Szulc P, Chapuy M C, Meunier P J, Delmas P D
INSERM Research Unit, Hôpital Edouard Herriot, Lyon, France.
Bone. 1996 May;18(5):487-8. doi: 10.1016/8756-3282(96)00037-3.
We have previously shown that elderly women with an increased serum undercarboxylated osteocalcin (ucOC) level have an increased risk of sustaining a hip fracture as compared to those with normal serum ucOC. We reassessed our findings on a larger number of hip fractures that occurred over 3 years in 183 institutionalized women (aged 70-97 years) belonging to a large prospective clinical trial. Total OC, carboxylated OC, ucOC, and alkaline phosphatase were significantly higher at baseline in those who sustained a hip fracture during the follow-up. The age-adjusted odds ratio for hip fracture was three times higher in women with increased ucOC at baseline (odds ratio = 3.1, 99.9% C.I. = 1.7-6.0, p < 0.001). In the logistic regression, ucOC was still predictive of the hip fracture when age and parathyroid hormone concentration were included into the model (odds ratio = 2.6, 95% C.I. = 1.05-6.4). These data confirm that ucOC is a marker of the increased risk of hip fracture in elderly institutionalized women. Serum ucOC may reflect some nutritional deficiency associated with increased bone fragility.
我们之前已经表明，与血清未羧化骨钙素（ucOC）水平正常的老年女性相比，血清ucOC水平升高的老年女性发生髋部骨折的风险增加。我们对来自一项大型前瞻性临床试验的183名（年龄在70 - 97岁之间）机构养老女性在3年期间发生的大量髋部骨折的研究结果进行了重新评估。在随访期间发生髋部骨折的患者中，总骨钙素（OC）、羧化骨钙素、ucOC和碱性磷酸酶在基线时显著更高。基线时ucOC升高的女性发生髋部骨折的年龄调整优势比高出三倍（优势比 = 3.1，99.9%置信区间 = 1.7 - 6.0，p < 0.001）。在逻辑回归分析中，当将年龄和甲状旁腺激素浓度纳入模型时，ucOC仍然可预测髋部骨折（优势比 = 2.6，95%置信区间 = 1.05 - 6.4）。这些数据证实，ucOC是机构养老老年女性髋部骨折风险增加的一个标志物。血清ucOC可能反映了一些与骨脆性增加相关的营养缺乏情况。
