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对一系列骨科患者的组织和血清骨代谢参数进行综合评估。

Comprehensive assessment of tissue and serum parameters of bone metabolism in a series of orthopaedic patients.

机构信息

Institute of Pharmacology and Toxicology, Jena University Hospital, Jena, Germany.

Department of Internal Medicine 2, HELIOS Hospital Erfurt, Erfurt, Germany.

出版信息

PLoS One. 2019 Dec 27;14(12):e0227133. doi: 10.1371/journal.pone.0227133. eCollection 2019.

Abstract

Bone diseases represent an increasing health burden worldwide, and basic research remains necessary to better understand the complexity of these pathologies and to improve and expand existing prevention and treatment approaches. In the present study, 216 bone samples from the caput femoris and collum femoris of 108 patients with degenerative or dysplastic coxarthrosis, hip fracture, or osteonecrosis were evaluated for the proportion of trabecular bone (TB) and expression of parathyroid hormone (PTH) type 1 receptor (PTH1R), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL). Serum levels of PTH, OPG, soluble RANKL (sRANKL), alkaline phosphatase (AP), osteocalcin, total procollagen type-1 intact N-terminal propeptide (TP1NP), tartrate-resistant acid phosphatase type 5b (TRAP5b), sclerostin, and C-telopeptide of type-1 collagen (ICTP) were also determined. Age was positively correlated with serum levels of PTH, OPG, and sclerostin but negatively associated with TB and sRANKL. Women exhibited less TB, lower sclerostin and ICTP, and higher TRAP5b. Impaired kidney function was associated with shorter bone decalcification time, less TB, lower sRANKL, and higher serum PTH, OPG, and sclerostin. Furthermore, correlations were observed between bone PTH1R and OPG expression and between serum PTH, OPG, and AP. There were also positive correlations between serum OPG and TP1NP; serum OPG and sclerostin; serum AP, osteocalcin, and TRAP5b; and serum sclerostin and ICTP. Serum OPG was negatively associated with sRANKL. In summary, clear relationships between specific bone metabolism markers were observed, and distinct influences of age, sex, and kidney function, thus underscoring their suitability as diagnostic or prognostic markers.

摘要

骨病是全球日益严重的健康负担,为了更好地理解这些病理的复杂性,并改进和扩展现有的预防和治疗方法,基础研究仍然是必要的。在本研究中,评估了 108 例退行性或发育性髋关节炎、髋部骨折或骨坏死患者的股骨头和股骨颈的 216 个骨样本,以评估其小梁骨(TB)的比例以及甲状旁腺激素(PTH)1 型受体(PTH1R)、骨保护素(OPG)和核因子 kappa-B 配体受体激活剂(RANKL)的表达。还测定了血清甲状旁腺激素(PTH)、骨保护素(OPG)、可溶性核因子 kappa-B 配体受体激活剂(sRANKL)、碱性磷酸酶(AP)、骨钙素、总胶原型 1 完整 N 端前肽(TP1NP)、抗酒石酸酸性磷酸酶 5b(TRAP5b)、硬化蛋白和 I 型胶原 C 端肽(ICTP)的水平。年龄与血清 PTH、OPG 和硬化蛋白呈正相关,与 TB 和 sRANKL 呈负相关。女性的 TB 较少,硬化蛋白和 ICTP 较低,TRAP5b 较高。肾功能受损与骨脱钙时间缩短、TB 减少、sRANKL 升高、血清 PTH、OPG 和硬化蛋白升高有关。此外,还观察到骨 PTH1R 和 OPG 表达之间以及血清 PTH、OPG 和 AP 之间存在相关性。血清 OPG 和 TP1NP 之间存在正相关;血清 OPG 和硬化蛋白;血清 AP、骨钙素和 TRAP5b;以及血清硬化蛋白和 ICTP。血清 OPG 与 sRANKL 呈负相关。总之,观察到特定骨代谢标志物之间存在明确的关系,并且年龄、性别和肾功能有明显的影响,这突出了它们作为诊断或预后标志物的适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2b2/6934299/5d4a51d92853/pone.0227133.g001.jpg

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