Evaluation of bone turnover by detecting serum beta-collagen degradation products and osteocalcin concentration
- 生命科学－已发表论文 
[中文摘要]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、骨钙索的含量,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=0.762 9,P＜0.05),骨钙素水平与年龄呈负相关(r=-0.989 7,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.[英文文摘] 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 p-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 femoris, trochanter and Ward trigone, and the concentrations of p-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 anincrease trend ofβ-Crosslaps (P < 0.01) and decrease of BGP (P < 0.05) compared with the normal group. ③ ln the patients with osteoporosis over 50 years, the bone mineral density in neck, trochiter and Ward triangle 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. ⑤ln terms of the cutoff value ofβ-Crosslaps and BGP, the diagnosis sensitivity were 69.6%, 21.5%, specificity 70.0%,78.3%, positive likelihood rati0 2.32, 0.99, negative likelihood rati0 0.434,1.002, false positive rate 30.0%,21.6%, false negative rate 30.3%, 78.4%, positive predictive value 75.3%, 56.6% and negative predictive value 63.6%, 43.1%. Combinedβ-Crosslaps and BGP, the diagnosis sensitivity was improved t0 77.2%. CONCLUSION:Combined β-Crosslaps, BGP and bone density measurement can properly and fully evaluate bone turnover,which is of significance in clinic in scanning and monitoring osteoporosis for middle-aged and elderly people and preventing osteoporotic fractures.