Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Department of Laboratory Medicine, People's Hospital of Tibet Autonomous Region, Tibet Lhasa, China.
J Clin Lab Anal. 2021 Dec;35(12):e24068. doi: 10.1002/jcla.24068. Epub 2021 Oct 26.
To measure and evaluate the distribution and possible contributing factors of seven bone metabolism-associated biomarkers in Tibet, a plateau province of China.
A total of 1615 individuals were recruited from Tibet at three different altitudes. The levels and possible contributing factors of serum calcium, serum phosphorus, ALP, 25OHD, PINP, CTX, and PTH were evaluated.
In total, 1246 Tibetan adults (males: n = 543) were eventually enrolled in this study. Multiple linear regression recognized age, sex, altitude, and BMI as the major effect factors. The levels of ALP, PINP, and CTX in males continuously decreased with age; however, those in females increased after approximately 39 years of age. Males had higher 25OHD levels (23.9 vs. 15.4 ng/ml) but lower levels of serum phosphorus (1.12 vs. 1.19 mmol/L) and PTH (41.3 vs. 47.4 pg/ml) than females. Before the age of 50, males had higher levels of calcium, ALP, PINP, and CTX than females, and the opposite trend was observed after the age of 50. The highest levels of serum calcium and phosphorus and the lowest levels of PINP and CTX were found in the Shigatse/Lhasa region, suggesting a better bone metabolism status. Compared with reports from plain areas of China, significantly higher levels of PINP (65.3 vs. 49.36 ng/ml) and CTX (0.46 vs. 0.37 ng/ml) were recorded in Tibetan adults.
A more active bone turnover status was found in Tibetan adults than in individuals from the plain areas of China.
测量和评估中国高原省份西藏的 7 种与骨代谢相关的生物标志物的分布及其可能的影响因素。
在西藏的三个不同海拔高度共招募了 1615 名个体。评估血清钙、磷、碱性磷酸酶（ALP）、25-羟维生素 D（25OHD）、I 型前胶原氨基端延长肽（PINP）、I 型胶原 C 端肽（CTX）和甲状旁腺激素（PTH）的水平和可能的影响因素。
共有 1246 名藏族成年人（男性：n=543）最终纳入本研究。多元线性回归确定年龄、性别、海拔和 BMI 为主要影响因素。男性的 ALP、PINP 和 CTX 水平随年龄增长而持续下降；而女性在大约 39 岁后则增加。男性的 25OHD 水平较高（23.9 比 15.4ng/ml），但血清磷（1.12 比 1.19mmol/L）和 PTH（41.3 比 47.4pg/ml）水平较低。50 岁之前，男性的钙、ALP、PINP 和 CTX 水平高于女性，而 50 岁后则相反。血清钙和磷水平最高，PINP 和 CTX 水平最低的是在日喀则/拉萨地区，提示骨代谢状态较好。与中国平原地区的报告相比，藏族成年人的 PINP（65.3 比 49.36ng/ml）和 CTX（0.46 比 0.37ng/ml）水平显著更高。
与中国平原地区的人群相比，藏族成年人的骨转换状态更为活跃。
