Ueda Misako, Inaba Masaaki, Okuno Senji, Nagasue Kyoko, Kitatani Kayoko, Ishimura Eiji, Shimizu Motokazu, Miki Takami, Kim Masao, Nishizawa Yoshiki
Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Am J Kidney Dis. 2002 Oct;40(4):802-9. doi: 10.1053/ajkd.2002.35692.
An intact collagen I amino-terminal propeptide (PINP) assay has been developed as a useful assay for bone formation. The present study was performed to investigate the clinical usefulness of serum PINP as a bone-formation marker in hemodialysis (HD) patients.
PINP and other bone-formation markers, ie, bone alkaline phosphatase (BAP) and intact osteocalcin (OC), were determined in serum samples collected from 209 HD patients.
Serum PINP levels, in contrast to serum BAP and OC levels, did not change significantly during a single HD session (P = 0.069; n = 14). There were significant positive correlations between serum PINP and BAP (r = 0.723; P < 0.001) and OC values (r = 0.739; P < 0.001), as well as intact parathyroid hormone (r = 0.652; P < 0.001) and bone-resorption marker values: deoxypyridinoline (DPD; r = 0.823; P < 0.001), pyridinoline (PYD; r = 0.735; P < 0.001), and beta-crosslaps (r = 0.705; P < 0.001). Serum PINP values correlated significantly more strongly than serum BAP values with all bone-resorption markers. Serum PINP values significantly correlated negatively with annual changes in bone mineral density (BMD) in the distal third of the radius (r = -0.286; P < 0.001). When subjects were divided into tertiles according to degree of bone loss, subjects with greater bone loss had significantly greater serum PINP, BAP, and OC levels, although PINP and OC provided greater discrimination than BAP. PINP-PYD and PINP-DPD ratios, indices of osteoblast function not confounded by enhanced bone resorption, significantly positively correlated with annual BMD changes in the distal third of the radius (PINP-PYD ratio, P = 0.008; PINP-DPD, P = 0.015).
Serum PINP may provide a better marker of osteoblast function in HD patients and thus be clinically useful for predicting radius bone loss.
完整的I型胶原蛋白氨基端前肽（PINP）检测已被开发为一种用于骨形成的有用检测方法。本研究旨在探讨血清PINP作为血液透析（HD）患者骨形成标志物的临床实用性。
对从209例HD患者采集的血清样本测定PINP和其他骨形成标志物，即骨碱性磷酸酶（BAP）和完整骨钙素（OC）。
与血清BAP和OC水平不同，血清PINP水平在单次HD治疗期间无显著变化（P = 0.069；n = 14）。血清PINP与BAP（r = 0.723；P < 0.001）、OC值（r = 0.739；P < 0.001）、完整甲状旁腺激素（r = 0.652；P < 0.001）以及骨吸收标志物值：脱氧吡啶啉（DPD；r = 0.823；P < 0.001）、吡啶啉（PYD；r = 0.735；P < 0.001）和β-交联C末端肽（r = 0.705；P < 0.001）之间均存在显著正相关。血清PINP值与所有骨吸收标志物的相关性显著强于血清BAP值。血清PINP值与桡骨远端三分之一处骨矿物质密度（BMD）的年度变化显著负相关（r = -0.286；P < 0.001）。当根据骨丢失程度将受试者分为三分位数时，骨丢失较多的受试者血清PINP、BAP和OC水平显著更高，尽管PINP和OC比BAP具有更大的区分度。PINP-PYD和PINP-DPD比值，即不受骨吸收增强影响的成骨细胞功能指标，与桡骨远端三分之一处的年度BMD变化显著正相关（PINP-PYD比值，P = 0.008；PINP-DPD，P = 0.015）。
血清PINP可能是HD患者成骨细胞功能的更好标志物，因此在临床上可用于预测桡骨骨丢失。
