Hoshino H, Kushida K, Takahashi M, Kawana K, Denda M, Yamazaki K, Inoue T
Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Japan.
Endocr Res. 1998 Feb;24(1):55-64. doi: 10.3109/07435809809031868.
Biochemical markers of bone turnover are expected to have some different characteristics among bone metabolic disorders. We compared bone formation markers: serum total alkaline phosphatase (s-Alp), serum osteocalcin (s-OC) and serum carboxy-terminal propeptide of type I collagen (s-PICP); and bone resorption markers: serum carboxy-terminal telopeptide of type I collagen (s-ICTP), urinary pyridinoline (u-Pyr) and urinary deoxypyridinoline (u-Dpyr) to examine which marker is the most suitable and reliable to evaluate bone turnover in patients with osteoporosis (n = 29), osteomalacia (n = 10), primary hyperparathyroidism (n = 6) and renal osteodystrophy (n = 21). The value of s-Alp in the osteomalacia group was significantly higher than those in the normal control group and the osteoporosis group (p < 0.001), and T-score of s-Alp was significantly higher than those of s-OC and s-PICP in the osteomalacia group. The values of u-Pyr and u-Dpyr in the primary hyperparathyroidism group were significantly higher than those in the other groups (p < 0.001). S-PICP, which are not dependent upon renal function, was much higher in the renal osteodystrophy group than in all other groups. In the osteoporosis group, T-score of s-ICTP was significantly higher than those of s-OC. Thus, s-Alp was a good marker in osteomalacia, u-Pyr and u-Dpyr in primary hyperparathyroidism, s-PICP in renal osteodystrophy, and s-ICTP in osteoporosis.
骨转换的生化标志物在不同的骨代谢紊乱中可能具有一些不同的特征。我们比较了骨形成标志物：血清总碱性磷酸酶（s-Alp）、血清骨钙素（s-OC）和血清I型胶原羧基末端前肽（s-PICP）；以及骨吸收标志物：血清I型胶原羧基末端肽（s-ICTP）、尿吡啶啉（u-Pyr）和尿脱氧吡啶啉（u-Dpyr），以检查哪种标志物最适合且可靠地评估骨质疏松症患者（n = 29）、骨软化症患者（n = 10）、原发性甲状旁腺功能亢进患者（n = 6）和肾性骨营养不良患者（n = 21）的骨转换情况。骨软化症组中s-Alp的值显著高于正常对照组和骨质疏松症组（p < 0.001），并且在骨软化症组中s-Alp的T值显著高于s-OC和s-PICP的T值。原发性甲状旁腺功能亢进组中u-Pyr和u-Dpyr的值显著高于其他组（p < 0.001）。不依赖于肾功能的s-PICP在肾性骨营养不良组中比所有其他组都高得多。在骨质疏松症组中，s-ICTP的T值显著高于s-OC的T值。因此，s-Alp是骨软化症的良好标志物，u-Pyr和u-Dpyr是原发性甲状旁腺功能亢进的良好标志物，s-PICP是肾性骨营养不良的良好标志物，s-ICTP是骨质疏松症的良好标志物。
