Pietschmann P, Pils P, Woloszczuk W, Maerk R, Lessan D, Stipicic J
Department of Medicine II, University of Vienna, Austria.
Paraplegia. 1992 Mar;30(3):204-9. doi: 10.1038/sc.1992.56.
Osteocalcin(OC) is a specific serum parameter of bone formation. Since bone metabolism disturbances, including osteoporosis, are seen in paraplegia, the serum levels of OC, midregional parathyroid hormone(mPTH), intact para-thyroid hormone (iPTH) and calcitonin (CT) serum levels were determined in 13 patients with paraplegia or tetraplegia and 15 control subjects by radioimmunoassay in a cross sectional study. In addition, the urinary hydroxyproline/creatine and the urinary calcium/creatinine ratio was determined. Serum OC levels were significantly increased in the patients with spinal cord injury (p less than 0.02), whereas serum levels of mPTH, iPTH and CT were not statistically different. The urinary hydroxyproline/creatinine ratio was significantly higher in the patients than in the controls (p less than 0.02), and the urinary calcium/creatinine ratio also tended to be higher in the patients. In a follow up study over 6 months after spinal cord injury, serum OC, serum iPTH, urinary hydroxyproline/creatinine ratio and the calcium/creatinine ratio were determined in 6 patients at monthly intervals. Hyperhydroxyprolinuria preceded the gradual increase of serum OC from normal to clearly elevated levels. Our data suggest that increased bone resorption in paraplegia is linked to an enhanced osteoblastic activity.
骨钙素（OC）是骨形成的一项特定血清参数。由于在截瘫患者中可见包括骨质疏松症在内的骨代谢紊乱，因此在一项横断面研究中，通过放射免疫分析法测定了13例截瘫或四肢瘫患者及15例对照者的血清OC、中段甲状旁腺激素（mPTH）、完整甲状旁腺激素（iPTH）和降钙素（CT）血清水平。此外，还测定了尿羟脯氨酸/肌酐以及尿钙/肌酐比值。脊髓损伤患者的血清OC水平显著升高（p<0.02），而血清mPTH、iPTH和CT水平无统计学差异。患者的尿羟脯氨酸/肌酐比值显著高于对照组（p<0.02），患者的尿钙/肌酐比值也有升高趋势。在脊髓损伤后6个月的随访研究中，对6例患者每月测定血清OC、血清iPTH、尿羟脯氨酸/肌酐比值和钙/肌酐比值。高羟脯氨酸尿症先于血清OC从正常水平逐渐升高至明显升高水平出现。我们的数据表明，截瘫患者骨吸收增加与成骨细胞活性增强有关。
