Kushida K, Takahashi M, Kawana K, Inoue T
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Japan.
J Clin Endocrinol Metab. 1995 Aug;80(8):2447-50. doi: 10.1210/jcem.80.8.7629240.
Recently, the biochemical markers for bone metabolism have been developed and are expected to reflect the minor change of bone turnover. We compared bone formation markers: alkaline phosphatase-(Alp), bone gla-protein(BGP), carboxy-terminal propeptide of type I collagen(PICP); and bone resorption markers: carboxy-terminal telopeptide of type I collagen(ICTP), pyridinoline(Pyr), deoxypyridinoline(Dpyr) to see if they reflected the effects of aging and menopause in 95 premenopausal and 66 postmenopausal healthy subjects. We also compared the bone turnover in 29 vertebral osteoporosis patients. All markers except ICTP significantly increased with age in the healthy subjects. Alp, BGP, PICP, Pyr, and Dpyr were significantly higher in the postmenopausal group than in the premenopausal group. BGP, Pyr, and Dpyr in premenopausal subjects in their 50s were already significantly increased compared with BGP, Pyr, and Dpyr in premenopausal subjects in their 30s and 40s. To evaluate the discrimination power of the six markers in the postmenopausal subjects and in patients with osteoporosis, the z scores of six markers were calculated against the premenopausal group. z-scores of bone resorption markers(ICTP, Pyr, and Dpyr) were much higher than those of bone formation markers (Alp, BGP, and PICP) in patients with osteoporosis, even though z-scores of bone resorption markers were similar to those of bone formation markers in postmenopausal subjects. In conclusion, Alp, BGP, PICP, Pyr, and Dpyr had good performance in postmenopausal status. Resorption markers increased more than formation markers in osteoporosis subjects, and the bone turnover in osteoporosis subjects was more uncoupled than in postmenopausal subjects.
近年来，骨代谢生化标志物不断发展，有望反映骨转换的微小变化。我们比较了骨形成标志物：碱性磷酸酶（Alp）、骨钙素（BGP）、I型胶原羧基端前肽（PICP）；以及骨吸收标志物：I型胶原羧基端肽（ICTP）、吡啶啉（Pyr）、脱氧吡啶啉（Dpyr），以观察它们是否能反映95名绝经前和66名绝经后健康受试者衰老和绝经的影响。我们还比较了29例椎体骨质疏松患者的骨转换情况。在健康受试者中，除ICTP外，所有标志物均随年龄显著增加。绝经后组的Alp、BGP、PICP、Pyr和Dpyr显著高于绝经前组。与30多岁和40多岁的绝经前受试者相比，50多岁的绝经前受试者的BGP、Pyr和Dpyr已经显著升高。为了评估这六种标志物在绝经后受试者和骨质疏松患者中的鉴别能力，计算了六种标志物相对于绝经前组的z分数。骨质疏松患者的骨吸收标志物（ICTP、Pyr和Dpyr）的z分数远高于骨形成标志物（Alp、BGP和PICP），尽管绝经后受试者的骨吸收标志物的z分数与骨形成标志物的z分数相似。总之，Alp、BGP、PICP、Pyr和Dpyr在绝经后状态下表现良好。骨质疏松患者中骨吸收标志物的增加超过骨形成标志物，且骨质疏松患者的骨转换比绝经后受试者更不协调。
