Vaculík Jan, Braun Martin, Dungl Pavel, Pavelka Karel, Stepan Jan J
Department of Orthopedics, Faculty of Medicine 1, Charles University Prague, and Bulovka Hospital, Prague, Czech Republic.
Department of Composites and Carbon Materials, Institute of Rock Structure and Mechanics, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
BMC Musculoskelet Disord. 2016 Jul 22;17:308. doi: 10.1186/s12891-016-1168-7.
Femoral neck fractures are a common occurrence in patients suffering from osteoporosis, while intracapsular hip fracture is rare in cases of osteoarthritis of the hip. Previous histomorphometric studies have emphasized the association between bone microarchitecture and the risk of low-impact fractures in osteoarthritis and osteoporosis patients. However, the strength of bone material is also a function of composition of organic bone matrix. In order to compare tissue material properties in these two clinical conditions, serum and bone pentosidine, a non-enzymatic collagen crosslinking element, was measured in patients who suffered a low-impact fracture, and in patients with advanced osteoarthritis.
The patient population consisted of 70 patients who underwent hemiarthroplasty surgery for a femoral neck fracture, and 41 patients with advanced hip joint osteoarthritis without a history of low- impact fracture, who were indicated for total hip joint replacement. Pentosidine content was analyzed in bone samples and in serum obtained from fracture and osteoarthritis patients using high performance liquid chromatography.
Serum and bone concentrations of pentosidine were higher in subjects with hip fractures compared with osteoarthritis after adjustment for age, sex, weight, serum creatinine, and diabetes. A significant positive correlation was found between bone and serum pentosidine in fractured cases. A comparable relationship was also demonstrated for pentosidine levels in serum and bone relative to differentiation of fracture and osteoarthritis cases.
Serum pentosidine can be considered a potential biomarker for identification of subjects with impaired bone quality and bone strength.
股骨颈骨折在骨质疏松患者中很常见，而髋关节囊内骨折在髋骨关节炎患者中很少见。以往的组织形态计量学研究强调了骨微结构与骨关节炎和骨质疏松患者低冲击骨折风险之间的关联。然而，骨材料的强度也是有机骨基质组成的函数。为了比较这两种临床情况下的组织材料特性，我们对发生低冲击骨折的患者和晚期骨关节炎患者的血清和骨戊糖苷（一种非酶促胶原交联成分）进行了测量。
患者群体包括70例行股骨颈骨折半髋关节置换术的患者和41例无低冲击骨折病史、因晚期髋关节骨关节炎而行全髋关节置换术的患者。使用高效液相色谱法分析骨折患者和骨关节炎患者的骨样本及血清中的戊糖苷含量。
在对年龄、性别、体重、血清肌酐和糖尿病进行校正后，髋部骨折患者的血清和骨中戊糖苷浓度高于骨关节炎患者。在骨折病例中，骨和血清戊糖苷之间存在显著的正相关。血清和骨中戊糖苷水平相对于骨折和骨关节炎病例的区分也显示出类似的关系。
血清戊糖苷可被视为识别骨质量和骨强度受损患者的潜在生物标志物。
