Guañabens N, Parés A, Alvarez L, Martínez de Osaba M J, Monegal A, Peris P, Ballesta A M, Rodés J
Metabolic Bone Diseases Unit, Hospital Clínic i Provincial, University of Barcelona, Spain.
J Bone Miner Res. 1998 Apr;13(4):731-8. doi: 10.1359/jbmr.1998.13.4.731.
The influence of a nonskeletal disease with increased connective tissue synthesis or degradation in the collagen-related markers of bone turnover has been evaluated in 34 women with primary biliary cirrhosis (PBC; age range 41-81 years), a disease with increased hepatic fibrosis, often associated with osteoporosis. Serum osteocalcin (BGP), and carboxy-terminal (PICP) and amino-terminal (PINP) propeptides of type I collagen were assessed as indexes of bone formation, whereas serum tartrate-resistant acid phosphatase (TRAP), and cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), and urinary hydroxyproline (HYP), pyridinoline (PYR), deoxypyridinoline (DPYR), and type I collagen cross-linked N- (NTX) and C-telopeptide (CTX) were measured as markers of bone resorption. The histologic stage of the disease and serum amino-terminal propeptide of type III collagen (PIIINP) as an index of liver fibrogenesis were also evaluated. BGP levels were significantly lower, whereas PICP and PINP levels were higher in patients than in controls. Among the bone resorption markers, serum ICTP and urinary PYR, DPYR, HYP, NTX, and CTX levels were significantly higher in patients than in controls. Serum PIIINP levels were also increased in PBC patients. BGP did not correlate with PICP and PINP, but these markers of bone formation as well as ICTP, PYR, DPYR, and NTX correlated with serum PIIINP levels. Serum TRAP did not correlate with collagen-related markers of bone resorption. Moreover, patients with PIIINP and bilirubin above normal levels had higher PICP, PINP, ICTP PYR, DPYR, CTX, and NTX. These markers correlated with the histologic stage of the disease, but not with osteopenia measured by densitometric procedures in 22 patients. In conclusion, collagen-related markers of bone turnover do not reflect bone remodeling in PBC. The close association of these markers with PIIINP and the clinical and histologic stage of the liver disease suggests that they are influenced by liver collagen metabolism.
在34名原发性胆汁性肝硬化（PBC；年龄范围41 - 81岁）女性患者中，评估了一种结缔组织合成或降解增加的非骨骼疾病对骨转换的胶原相关标志物的影响。原发性胆汁性肝硬化是一种肝纤维化增加的疾病，常伴有骨质疏松症。血清骨钙素（BGP）、I型胶原的羧基末端（PICP）和氨基末端（PINP）前肽被评估为骨形成指标，而血清抗酒石酸酸性磷酸酶（TRAP）、I型胶原交联羧基末端肽（ICTP）、尿羟脯氨酸（HYP）、吡啶啉（PYR）、脱氧吡啶啉（DPYR）以及I型胶原交联N末端（NTX）和C末端肽（CTX）被测定为骨吸收标志物。还评估了疾病的组织学分期以及血清III型胶原氨基末端前肽（PIIINP）作为肝纤维化指标。患者的BGP水平显著较低，而PICP和PINP水平高于对照组。在骨吸收标志物中，患者的血清ICTP、尿PYR、DPYR、HYP、NTX和CTX水平显著高于对照组。PBC患者的血清PIIINP水平也升高。BGP与PICP和PINP不相关，但这些骨形成标志物以及ICTP、PYR、DPYR和NTX与血清PIIINP水平相关。血清TRAP与骨吸收的胶原相关标志物不相关。此外，PIIINP和胆红素高于正常水平的患者具有更高的PICP、PINP、ICTP、PYR、DPYR、CTX和NTX。这些标志物与疾病的组织学分期相关，但与22例患者通过骨密度测量程序测得的骨质减少无关。总之，骨转换的胶原相关标志物不能反映PBC中的骨重塑。这些标志物与PIIINP以及肝病的临床和组织学分期密切相关，表明它们受肝胶原代谢的影响。
