摘要
目的:分析中老年人骨密度与血清β-胶原降解产物、骨钙素的关系,以及其在骨质疏松症中评价骨转换的价值。方法:①选择来自厦门大学附属中山医院老年科2003-06/2005-06门诊健康体检者238例,年龄50～86岁。正常组99例,女69例,男30例,骨质疏松症组139例,女94例,男45例,两组均以每10岁为1个年龄组。②采集受试者空腹时肘静脉血,采用电化学发光免疫分析法分析血清β-胶原降解产物、骨钙素的含量,同时用LUNAR双能X射线骨密度仪测量髋骨骨密度。观察两组股骨头、大转子、Ward三角区骨密度,β-胶原降解产物和骨钙素浓度变化。结果:纳入238例,全部进入结果分析。①健康人血清中的β-胶原降解产物与年龄呈正相关(r=0.7629,P<0.05),骨钙素水平与年龄呈负相关(r=-0.9897,P<0.05),二者都与性别无关(P>0.05)。②骨质疏松症各年龄组的β-胶原降解产物水平高于正常组(P<0.01),骨钙素水平低于正常组(P<0.05)。③50岁以上骨质疏松症患者股骨颈、大转子、Ward三角区骨密度较正常组显著下降(P<0.01)。④骨质疏松症患者各部位骨密度与β-胶原降解产物和骨钙素浓度无相关性。⑤β-胶原降解产物骨钙素分别取截断值时,诊断敏感性为69.6%,21.5%,特异性为70.0%,78.3%,阳性似然比为2.32,0.99,阴性似然比为0.434,1.002,假阳性率为30.0%,21.6%,假阴性率为30.3%,78.4%,阳性预测值为75.3%,56.6%,阴性预测值为63.6%,43.1%。联合检测两指标,诊断的敏感性达77.2%。结论:联合检测血清β-胶原降解产物、骨钙素、骨密度能全面合理评价骨转换,在中老年骨质疏松症的早期筛查及诊断,预防危险性骨损伤发生中具有重要的临床指导价值。
AIM： To investigate the relationship among bone mineral density, serum type Ⅰ collagen degradation products （β-Crosslaps） and osteocalcin （BGP）, so as to explore the clinical value in evaluating bone turnover in patients with osteoporosis.
METHODS： ①Totally 238 healthy physical examinees aged 50-86 years from Department of Gerontology of Zhongshan Hospital, Xiamen Unviersity between June 2003 and June 2005 were selected. The subjects were divided into normal group （n =99） included 69 females and 30 males, and osteoporosis group （n =139） included 94 females and 45 males. The two groups were subdivided into age groups by 10 years old. ②The blood from ulnar vein was collected from the subjects in fasting to detect the concentrations of β-Crosslaps and BGP by ECLIA. The haunch bone mineral density was measured by dual energy X-ray absorptimetry to observe the changes in the bone mineral density of caput femods, trochanter and Ward trigone, and the concentrations of β-Crosslaps and BGP
RESULTS： All 238 subjects were involved in the result analysis. ①Serum level of β-Crosslaps was correlated positively with age in normal people （r =0.762 9, P 〈 0.05）, while serum BGP was correlated negatively with age （r =-0.989 7, P 〈 0.05）. Both of them had no correlation with sex （P 〉 0.05）. ②Patients with osteoporosis in different age groups had an incresse trend of β-Crosslaps （P 〈 0.01） and decrease of BGP （P 〈 0.05） compared with the normal group. ③in the patients with osteoporosis over 50 years, the bone mineral density in neck, trochiter and Ward tdangle was significantly lower than that of the normal group （P 〈 0.01）. ④β-Crosslaps and BGP were not correlated to bone mineral density in various parts of body of the patients. ⑤in terms of the cutoff value of β-Cresslaps and BGP, the diagnosis sensitivity were 69.6%, 21.5%, specificity 70.0%,78.3%, positive likelihood ratio 2.32, 0.99, negative likelihood ratio 0.434,1.002, false positive rate 30
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第2期268-270,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
