Center of Excellence for Osteoporosis Research, King Abdulaziz University, Jeddah, Saudi Arabia.
Bone. 2010 Oct;47(4):804-14. doi: 10.1016/j.bone.2010.07.017. Epub 2010 Jul 23.
Biochemical bone turnover markers (BTMs) provide important information on the diagnosis, therapy and monitoring of metabolic bone diseases including osteoporosis. One goal of antiresorptive therapy in women is to decrease biochemical BTMs to the lower half of reference intervals for healthy pre-menopausal counterparts, using newly developed automated assays of such markers. The main objectives of the present study were to: (1) establish reference interval values for the following biochemical BTMs: serum osteocalcine (s-OC), bone alkaline phosphatase (s-bone ALP), procollagen type 1 N-terminal propeptide (s-PINP), crosslinked C-terminal telopeptide of Type 1 collagen (s-CTX), tartarate-resistant acid phosphatase isoform 5b (s-TRACP-5b) and urinary: CTX (u-CTX), N-telopeptides of type 1 collagen (u-NTX), pyridinoline (u-PYD) and deoxypyridinoline (u-DPD) in randomly selected Saudi healthy pre-menopausal women; (2) study the changes in biochemical BTMs in relation to age in pre- and post-menopausal women and the factors reported to influence bone turnover and (3) determine the effect of menopausal status on BTMs. A total of 2125 women were studied [including (n=1557) pre-, and (n=568) post-menopausal women, respectively, aged 20-79 years]. A total of 765 healthy pre-menopausal women (aged 35-45 years) were used to establish reference intervals for biochemical BTMs. All women studied were medically examined and had their bone mineral density (BMD) values obtained for the lumbar spine (L(1)-L(4)) and femoral neck according to detailed inclusion criteria. In all women, values of biochemical BTMs, decreased with increasing age up to the age of 45 years, increased steeply among women in their 50s and remained increased in post-menopausal women. Significant increases were evident in all biochemical BTMs in post-menopausal women with >5 years since menopause with the exception of s-OC, u-DPD, and u-PYD. Using stepwise multiple linear regression analysis, several variables were identified (depending on the BTM) as determinants of BTMs including age, BMI, parity, FSH, LH, PTH, s-Ca, s-Mg, s-PO(4) and 25(OH)D. In the reference intervals group, there are no significant correlations between any of the biochemical BTMs and age of menarche, day of menstrual cycle, physical activity, total daily dietary calcium and caffeine intakes and parity. It is recommended that the age range 35-45 years should be used when establishing biochemical BTMs reference intervals in Saudi Arabian pre-menopausal women.
生化骨转换标志物 (BTM) 为代谢性骨病（包括骨质疏松症）的诊断、治疗和监测提供了重要信息。女性抗吸收治疗的一个目标是使用新开发的此类标志物的自动化检测方法，将生化 BTM 降低到健康绝经前对照者参考区间的下半部分。本研究的主要目的是：(1) 为以下生化 BTM 建立参考区间值：血清骨钙素 (s-OC)、骨碱性磷酸酶 (s-bone ALP)、I 型前胶原 N 端前肽 (s-PINP)、I 型胶原交联 C 端肽 (s-CTX)、酒石酸抗性酸性磷酸酶同工酶 5b (s-TRACP-5b) 和尿：CTX (u-CTX)、I 型胶原 N 端肽 (u-NTX)、吡啶啉 (u-PYD) 和脱氧吡啶啉 (u-DPD) 在随机选择的沙特健康绝经前女性中；(2) 研究生化 BTM 随年龄变化在绝经前和绝经后妇女中的变化，以及报告影响骨转换的因素；(3) 确定绝经状态对 BTM 的影响。共研究了 2125 名女性[包括 (n=1557) 绝经前和 (n=568) 绝经后女性，年龄 20-79 岁]。共 765 名健康绝经前女性（年龄 35-45 岁）用于建立生化 BTM 的参考区间。所有接受研究的女性均经过医学检查，并根据详细的纳入标准获得了腰椎 (L(1)-L(4)) 和股骨颈的骨密度 (BMD) 值。在所有女性中，生化 BTM 值随年龄增长至 45 岁而降低，50 多岁女性急剧增加，绝经后女性持续增加。绝经后女性的所有生化 BTM 值均显著增加，绝经时间超过 5 年，除 s-OC、u-DPD 和 u-PYD 外。使用逐步多元线性回归分析，确定了几个变量（取决于 BTM）作为 BTM 的决定因素，包括年龄、BMI、产次、FSH、LH、PTH、s-Ca、s-Mg、s-PO(4) 和 25(OH)D。在参考区间组中，生化 BTM 与初潮年龄、月经周期天数、体力活动、每日总膳食钙和咖啡因摄入量以及产次之间没有显著相关性。建议在建立沙特阿拉伯绝经前女性生化 BTM 参考区间时使用 35-45 岁年龄范围。
