血清抗酒石酸酸性磷酸酶5b是监测阿仑膦酸盐治疗的有用标志物：与其他骨转换标志物的比较。

Serum TRACP 5b is a useful marker for monitoring alendronate treatment: comparison with other markers of bone turnover.

作者信息

Nenonen Arja, Cheng Sulin, Ivaska Kaisa K, Alatalo Sari L, Lehtimäki Terho, Schmidt-Gayk Heinrich, Uusi-Rasi Kirsti, Heinonen Ari, Kannus Pekka, Sievänen Harri, Vuori Ilkka, Väänänen H Kalervo, Halleen Jussi M

机构信息

Rheumatism Foundation Hospital, Heinola, and Department of Clinical Chemistry, University Hospital of Tampere, Finland.

出版信息

J Bone Miner Res. 2005 Oct;20(10):1804-12. doi: 10.1359/JBMR.050403.

DOI:10.1359/JBMR.050403

PMID:16355501

Abstract

UNLABELLED

We studied clinical performance of serum TRACP 5b and other bone turnover markers, including S-CTX, U-DPD, S-PINP, S-BALP, and S-OC, for monitoring alendronate treatment. TRACP 5b had higher clinical sensitivity, area under the ROC curve, and signal-to-noise ratio than the other markers.

INTRODUCTION

The purpose of this study was to compare the clinical performance of serum TRACP 5b (S-TRACP5b) with that of other markers of bone turnover in the monitoring of alendronate treatment.

MATERIALS AND METHODS

This double-blinded study included 148 healthy postmenopausal women that were randomly assigned into two groups: one receiving 5 mg alendronate daily (n=75) and the other receiving placebo (n=73) for 12 months. All individuals in both groups received calcium and vitamin D daily. The bone resorption markers S-TRACP5b, serum C-terminal cross-linked telopeptides of type I collagen (S-CTX), and total urinary deoxypyridinoline (U-DPD), and the serum markers of bone formation procollagen I N-terminal propeptide (S-PINP), bone-specific alkaline phosphatase (S-BALP), and total osteocalcin (S-OC) were assessed at baseline and at 3, 6, and 12 months after initiation of treatment. Lumbar spine BMD (LBMD) was measured at baseline and 12 months.

RESULTS

Compared with the placebo group, LBMD increased, and all bone markers decreased significantly more in the alendronate group (p<0.001 for each parameter). The decrease of S-TRACP5b after first 3 months of alendronate treatment correlated significantly with the changes of all other markers except S-OC, the best correlation being with S-CTX (r=0.60, p<0.0001). The changes of LBMD at 12 months only correlated significantly with the changes of S-TRACP5b (r=-0.32, p=0.005) and S-CTX (r=-0.24, p=0.037) at 3 months. Based on clinical sensitivity, receiver operating characteristic (ROC) curves, and signal-to-noise ratio, S-TRACP5b, S-CTX, and S-PINP were the best markers for monitoring alendronate treatment. Clinical sensitivity, area under the ROC curve, and signal-to-noise ratio were higher for S-TRACP5b than for the other markers.

CONCLUSION

These results show that S-TRACP5b, S-CTX, and S-PINP are useful markers for monitoring alendronate treatment.

摘要

未标注

我们研究了血清抗酒石酸酸性磷酸酶5b（TRACP 5b）以及其他骨转换标志物，包括血清Ⅰ型胶原交联C末端肽（S-CTX）、尿脱氧吡啶啉（U-DPD）、血清Ⅰ型前胶原N端前肽（S-PINP）、骨特异性碱性磷酸酶（S-BALP）和总骨钙素（S-OC）在监测阿仑膦酸盐治疗中的临床性能。与其他标志物相比，TRACP 5b具有更高的临床敏感性、ROC曲线下面积和信噪比。

引言

本研究的目的是比较血清抗酒石酸酸性磷酸酶5b（S-TRACP5b）与其他骨转换标志物在监测阿仑膦酸盐治疗中的临床性能。

材料与方法

这项双盲研究纳入了148名健康绝经后女性，她们被随机分为两组：一组每天服用5mg阿仑膦酸盐（n = 75），另一组服用安慰剂（n = 73），为期12个月。两组所有个体每天均补充钙和维生素D。在基线以及治疗开始后的3、6和12个月时，评估骨吸收标志物S-TRACP5b、血清Ⅰ型胶原交联C末端肽（S-CTX）和尿总脱氧吡啶啉（U-DPD），以及骨形成标志物血清Ⅰ型前胶原N端前肽（S-PINP）、骨特异性碱性磷酸酶（S-BALP）和总骨钙素（S-OC）。在基线和12个月时测量腰椎骨密度（LBMD）。

结果

与安慰剂组相比，阿仑膦酸盐组的LBMD增加，所有骨标志物的下降更为显著（每个参数p < 0.001）。阿仑膦酸盐治疗前3个月后S-TRACP5b的下降与除S-OC外的所有其他标志物的变化显著相关，与S-CTX的相关性最佳（r = 0.60，p < 0.0001）。12个月时LBMD的变化仅与3个月时S-TRACP5b（r = -0.32，p = 0.005）和S-CTX（r = -0.24，p = 0.037）的变化显著相关。基于临床敏感性、受试者工作特征（ROC）曲线和信噪比，S-TRACP5b、S-CTX和S-PINP是监测阿仑膦酸盐治疗最好的标志物。S-TRACP5b的临床敏感性、ROC曲线下面积和信噪比高于其他标志物。