CAJ | 학술논문

目的探讨中老年妇女骨转换生化指标与骨密度随绝经的变化.方法 408名符合条件40 ～80岁的女性志愿者,同一时间段留取血清和晨尿,统一用酶免方法测定血清骨碱性磷酸酶(BAP)、骨钙素和尿I型胶原氨基末端肽(uNTX);用舣能X线骨密度仪测定前后位腰椎1-4(L1-4)、左侧股骨颈的骨密度.结果 (1)BAP、骨钙素和uNTX与年龄、孕次、生育次数和绝经年限呈正相关(均P<O.01);L1-4和股骨颈部位的骨密度与年龄、孕次、生育次数和绝经年限呈负相关(均P<O.01).(2)40～55岁绝经后妇女BAP、骨密度和uNTX水平均较绝经前妇女高(P<O.01),而绝经后妇女的L1-4股骨颈部位的骨密度均低于绝经前妇女(P<O.01).(3)绝经年限1～5年组、6～10年组、11～15年组和≥16年组的BAP、骨钙素和uNTX均较绝经前组增高(P<O.01),尤其在绝经后前5年迅速升高,而L1-4、股骨颈部位的骨密度则急剧降低.(4)骨质疏松组和低骨量组BAP、骨钙素和uNTX浓度均高于骨量正常组(P<O.05).结论妇女绝经后骨密度降低,骨质疏松的发生与高骨代谢转换率有关.因此监测骨转换生化指标有助于绝经后骨质疏松症的早期防治.
목적 탐토중노년부녀골전환생화지표여골밀도수절경적변화.방법 408명부합조건40 ～80세적녀성지원자,동일시간단류취혈청화신뇨,통일용매면방법 측정혈청골감성린산매(BAP)、골개소화뇨I형효원안기말단태(uNTX);용의능X선골밀도의측정전후위요추1-4(L1-4)、좌측고골경적골밀도.결과 (1)BAP、골개소화uNTX여년령、잉차、생육차수화절경년한정정상관(균P<O.01);L1-4화고골경부위적골밀도여년령、잉차、생육차수화절경년한정부상관(균P<O.01).(2)40～55세절경후부녀BAP、골밀도화uNTX수평균교절경전부녀고(P<O.01),이절경후부녀적L1-4고골경부위적골밀도균저우절경전부녀(P<O.01).(3)절경년한1～5년조、6～10년조、11～15년조화≥16년조적BAP、골개소화uNTX균교절경전조증고(P<O.01),우기재절경후전5년신속승고,이L1-4、고골경부위적골밀도칙급극강저.(4)골질소송조화저골량조BAP、골개소화uNTX농도균고우골량정상조(P<O.05).결론 부녀절경후골밀도강저,골질소송적발생여고골대사전환솔유관.인차감측골전환생화지표유조우절경후골질소송증적조기방치.
Objective To study the changes of biochemical markers of bone turnover and bone mineral density (BMD) in mid- and old-aged women.Methods A total of 408 female volunteers aged 40 to 86 years were enrolled.Serum bone alkaline phosphatase (BAP),osteoealtin and urine type I collagen N-telopeptide(uN'TX) were measured using ELISA,and BM D at anteroposterior lumbar spine 1-4(L1-4)and femoral neck (FN) was detected by dual energy X-ray absorptiometry (QDR4500A).Results (1) Serum BAP,osteocaltin and uNTX levels were positively correlated with age,parity,number of births and duration of menopause (all P<O.O 1),while BMD at L1-4 and FN were negatively correlated with age,parity,number of births and duration of menopause (all P<0.01).(2)In subjects aged 40 to 55 years,levels of serum BAP,osteocahin and uNTX significantly increased in postmenopausal women compared with premenopausal women,whereas BMD at L1-4 and FN decreased(all P<O.01).(3)The levels of the bone biomarkers increased rapidly,but those of BMD at both sites decreased abruptly within five years after menopause(all P<O.O1).(4)Serum BAP,osteocahin and uNTX values in women with osteoporosis and osteopenia were lower than those in normal BMD women(all P<0.05).Conclusion Increased bone biomarker levels in postmenopausal women are associated with a decreased BMD value and increased risk factors for osteoporosis.Measurmeut of the biochemical markers of bone turnover seems to be helpful for early diagnosis and prevention of osteoporosis.