Bornefalk E, Dahlén I, Michaëlsson K, Ljunghall S
Department of Medicine, Akademiska sjukhuset, Uppsala, Sweden.
Calcif Tissue Int. 1998 Jul;63(1):9-13. doi: 10.1007/s002239900482.
It is generally accepted that bone formation is depressed during corticosteroid treatment, but the effects of glucocorticoids on bone resorption are less well characterized. We have investigated the effects of short-term treatment with high-dose oral glucocorticoids on biochemical markers of bone turnover in 20 consecutive patients with asthma who sought help for acute respiratory obstruction in our emergency department. Serum concentrations of the carboxy-terminal cross-linked telopeptide of type 1 collagen (1CTP), reflecting bone resorption, and the carboxy-terminal propeptide of type 1 procollagen (P1CP), reflecting bone formation, were measured by radioimmunoassay. Changes of the circulating levels of the bone resorption marker 1CTP after treatment were age dependent with a significant negative correlation (r = -0.54, P = 0.01). The dependency on age remained when correcting, in a multiple linear regression analysis, for 1CTP levels at admission, weight, sex, and daily maintenance dose of inhaled glucocorticoids. Circulating levels of P1CP were suppressed in the whole group 1 week after initiation of glucocorticoid therapy, from 123.3 +/- 10.2 ng/ml at admission to 88.1 +/- 6.3 ng/ml after 1 week (P < 0.01). The changes in P1CP levels were not related to age. Our data indicate that bone formation is suppressed by glucocorticoids in all age groups, whereas the effect of glucocorticoids on markers of bone resorption is dependent on age.
一般认为，皮质类固醇治疗期间骨形成受到抑制，但糖皮质激素对骨吸收的影响尚不十分清楚。我们调查了20例因急性呼吸阻塞到我们急诊科寻求帮助的连续哮喘患者，给予高剂量口服糖皮质激素短期治疗对骨转换生化标志物的影响。通过放射免疫分析法测定反映骨吸收的1型胶原羧基末端交联肽（1CTP）和反映骨形成的1型前胶原羧基末端前肽（P1CP）的血清浓度。治疗后骨吸收标志物1CTP循环水平的变化与年龄相关，呈显著负相关（r = -0.54，P = 0.01）。在多元线性回归分析中，校正入院时的1CTP水平、体重、性别和吸入糖皮质激素的每日维持剂量后，年龄依赖性仍然存在。糖皮质激素治疗开始1周后，全组P1CP的循环水平受到抑制，从入院时的123.3±10.2 ng/ml降至1周后的88.1±6.3 ng/ml（P < 0.01）。P1CP水平的变化与年龄无关。我们的数据表明，糖皮质激素在所有年龄组中均抑制骨形成，而糖皮质激素对骨吸收标志物的影响则取决于年龄。
