Eastell R, Robins S P, Colwell T, Assiri A M, Riggs B L, Russell R G
Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, UK.
Osteoporos Int. 1993 Sep;3(5):255-60. doi: 10.1007/BF01623829.
The aims of the study were to evaluate the use of bone-specific biochemical markers of turnover in type I osteoporosis, to test for evidence of heterogeneity of bone turnover in this condition, and to attempt to devise an 'uncoupling index' by using the relationship between bone-specific biochemical markers of bone formation and bone resorption. In women with type I osteoporosis (mean age 64 years, SD 5; n = 63) the mean level of serum osteocalcin, a specific biochemical marker of bone formation, was 9.9 ng/ml (SD 2.0), which was higher than the level in normal postmenopausal women (mean age 65 years, SD 6; n = 8.9 ng/ml (SD 2.0; p < 0.01). The variance of serum osteocalcin levels in the two groups was similar. Compared with this 11% increase in the biochemical marker for bone formation, the markers of bone resorption, total urinary deoxypyridinoline (bone-specific), pyridinoline and hydroxyproline were increased by 40% (p < 0.0001), 61% (p < 0.0001) and 25% (p < 0.01), respectively. Furthermore, these biochemical markers of bone resorption had greater variance in women in type I osteoporosis than in the normal postmenopausal women (p < 0.01). The urinary excretion of the free crosslinks deoxypyridinoline, pyridinoline and glycosylated pyridinoline were increased by 26% (p < 0.001), 17% (p < 0.01) and 13% (NS) respectively. An 'uncoupling index' was calculated for the difference between urinary deoxypyridinoline and serum osteocalcin using the results from the normal women and expressed as z-scores. We conclude that the pyridinium crosslinks of collagen enable better discrimination between normal and osteoporotic women than does hydroxyproline.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估骨转换的骨特异性生化标志物在I型骨质疏松症中的应用，检测这种情况下骨转换异质性的证据，并尝试通过利用骨形成和骨吸收的骨特异性生化标志物之间的关系设计一个“解偶联指数”。在I型骨质疏松症女性患者（平均年龄64岁，标准差5；n = 63）中，骨形成的特异性生化标志物血清骨钙素的平均水平为9.9 ng/ml（标准差2.0），高于正常绝经后女性（平均年龄65岁，标准差6；n = 8.9 ng/ml（标准差2.0；p < 0.01）。两组血清骨钙素水平的方差相似。与骨形成生化标志物11%的增加相比，骨吸收标志物、总尿脱氧吡啶啉（骨特异性）、吡啶啉和羟脯氨酸分别增加了40%（p < 0.0001）、61%（p < 0.0001）和25%（p < 0.01）。此外，I型骨质疏松症女性的这些骨吸收生化标志物的方差比正常绝经后女性更大（p < 0.01）。游离交联物脱氧吡啶啉、吡啶啉和糖基化吡啶啉的尿排泄分别增加了26%（p < 0.001）、17%（p < 0.01）和13%（无显著性差异）。利用正常女性的结果计算尿脱氧吡啶啉和血清骨钙素之间差异的“解偶联指数”，并以z分数表示。我们得出结论，与羟脯氨酸相比，胶原蛋白的吡啶交联物能更好地区分正常女性和骨质疏松女性。（摘要截短至250字）
