Łukaszkiewicz Jacek, Karczmarewicz Elzbieta, Płudowski Paweł, Jaworski Maciej, Czerwiński Edward, Lewiński Andrzej, Marcinowska-Suchowierska Ewa, Milewicz Andrzej, Spaczyński Marek, Lorenc Roman S
Department of Biochemical and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
Med Sci Monit. 2008 Dec;14(12):PH65-70.
One of the most important risk factors for osteoporotic fractures in postmenopausal women is elevated bone turnover (EBT), occurring in 25-30% of this population. This study's aim was to find a correlation between bone resorption and bone formation markers to assess bone turnover rate and qualify an individual postmenopausal woman as a possible EBT subject.
MATERIAL/METHODS: Three hundred twenty postmenopausal women (> or = one year after the last menstruation, < or = 70 years old) were enrolled at seven clinical sites in this cross-sectional observational study conducted within the EPOLOS. The group was a random sample of the population. The study was performed in a referral center involved in the diagnosis and treatment of osteoporosis. The exclusion criteria included pregnancy, cancer, fracture in the last year, and overweight (> 100 kg). Bone mineral density (BMD) measurements of the lumbar spine, total hip, trochanter, and femoral neck regions were performed. Bone resorption and formation rates were evaluated by serum levels of C-terminal telopeptide of type I collagen (CTX) and osteocalcin (OC), respectively.
Using logistic regression to correlate the concentrations of CTX and OC it was possible not only to distinguish the EBT subgroup, but also to construct a simple nomogram for easy classification of individual patients as possible EBT subjects. EBT patients showed generally decreased BMD values and increased bone formation and resorption rates.
Evaluation of both CTX and OC levels enables a more proper indication for EBT. The proposed nomogram may assist in evaluating outcome from the two markers of bone turnover.
绝经后女性骨质疏松性骨折最重要的危险因素之一是骨转换率升高（EBT），该人群中25%-30%会出现这种情况。本研究的目的是找出骨吸收和骨形成标志物之间的相关性，以评估骨转换率，并确定个体绝经后女性是否可能属于EBT人群。
材料/方法：在EPOLOS开展的这项横断面观察性研究中，在7个临床地点招募了320名绝经后女性（末次月经后≥1年，≤70岁）。该组为人群随机样本。研究在一家参与骨质疏松症诊断和治疗的转诊中心进行。排除标准包括妊娠、癌症、去年有骨折史以及超重（>100 kg）。对腰椎、全髋、大转子和股骨颈区域进行骨密度（BMD）测量。分别通过血清I型胶原C末端肽（CTX）和骨钙素（OC）水平评估骨吸收和形成率。
使用逻辑回归分析CTX和OC的浓度，不仅可以区分EBT亚组，还可以构建一个简单的列线图，以便轻松将个体患者分类为可能的EBT人群。EBT患者的BMD值通常较低，骨形成和骨吸收率较高。
评估CTX和OC水平能够更准确地判断EBT情况。所提出的列线图可能有助于评估这两种骨转换标志物的结果。
