Katagiri M, Fukunaga M, Ohtawa T, Harada T
Department of Surgery, Eiju General Hospital, 2-11-7 Motoasakusa, Taitouku, Tokyo 111, Japan.
World J Surg. 1996 Sep;20(7):753-6; discussion 756-7. doi: 10.1007/s002689900114.
Serum levels of the carboxy-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP) and the carboxy-terminal propeptide of type I procollagen (PICP) were measured in 95 patients with renal hyperparathyroidism who had undergone a total parathyroidectomy and autotransplantation of a small portion of the resected gland. The results were compared with the serum levels of other bone metabolic markers and bone mineral densities in the distal radius (R-BMD) and lumbar vertebrae (L-BMD), which were measured by dual energy x-ray absorptiometry and converted to the percentage of the mean value of sex- and age-matched healthy controls. The preoperative mean values of ICTP and PICP were 142.4 ng/ml and 187.8 ng/ml, respectively. Although the serum levels of PICP levels exceeded the normal range in 42.1% of the patients, those of ICTP exceeded it in all of them. The serum levels of ICTP correlated positively not only with those of tartrate-resistant acid phosphatase (TRACP), total alkaline phosphatase (ALP), and osteocalcin but also negatively with the values of %R-BMD and %L-BMD and seemed to manifest specifically the disturbance of bone metabolism. On the other hand, the serum levels of PICP correlated with those of ALP and TRACP but not with values of %BMDs. After surgery, the serum levels of ICTP decreased gradually, but those of PICP increased immediately up to peak values at 7 days and then decreased gradually after 14 days, reaching the normal range at 3 months. These changes in the bone metabolic markers seemed to reflect the change in bone metabolism that was converting from bone resorption to bone formation. The percent change in the PICP/ICTP ratio at 7 days correlated significantly with the percent change in R-BMD at 12 months, and it was suggested that postoperative bone gain might be predicted using a combination of postoperative changes in PICP and ICTP.
对95例接受甲状旁腺全切除术及部分切除腺体自体移植的肾性甲状旁腺功能亢进患者，检测其血清I型胶原羧基末端吡啶啉交联终肽（ICTP）和I型前胶原羧基末端前肽（PICP）水平。将结果与其他骨代谢标志物的血清水平以及通过双能X线吸收法测量的桡骨远端（R - BMD）和腰椎（L - BMD）骨密度进行比较，并将其转换为性别和年龄匹配的健康对照者平均值的百分比。术前ICTP和PICP的平均值分别为142.4 ng/ml和187.8 ng/ml。虽然42.1%的患者PICP血清水平超过正常范围，但所有患者的ICTP血清水平均超过正常范围。ICTP血清水平不仅与抗酒石酸酸性磷酸酶（TRACP）、总碱性磷酸酶（ALP）和骨钙素水平呈正相关，还与%R - BMD和%L - BMD值呈负相关，似乎特别体现了骨代谢紊乱。另一方面，PICP血清水平与ALP和TRACP水平相关，但与%BMDs值无关。术后，ICTP血清水平逐渐下降，但PICP血清水平立即升高，在7天达到峰值，然后在术后14天逐渐下降，3个月时恢复到正常范围。这些骨代谢标志物的变化似乎反映了骨代谢从骨吸收向骨形成的转变。术后7天PICP/ICTP比值的变化百分比与术后12个月R - BMD的变化百分比显著相关，提示可通过联合术后PICP和ICTP的变化来预测术后骨量增加。
