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| 中老年女性骨转换指标与骨密度和骨质疏松风险的关系 |
| The relationships between bone turnover markers and bone mineral density and risk for osteoporosis in middle-aged and older women |
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| DOI：10.3969/j.issn.1006.7108.2016.12.013 |
| 中文关键词: 骨转换指标；骨密度；骨质疏松 骨质疏松风险；中老年女性 |
| 英文关键词:Bone turnover markers Bone mineral density Osteoporosis Osteoporotic risk Middle-aged women |
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| 中文摘要: |
| 目的 了解中老年女性骨转换指标变化对骨密度（BMD)和骨质疏松患病风险的影响。方法632名健康中老年女性 (年龄40?89岁），测定空腹血清骨特异性碱性磷酸酶（BAP)、骨钙素（OC)、骨I型胶原C -末端肽（sCTX)和N-末端肽 (sNTX),以及腰椎和近端股骨骨密度（BMD)，并分析这些骨转换指标与BMD和骨质疏松患病风险的关系。结果 本研究检测的各种骨转换指标与腰椎、股骨颈和髋部BMD呈显著负相关(r=-0.238~ -0. 528,P均=0.000)。调整年龄、身高、体重和体重指数后，血清BAP、OC和sCTX与腰椎和股骨颈BMD的偏相关系数仍然有显著性意义。多元线性回归分析显示，这些骨转换指标对腰椎BMD是一个有意义的负性决定因素，大约可以解释腰椎BMD 7.6% ~ 27. 9%的变异性。各种骨转换指标水平最高的四分位组（Q4)与最低的组（Q1)比较,腰椎、股骨颈和髋部的骨质疏松患病风险，分别显著增加4. 6?15倍（OR = 4.6~15,95% CI:2.6?30)，3.2~13 倍（OR=3.2?13,95% CI: 1. 5 ?36)和 3. 0 ?13 倍（OR = 3. 0 ~ 13,95% CI：1.3 ~44)。结论 本研究揭示了中老年女性骨转换指标与BMD和骨质疏松患病风险的关系，提示骨转换指标水平变化是中老年女性BMD的重要决定因素，骨形成指标和/或骨吸收指标水平增加者骨质疏松患病率和患病风险大大增加。 |
| 英文摘要: |
| Objective The objective of this study was to investigate the correlations between bone turnover markers and BMD at various skeletal sites in middle-aged and older women，and to study the associations between changes in the levels of bone turnover markers and the risk for osteoporosis. Methods A cross-sectional study of 632 healthy middle-aged and older women aged 40 - 89 years was conducted. The levels of serum bone-specific alkaline phosphatase (BAP)，osteocalcin ( OC)，serum cross-linked C- terminal telopeptides of type I collagen (sCTX) and cross-linked N-terminal telopeptides of type I collagen (sNTX) were assessed. BMD at the lumbar spine and the hip was measured using DXA. Results Correlation analyses showed significant negative correlations between bone turnover marker and BMD at different skeletal sites ( r = - 0. 238 to - 0. 528，all P = 0. 000). After adjustments for age, body height, weight and body mass index, the partial correlation coefficients between serum BAP, OC and sCTX，and BMD at various skeletal sites were still significant. Multivariate linear regression analyses indicated that bone turnover markers were negative determinants of BMD at lumbar spine, explaining 7.6% -27. 9% of the variance. Odds ratios (ORs) were calculated by comparing the highest quartile of bone turnover markers (Q4, case groups) and the lowest quartile (Q1, control groups). The risk for osteoporosis at lumbar spine, femoral neck and hip in the Q4 group were 4. 6 - 15 times ( OR =4. 6 - 15, 95% CI： 2.6-30) ,3.2-13 times (OR=3. 2 -13，95% CI： 1.5 -36)，and 3. 0 - 13 times (OR =3.0-13, 95% CI： 1.3 - 44) the risk of the Q1 group, respectively. Conclusion This study clarified the relationships between bone turnover markers and BMD in middle-aged and older women. Bone turnover marker levels were found to be important determinants of BMD. Furthermore, the prevalence and risk of osteoporosis significantly increased with increase in the levels of bone turnover markers. |
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