孕期骨转换的生化标志物：一项纵向研究。

Biochemical markers of bone turnover during pregnancy: a longitudinal study.

作者信息

Hellmeyer L, Ziller V, Anderer G, Ossendorf A, Schmidt S, Hadji P

机构信息

Department of Obstetrics and Perinatal medicine, Philipps-University of Marburg.

出版信息

Exp Clin Endocrinol Diabetes. 2006 Oct;114(9):506-10. doi: 10.1055/s-2006-951627.

DOI:10.1055/s-2006-951627

PMID:17115348

Abstract

OBJECTIVE

The objective of this study was to prospectively investigate the effect of pregnancy on biochemical markers of bone turnover in healthy pregnant women.

METHODS

During the course of our longitudinal study, biochemical markers of bone remodeling were measured in all three trimester of pregnancy (first trimester: 12.5+/-1.8 SD, second trimester: 21.6+/-1 SD, third trimester: 34.8+/-1.6 SD weeks of gestation). Serum type I collagen C-telopeptides (CTX) and a crosslinked peptide of the carboxy-terminal telopeptide of type I collagen (ICTP) were used as markers of bone resorption. Bone alkaline phosphatase (BAP) and the N-terminal propeptides of type I collagen (PINP) were used as biochemical markers of bone formation. Blood samples for the analysis of all 4 biochemical markers according to each trimester of pregnancy were available in 49 patients.

RESULTS

The main changes for all biochemical markers were seen between the second and the third trimester. According to the markers of bone resorption, both serum CTX and ICTP showed a significant increase from the first to the third and from the second to the third trimester (p<0.001; median percentage change: CTX=101.5% and ICTP=40%). Concerning markers of bone formation, PINP showed a significant decrease from the first to the second trimester (p=0.001) followed by a significant increase from the second to the third trimester (p<0.001, 63.8%) and an overall increase from the first to the third trimester (p<0.001). BAP also showed a significant increase from the second to the third trimester (p<0.001; 51.7%) and an overall increase from the first to the third trimester (p<0.001).

CONCLUSION

Markers of bone resorption were significantly increased during pregnancy. In contrast to bone resorption, markers of bone formation showed an increase as well as a decrease during pregnancy indicating a state of high bone turnover. This might coincide with the change in bone mineral density that was observed in some, but not all, studies using "dual-energy x-ray absorptiometry" (DXA) as well as "quantitative ultrasonometry" (QUS).

摘要

目的

本研究的目的是前瞻性地调查妊娠对健康孕妇骨转换生化标志物的影响。

方法

在我们的纵向研究过程中，在妊娠的所有三个阶段（第一阶段：妊娠12.5±1.8标准差周，第二阶段：妊娠21.6±1标准差周，第三阶段：妊娠34.8±1.6标准差周）测量骨重塑的生化标志物。血清I型胶原C末端肽（CTX）和I型胶原羧基末端肽的交联肽（ICTP）用作骨吸收标志物。骨碱性磷酸酶（BAP）和I型胶原N末端前肽（PINP）用作骨形成的生化标志物。49例患者可获得根据妊娠各阶段分析所有4种生化标志物的血样。

结果

所有生化标志物的主要变化出现在妊娠第二阶段和第三阶段之间。根据骨吸收标志物，血清CTX和ICTP从第一阶段到第三阶段以及从第二阶段到第三阶段均显著增加（p<0.001；中位数百分比变化：CTX=101.5%，ICTP=40%）。关于骨形成标志物，PINP从第一阶段到第二阶段显著降低（p=0.001），随后从第二阶段到第三阶段显著增加（p<0.001，63.8%），从第一阶段到第三阶段总体增加（p<0.001）。BAP从第二阶段到第三阶段也显著增加（p<0.001；51.7%），从第一阶段到第三阶段总体增加（p<0.001）。