osteoporosis group,and the weight and BMI levels were lower than those in non-osteoporosis group,with statistical significance (P<0.05).The level of bone mineral density in osteoporosis group was significantly lower than that in non-osteoporosis group,and the level of N-MID was higher than that in non-osteoporosis group,with statistical significance (P<0.05).There were no statistical differences in serum 25-OH-VD,β-CTX,Toal-P1NP and PTH between the two groups (P>0.05).Conclusion Bone metabolism indicators can reflect bone turnover status in a timely manner,with high sensitivity and strong specificity.Combined with clinical bone density measurement,it is beneficial for the diagnosis and classification of osteoporosis,differential diagnosis of metabolic bone diseases,prediction of fracture risk,anti osteoporosis treatment,and efficacy evaluation.

关 键 词：骨代谢标志物 老年骨质疏松症 25-OH-VD β-CTX N-MID t-PINP 

分 类 号：R58[医药卫生—内分泌]