Inaba Masaaki
Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Japan.
Clin Calcium. 2012 Jun;22(6):839-44.
The measurement of biochemical markers for bone metabolism is officially approved in clinical practice for osteoporosis in Japan for the purpose of assessment of bone metabolism and thus for rational selection of anti-osteoporotic drug and the early determination of its effect. In 2011 version of guideline for protection and treatment for osteoporosis and 2012 version of guideline for bone metabolic marker, the novel marker, such as P1NP, which responds precisely to newly-approved PTH (1-34) with bone-formation stimulating effect was focused. Furthermore, the effect of renal dysfunction on the markers which were secreted into urine was also emphasized because of the apparent increases in their serum levels independent of bone metabolic state.
在日本,用于评估骨代谢的骨代谢生化标志物检测在临床实践中已被正式批准用于骨质疏松症,目的是评估骨代谢,从而合理选择抗骨质疏松药物并早期确定其疗效。在2011年版的骨质疏松症防治指南和2012年版的骨代谢标志物指南中,重点关注了新型标志物,如能精确反映新批准的具有骨形成刺激作用的甲状旁腺激素(1-34)的I型前胶原氨基端前肽(P1NP)。此外,由于肾功能不全患者这些标志物的血清水平明显升高且与骨代谢状态无关,因此也强调了肾功能不全对尿液中分泌的标志物的影响。