BMC Musculoskelet Disord. 2013 Jan 3;14:6. doi: 10.1186/1471-2474-14-6.
Until now the exact biochemical processes during healing of metaphyseal fractures of healthy and osteoporotic bone remain unclear. Especially the physiological time courses of 25(OH)D(3) (Vitamin D) as well as PTH (Parathyroid Hormone) the most important modulators of calcium and bone homeostasis are not yet examined sufficiently. The purpose of this study was to focus on the time course of these parameters during fracture healing.
In the presented study, we analyse the time course of 25(OH)D3 and PTH during fracture healing of low BMD level fractures versus normal BMD level fractures in a matched pair analysis. Between March 2007 and February 2009 30 patients older than 50 years of age who had suffered a metaphyseal fracture of the proximal humerus, the distal radius or the proximal femur were included in our study. Osteoporosis was verified by DEXA measuring. The time courses of 25(OH)D(3) and PTH were examined over an eight week period. Friedmann test, the Wilcoxon signed rank test and the Mann-Withney U test were used as post-hoc tests. A p-value ≤ 0.05 was considered significant.
Serum levels of 25(OH)D(3) showed no differences in both groups. In the first phase of fracture healing PTH levels in the low BMD level group remained below those of the normal BMD group in absolute figures. Over all no significant differences between low BMD level bone and normal BMD level bone could be detected in our study.
The time course of 25(OH)D(3) and PTH during fracture healing of patients with normal and low bone mineral density were examined for the first time in humans in this setting and allowing molecular biological insights into fracture healing in metaphyseal bones on a molecural level. There were no significant differences between patients with normal and low BMD levels. Hence further studies will be necessary to obtain more detailed insight into fracture healing in order to provide reliable decision criteria for therapy and the monitoring of fracture healing.
目前为止，健康骨和骨质疏松骨的干骺端骨折愈合过程中的确切生化过程仍不清楚。特别是最重要的钙和骨稳态调节剂 25（OH）D（3）（维生素 D）和 PTH（甲状旁腺激素）的生理时间过程还没有得到充分的检查。本研究的目的是关注这些参数在骨折愈合过程中的时间过程。
在本研究中，我们在配对分析中分析了低骨密度骨折与正常骨密度骨折患者骨折愈合过程中 25（OH）D3 和 PTH 的时间过程。2007 年 3 月至 2009 年 2 月期间，我们纳入了 30 名年龄大于 50 岁的患者，这些患者患有肱骨近端、桡骨远端或股骨近端干骺端骨折。骨质疏松症通过 DEXA 测量来验证。在 8 周的时间内检查了 25（OH）D（3）和 PTH 的时间过程。弗里德曼检验、Wilcoxon 符号秩检验和 Mann-Whitney U 检验被用作事后检验。p 值≤0.05 被认为具有统计学意义。
两组患者的血清 25（OH）D（3）水平无差异。在骨折愈合的第一阶段，低骨密度组的 PTH 水平在绝对值上仍低于正常骨密度组。在我们的研究中，在低骨密度骨和正常骨密度骨之间没有发现显著差异。
首次在该背景下检查了正常和低骨密度患者骨折愈合过程中 25（OH）D（3）和 PTH 的时间过程，从而使分子生物学能够深入了解干骺端骨折愈合的分子水平。在正常和低骨密度组之间没有发现显著差异。因此，需要进一步的研究以更详细地了解骨折愈合情况，从而为治疗和监测骨折愈合提供可靠的决策标准。
