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血清总I型前胶原氨基端前肽、β-交联羧基端肽及25-羟基维生素D3检测在评估老年骨质疏松患者髋部脆性骨折风险中的临床价值

[Clinical value of serum total P1NP, β-CTX and 25(OH)D3 detection in evaluating risks of fragile hip fracture in elderly patients with osteoporosis].

作者信息

Lou Huiling, Peng Cheng, Chen Qiaocong

机构信息

Department of Gerontology, Guangzhou First Municipal People's Hospital, Guangzhou 510180, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2012 Sep;32(9):1346-9.

Abstract

OBJECTIVE

To investigate the clinical value of serum total procollagen type 1 aminoterminal propeptide (total P1NP), cross-linked C-terminal telopeptide of type I collagen (β-CTX) and 25(OH)D3 detection in evaluating the risks of fragile hip fracture in elderly patients with osteoporosis.

METHODS

Serum levels of total P1NP, β-CTX and 25(OH)D3 was measured in 68 elderly osteoporotic patients with fragile hip fracture and 68 age- and gender-matched osteoporotic controls without fragile hip fracture. In both groups, bone mineral density (BMD) was detected with dual X-ray absorptiometry.

RESULTS

The serum levels of total P1NP and β-CTX were significantly higher and 25(OH)D3 level was significantly lower in fragile hip fracture group than in the control group (P<0.05), but the two groups showed no significant difference in lumbar or total hip BMD. Bivariate correlation analysis suggested that in fragile hip fracture group, serum 25(OH)D3 level was positively, while serum total P1NP and β-CTX levels were inversely correlated with lumbar and total hip BMD (P<0.05). In control group, 25(OH)D3 was not related to lumbar or total hip BMD, and serum total P1NP and β-CTX levels were inversely correlated with total hip BMD (P<0.05) but not related to lumbar BMD.

CONCLUSION

In osteoporotic elderly patients with close BMD levels, high serum levels of total P1NP and β-CTX and low serum levels of 25(OH)D3 might independently indicate high fragile hip fracture risk, and detection of the three markers can help identify high-risk individuals.

摘要

目的

探讨血清Ⅰ型前胶原氨基端前肽(总P1NP)、Ⅰ型胶原交联C末端肽(β-CTX)及25(OH)D3检测在评估老年骨质疏松性髋部脆性骨折风险中的临床价值。

方法

测定68例老年骨质疏松性髋部脆性骨折患者及68例年龄、性别匹配的无髋部脆性骨折的骨质疏松症对照者的血清总P1NP、β-CTX及25(OH)D3水平。两组均采用双能X线吸收法检测骨密度(BMD)。

结果

髋部脆性骨折组血清总P1NP和β-CTX水平显著高于对照组,25(OH)D3水平显著低于对照组(P<0.05),但两组腰椎或全髋BMD无显著差异。双变量相关性分析表明,在髋部脆性骨折组中,血清25(OH)D3水平与腰椎和全髋BMD呈正相关,而血清总P1NP和β-CTX水平与腰椎和全髋BMD呈负相关(P<0.05)。在对照组中,25(OH)D3与腰椎或全髋BMD无关,血清总P1NP和β-CTX水平与全髋BMD呈负相关(P<0.05),但与腰椎BMD无关。

结论

在骨密度水平相近的老年骨质疏松症患者中,血清总P1NP和β-CTX水平升高及25(OH)D3水平降低可能独立提示髋部脆性骨折风险较高,检测这三种标志物有助于识别高危个体。

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