Iki Masayuki, Akiba Takashi, Matsumoto Toshio, Nishino Harumi, Kagamimori Sadanobu, Kagawa Yoshiko, Yoneshima Hideo
Department of Public Health, Kinki University School of Medicine , 377-2 Oono-Higashi, Osaka-Sayama, 589-8511 Osaka, Japan.
Osteoporos Int. 2004 Dec;15(12):981-91. doi: 10.1007/s00198-004-1634-1. Epub 2004 Jul 31.
The present study was conducted as a part of the Japanese Population-based Osteoporosis (JPOS) Study to establish reference values on the biochemical markers of bone turnover in the general Japanese female population over an applicable age range. The study recruited 3250 women aged 15-79 years, randomly selected from five municipalities throughout Japan, and obtained measurements of serum osteocalcin (OC) and bone-specific alkaline phosphatase (BAP); free and total forms of immunoreactive deoxypyridinoline, free pyridinolines and type I collagen cross-linked C-terminal telopeptide (CTx) in urine; serum intact parathyroid hormone (PTH) and 1,25 dihydroxy vitamin D (1,25 (OH)2D); and bone density at the spine, hip and distal forearm. After excluding subjects with apparent or suggested abnormalities affecting bone mass, 2535 (78%) subjects were further analyzed. The authors presented 5-year age-specific mean values of the markers and mean marker levels derived from women aged 30-44 years with normal bone density as a healthy young adult reference. Values of the markers decreased with increasing age before the age of 40, increased steeply among subjects in their 50s, and remained elevated in the elderly. Serum calcium, phosphorus, PTH and 1,25 (OH)2D levels were higher in postmenopausal women than in premenopausal women. However, 1,25 (OH)2D was lower among early postmenopausal subjects. The levels of OC, BAP, CTx, PTH and 1,25(OH)2D were significantly greater for women with osteoporosis than for those without. The diagnostic value of the markers was limited as the sensitivity and specificity ranged from 55% to 60%. These findings will aid health professionals in the correct assessment of bone turnover status in Japanese women over a wide range of age.
本研究作为日本基于人群的骨质疏松症(JPOS)研究的一部分开展,旨在确立日本一般成年女性在适用年龄范围内骨转换生化标志物的参考值。该研究招募了3250名年龄在15 - 79岁之间的女性,她们是从日本全国五个城市随机选取的,并对血清骨钙素(OC)、骨特异性碱性磷酸酶(BAP);尿液中免疫反应性脱氧吡啶啉、游离吡啶啉和I型胶原交联C末端肽(CTx)的游离和总形式;血清完整甲状旁腺激素(PTH)和1,25 - 二羟维生素D(1,25(OH)2D);以及脊柱、髋部和前臂远端的骨密度进行了测量。在排除有明显或提示影响骨量异常的受试者后,对2535名(78%)受试者进行了进一步分析。作者给出了这些标志物的5岁年龄组特异性均值,以及以骨密度正常的30 - 44岁女性的均值作为健康年轻成年人参考值。这些标志物的值在40岁之前随年龄增长而下降,在50多岁的受试者中急剧上升,并在老年人中保持升高。绝经后女性的血清钙、磷、PTH和1,25(OH)2D水平高于绝经前女性。然而,绝经早期受试者的1,25(OH)2D水平较低。骨质疏松女性的OC、BAP、CTx、PTH和1,25(OH)2D水平显著高于非骨质疏松女性。这些标志物的诊断价值有限,因为其敏感性和特异性在55%至60%之间。这些发现将有助于健康专业人员正确评估日本各年龄段女性的骨转换状态。