Kalaï Eya, Bahlous Afef, Makdouli Abdelaziz, Sahli Hella, Klouz Anis, Lakhal Mohamed, Sellami Slaheddine, Abdelmoula Jouda
Service de biochimie clinique, Hôpital Charles Nicolle, Tunis, Tunisie.
Tunis Med. 2008 Feb;86(2):122-7.
Postmenopausal osteoporosis is especially female pathology, whose incidence increases with age.
The purposes of this study are to evaluate the level of bone turnover by the determination of markers of bone formation (PAL, BAP) and marker of bone resorption (CTX) in the osteoporotic women, to study the correlations between bone biochemical markers, clinical parameters and radiological measurements and to assess the interest of biochemical markers therapeutic monitoring after 6 months of antiresorptive treatment.
The authors report a prospective study of 134 osteoporotic women classified in two groups according to the presence of osteoporotic fracture. Patients of the first group G1 (n=102) with fractures, were treated by the bisphosphonates (risedronate), whereas the ones of the second group G2 (n=32) without fractures, were submited to calcic supplementation and vitamin D.
The analyses showed that the femoral and lumbar BMD were statistically lower in the presence of osteoporotic fractures. However, the values of CTX were statistically higher in the patients of G1 group compared to those of the G2 group (0,708 +/- 0,332 ng/ml versus 0,514 +/- 0,225 ng/ml). The CTX were statistically correlated with the femoral and lumbar BMD (r = -0,21, p<0,05 and r= -0,348, p<0,001). The hypovitminosis were observed in 50,98% (52/102) of women with ostéoporotic fractures, whereas it was only 25% (8/32) in women without fractures. After 6 months of treatment by the bisphosphonates, the PAL, the BAP and the CTX have decreased with an average of, respectively, 19%, 46,5% and 62,9%. These variations were significantly more important in G1 group.
The biochemical markers of bone turnover, in particular those of the resorption (CTX), can predict the postmenopausal woman's bone loss evaluated by BMD, the risk of fractures and the efficiency of the bone treatments.
绝经后骨质疏松症是一种典型的女性疾病，其发病率随年龄增长而增加。
本研究旨在通过测定骨质疏松症女性的骨形成标志物（PAL、BAP）和骨吸收标志物（CTX）来评估骨转换水平，研究骨生化标志物、临床参数与放射学测量之间的相关性，并评估抗吸收治疗6个月后生化标志物在治疗监测中的作用。
作者报告了一项对134名骨质疏松症女性的前瞻性研究，根据是否存在骨质疏松性骨折将其分为两组。第一组G1（n=102）有骨折的患者接受双膦酸盐（利塞膦酸盐）治疗，而第二组G2（n=32）无骨折的患者接受钙补充剂和维生素D治疗。
分析表明，存在骨质疏松性骨折时，股骨和腰椎骨密度在统计学上较低。然而，G1组患者的CTX值在统计学上高于G2组（0.708±0.332 ng/ml对0.514±0.225 ng/ml）。CTX与股骨和腰椎骨密度在统计学上相关（r = -0.21，p<0.05和r = -0.348，p<0.001）。骨质疏松性骨折女性中50.98%（52/102）存在维生素缺乏，而无骨折女性中仅为25%（8/32）。双膦酸盐治疗6个月后，PAL、BAP和CTX均下降，平均分别下降19%、46.5%和62.9%。这些变化在G1组中更为显著。
骨转换的生化标志物，特别是骨吸收标志物（CTX），可以预测通过骨密度评估的绝经后女性的骨质流失、骨折风险和骨治疗效果。
