Tamburino G, Fiore C E
Istituto di Clinica Medica, Luigi Condorelli, Università degli Studi, Catania, Italy.
Ann Ital Med Int. 1990 Jul-Sep;5(3 Pt 3):296-302.
Bone metabolism is characterized by continuous remodeling in which different cell lines, hormone systems and local mediators intervene. A useful method for the study of this process is evaluation of the physiopathological and clinical significance of substances which are involved in local turnover and at the same time are present in general circulation. These plasmatic markers are represented chiefly by bone-Gla-protein and alpha-HS-glycoprotein--peptides which belong to the more specific proteic component of the organic matrix in which reabsorption and neoformation take place, from the phosphatases to interleukin-1. Each one of these markers is described by analyzing the biochemical characteristics, the reciprocal correlations, and the potentials and limits in clinical practice. At present, none of these can guarantee formulation of a precise diagnosis of disease: they are, rather, biochemical indicators of the degree of bone turnover. The relevance of biochemical indicators becomes greater as the remodeling process increases, such as in Paget's disease. It lessens in conditions characterized by decreased cellularity such as osteoporosis. The study of these parameters during the course of therapeutic follow-up is extremely important.
骨代谢的特征是持续重塑，不同细胞系、激素系统和局部介质均参与其中。研究这一过程的一种有用方法是评估参与局部更新且同时存在于全身循环中的物质的生理病理和临床意义。这些血浆标志物主要由骨钙素和α-HS-糖蛋白——属于有机基质中更具特异性的蛋白质成分的肽类组成，从磷酸酶到白细胞介素-1，在该有机基质中发生重吸收和新骨形成。通过分析这些标志物各自的生化特性、相互关系以及临床实践中的潜力和局限性来对其进行描述。目前，这些标志物中没有一个能够保证对疾病做出精确诊断：相反，它们是骨转换程度的生化指标。随着重塑过程的增加，如在佩吉特病中，生化指标的相关性变得更大。而在以细胞数量减少为特征的情况下，如骨质疏松症，其相关性则降低。在治疗随访过程中对这些参数进行研究极为重要。
