Delmas P D, Wahner H W, Mann K G, Riggs B L
J Lab Clin Med. 1983 Oct;102(4):470-6.
Controversy persists regarding the abnormality of bone turnover responsible for bone loss in women with postmenopausal osteoporosis. To evaluate this, we measured serum bone Gla-protein (BGP), a specific marker for bone turnover, in 62 untreated patients with postmenopausal osteoporosis. Results were compared with those in 142 normal women and were expressed as standard deviations from the age-adjusted predicted mean (Z score). Serum BGP was increased (+0.48 S.D., p = 0.002) in the osteoporotic patients; 9.7% of patients were greater than 2 S.D. above but none were greater than 2 S.D. below the normal mean. Moreover, when data from normal postmenopausal women (ages 51 to 75 years) and the osteoporotic patients were merged, significant negative correlation existed (r = -0.36, p less than 0.001) between serum BGP and bone density of the lumbar spine assessed by dual photon absorptiometry. Serum alkaline phosphatase, a less specific marker for bone formation, was also increased (+0.96 S.D., p less than 0.001) in the osteoporotic patients. The data suggest that overall bone turnover is increased in patients with postmenopausal osteoporosis and do not support the concept that an absolute decrease in bone formation is the major cause of the bone loss.
对于绝经后骨质疏松症女性骨质流失所涉及的骨转换异常问题，争议仍然存在。为了对此进行评估，我们对62例未经治疗的绝经后骨质疏松症患者测量了血清骨钙素（BGP），这是一种骨转换的特异性标志物。将结果与142名正常女性的结果进行比较，并表示为相对于年龄校正预测均值的标准差（Z评分）。骨质疏松症患者的血清BGP升高（+0.48标准差，p = 0.002）；9.7%的患者高于正常均值2个标准差以上，但没有患者低于正常均值2个标准差以下。此外，当将绝经后正常女性（年龄51至75岁）和骨质疏松症患者的数据合并时，血清BGP与通过双能光子吸收法评估的腰椎骨密度之间存在显著负相关（r = -0.36，p小于0.001）。血清碱性磷酸酶，一种对骨形成特异性较低的标志物，在骨质疏松症患者中也升高（+0.96标准差，p小于0.001）。数据表明，绝经后骨质疏松症患者的总体骨转换增加，不支持骨形成绝对减少是骨质流失主要原因的观点。
