老年男性代谢综合征患者骨密度与骨量、骨代谢物的关系
罗南萍，刘恒国，李金花，胡成进
课题背景：从骨量减少到骨质疏松症发生过程中，与环境因素、年龄、激素调控、营养状况、遗传因素、体质量指数等有关。采用骨密度测定诊断骨质疏松是较为准确的方法，但不能测定早期骨质疏松的变化，而骨代谢指标则能早期反映全身骨代谢变化。
应用要点：随着对骨质疏松症研究的不断深入，应用骨转换指标、骨代谢指标与骨密度测定同时应用，对骨质疏松症的早期诊断，预测骨量丢失和判断疗效等具有及其重要的临床意义。
相关链接：骨密度测量是诊断骨质疏松症的主要定量依据，骨密度和对骨量的影响及其他骨代谢指标相互关系是近几年来的研究热点。骨钙素、I型胶原C端肽、甲状旁腺素等骨代谢物在骨吸收和骨形成过程中起重要作用，它们可促进成骨细胞增殖，促进骨形成和矿化，增加成骨细胞的数量，减少骨量丢失，还可促进肾脏1，25（OH）2D3的合成，促进肠道钙磷吸收，其代谢异常与骨质疏松的发生密切相关。�
摘要
目的：观察老年男性代谢综合征患者骨密度与骨代谢指标含量表达的变化规律。
方法：选择2006-05/06济南地区部队干休所离休老干部查体人员。代谢综合征及其相关组分诊断标准采用1999年WHO代谢综合征的工作定义。应用SetriscamTM数字化成像技术及放射免疫分析法，对代谢综合征组90例（其中骨质疏松22例和骨量减少30例），单纯高血压组38例，单纯糖尿病组30例，单纯高血脂组32例患者进行骨密度、骨钙素等骨代谢指标和生化指标的测定，与相同年龄对照组进行比较，并对骨密度与各项骨代谢指标进行相关性分析。
结果：①代谢综合征骨质疏松组、代谢综合征骨量减少组、单纯糖尿病组的骨密度和峰值百分比明显低于正常对照组（P < 0.05~0.01）。②代谢综合征组、代谢综合征骨质疏松和骨量减少组骨钙素、Ⅰ型胶原C端肽低于正常对照组（P < 0.05~0.01），甲状旁腺素高于正常对照组（P < 0.05）。三组患者均存在不同程度高血糖、高血压和血脂紊乱。③代谢综合征骨质疏松组骨密度与骨钙素呈正相关关系（r =0.262），与甲状旁腺素呈负相关（r =-0.233），与血压呈明显负相关（r =-0.285），与生化指标之间无相关性。
结论：代谢综合征骨质疏松患者骨密度与骨钙素、甲状旁腺素、Ⅰ型胶原C端肽、血压之间密切相关。
关键词：骨密度；骨代谢物；骨质疏松；代谢综合征；放射免疫分析；组织构建
罗南萍，刘恒国，李金花，胡成进.老年男性代谢综合征患者骨密度与骨量、骨代谢物的关系[J].中国组织工程研究与临床康复，2008，12(7):1247-1250 [www.zglckf.com/zglckf/ejournal/upfiles/08-7/7k-1247(ps).pdf]
解放军济南军区总医院实验诊断科，山东省济南市
250031
罗南萍，女，1950年生，江西省吉水县人，汉族，1989年解放军第三军大学毕业，主任技师，主要从事老年病的免疫学研究。
lnp2000cn@yahoo.
com.cn
中图分类号:R681.4
文献标识码:B
文章编号:1673-8225
(2008)07-01247-04
收稿日期：2007-07-23 修回日期：2007-09-14（07-50-7-3970/M·A）
Correlation of bone mineral density to bone mass and bone metabolic products in aged males with metabolic syndrome
Abstract
AIM：To observe the change rules of bone mineral density (BMD) and bone metabolic products in aged male patients with metabolic syndrome (MS).
METHODS: The retired cadres who underwent physical examination in Cadre Reset Institute of Jinan were selected from May to June 2006. Based on the MS diagnosis criteria in 1999, SetriscamTM digital image-graph technology and radio-immunoassay were used to measure bone metabolic indexes, such BMD and osteocalcin, and biochemical markers in 90 MS patients, including 22 patients with osteoporosis and 30 patients with decreased bone mass, 38 hypertensive patients, 30 DM patients and 32 hyperlipemia (HP) patients. The results were analyzed and compared with those of the control group. While, the correlation of BMD with each bone metabolic indexes was investigated.
RESULTS: ① The BMD and the peak value ratio in the MS with osteoporosis, the decreased bone mass and the only DM groups were significantly decreased as compared with those of the control group (P < 0.05-0.01). ② The osteocalcin level and the type Ⅰ collagen carboxyl terminal peptide level in the MS, the MS with osteoporosis and the decreased bone mass groups were also significantly decreased as compared with those in the normal control group (P < 0.05-0.01). While, the level of parathyroid hormone (PTH) was significantly higher than that in the control group (P < 0.05). Hyperglycemia, hypertension and dyslipoidemia were all found in the three experimental groups. ③ BMD was positively correlated with osteocalcin in the MS with osteoporosis group (r =0.262), negatively correlated with the increased PTH (r = -0.233) and the blood pressure (r =-0.285) and not correlated with other biological indexes.
CONCLUSION: BMD is closely related to osteocalcin, PTH, type Ⅰ collagen carboxyl terminal peptide and blood pressure in osteoporotic patients with MS.
Luo NP, Liu HG, Li JH, Hu CJ.Correlation of bone mineral density to bone mass and bone metabolic products in aged males with metabolic syndrome.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(7):1247-1250(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-7/7k-1247(ps).pdf]
Department of Spinal Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China
Luan Jun-wei★, Studying for master's degree, Resident physician, Department of Spinal Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China
ljw_003@hotmail.
com
Correspondence to: Chen Xiao-liang, Professor, Chief physician, Tutor of master, Department of Spinal Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China
Received: 2007-09-07
Accepted: 2007-10-26
Advertisement |
 |