分析骨转换生化标志物在骨质疏松症治疗中的临床应用

目的:探讨对骨质疏松症患者施以治疗过程中,分析骨转换生化标志物的临床检测价值.方法:选择我院2013年04月~2016年02月收治的106例骨质疏松症患者作为实验对象;所有骨质疏松症患者分组通过随机数表法展开;对照组:常规治疗;观察组:常规治疗+骨转换生化标志物检测;对骨质疏松症疾病治愈率以及观察组骨转换指标差异回顾性分析.结果:观察组骨质疏松症患者疾病治愈率(96.23%)同对照组骨质疏松症患者(60.38%)比较,增加程度显著(P<0.05);观察组骨质疏松症患者治疗后骨转换生化指标表现同治疗前比较,改善程度显著(P<0.05).结论:对于骨质疏松症患者在治疗期间施以骨转换生化标志物检测,对于患者的骨形成情况以及患者的骨吸收情况可以有效加以敏感反应,从而对于骨质疏松症疾病疗效的提高可以奠定基础.     

阴道分泌物生化标志物联合检测的评价

目的 探讨阴道分泌物生化标志物联合检测的临床应用价值.方法 随机选取200例妇科门诊阴道炎患者的分泌物,采用试剂盒联合检测阴道分泌物的pH值、过氧化氢、白细胞酯酶、唾液酸苷酶、脯氨酸氨肽酶以及N-乙酰-β-D氨基葡萄糖苷酶6项生化标志物,并与革兰染色镜检结果比较.结果 6项生化标志物联合检测乳杆菌属、白细胞、细菌性阴道病、假丝酵母菌属以及滴虫,与革兰染色镜检的总符合率分别为85.5％、95.0％、97.5％、93.0％、90.5％,仅有滴虫检测与革兰染色镜检差异有统计学意义(P＜0.05),其他各组差异均无统计学意义.结论 阴道分泌物生化标志物联合检测可替代革兰染色镜检,具有很好的应用前景.     

中老年人骨代谢生化标志物骨钙素测定的临床价值

目的 通过对中老年人群进行骨代谢生化指标血清骨钙素(BGP)和血清碱性磷酸酶(ALP)、血清钙(Ca)、血清磷(P)的检测,探讨中老年人群的骨代谢动态变化,以及影响血清BGP含量变化的相关因素.方法 随机选择社区中老年居民1 500例.其中男703例,女797例.按性别、年龄、分组,每10岁为一年龄组.对所有参加人员均进行血清BGP、ALP、 Ca、 P的测定.结果 男、女两性组随着年龄的增长,血清BGP含量均逐渐降低,说明中老年人群的骨代谢处于缓慢高分解 、低合成的负平衡状态.两者呈负相关性.但是在女性年龄(50～59岁)组,血清BGP含量却明显高于另两年龄组.差异有统计学意义.血清ALP、Ca、P在两性组差异无统计学意义.结论 血清BGP是反映骨代谢指标的一项敏感而特异的指标,在中老年人群中检测BGP水平可及时进行高危骨折风险的评估.     

围绝经期妇女骨质疏松患者血清铁蛋白与骨密度及骨转换生化标志物的关系

目的 探讨围绝经期妇女骨质疏松患者血清铁蛋白与骨密度及骨转换生化标志物的相关性.方法 选取2015年5月-2017年10月绍兴第二医院门诊确诊的围绝经期妇女160例,其中骨质疏松者75例为骨质疏松组,未出现骨质疏松者85例为对照组.采用化学发光免疫分析仪检测两组血清铁蛋白表达水平,采用全身数字化双能X线骨密度仪检测两组...     

贵州省男青年骨形成生化标志物及形态指标分析

目的了解贵州省男性青年骨代谢生化标志物的特点及影响因素,为研究贵州省青少年生长发育提供参考资料。方法选取来自贵州省各地区426名18~20岁的男性青年,检测骨钙素(OC)、骨碱性磷酸酶(BAP)、血清钙磷水平及身高和体重。结果男青年OC,BAP及身高与体重呈正相关,高海拔地区与低海拔地区男性青年的各项测定指标差异无统计学意义;汉族男青年OC,BAP及身高,体重均高于少数民族,差异均有统计学意义(P值均0.05)。家庭经济条件和父母文化程度对OC,BAP,身高和体重的影响具有统计学意义(P值均0.05)。结论贵州地理海拔高度对男性青年骨形成生化标志物及主要形态指标的影响较小,种族遗传是主要影响因素,家庭经济条件和父母文化程度对男性青年骨形成生化标志物及身高体重有影响。     

藏族女性青少年血清钙磷及骨代谢生化标志物水平检测结果分析

目的了解藏族女性青少年血清钙、磷及骨代谢生化标志物水平,为藏族青少年生长发育研究提供相应资料。方法采用分层整群抽样方法,从拉萨市和那曲地区中小学生中抽取12～18岁藏族健康女性青少年336名,检测血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)、骨性碱性磷酸酶(BAP)、骨钙素(BGP)水平。结果藏族女性青少年血清钙与年龄不相关(P>0.05),但拉萨地区明显高于那曲地区(P<0.05)。血清P,ALP,BAP,BGP水平与年龄均呈负相关(P值均<0.01),且各指标在多数年龄组表现为拉萨地区明显高于那曲地区(P值均<0.05)。除血清钙外,其他指标之间呈显著正相关(P值均<0.01)。结论藏族女性青少年血清钙、磷及骨代谢生化标志物水平随着年龄的增加、居住地海拔高度的增加,各指标水平逐渐降低。     

颅脑损伤的生化检测标志物研究进展

<正>中枢神经系统(central nervous system,CNS)是神经系统的主要组成部分,包括位于椎管内的脊髓和位于颅腔内的脑。中枢神经系统损伤的原因大致可分为外伤、中毒、病毒感染、遗传缺陷、营养障碍等,临床表现由损伤部位和程度所决定。目前,中枢神经系统损伤的确诊大部分依赖于临床表现及临床影像学资料。在中枢神经损伤中,创伤性颅脑损伤(traumatic brain injury,TBI)是青壮年致死、致残的主要原因之     

骨生化标志物的动态检测在预测下肢长骨骨折延迟愈合的临床意义

目的探讨骨生化标志物的动态检测在预测下肢长骨骨折延迟愈合的临床意义。方法选取我院2013年10月至2015年8月的下肢长骨骨折手术治疗病例60例,平均分为两组。其中延迟组为延迟愈合,愈合组为正常愈合,分别于伤后24小时内、术后1周及术后第4、8、12周检测静脉血BAP、OC、CTX及尿液DPD含量。结果 1两组在性别、年龄、体重、骨折部位、骨折类型、受伤机制等方面比较无统计学意义(P>0.05);2术后第8、12周,延迟组OC含量(ng/m L)分别为25.15±4.10、28.33±3.92,高于同时期愈合组的22.20±4.06、23.73±4.25,组间比较有统计学意义(P<0.05);延迟组CTX含量(ng/m L)分别为0.74±0.16、0.42±0.14,高于同时期愈合组的0.66±0.14、0.27±0.11,组间比较有统计学意义(P<0.05);3术后第12周,延迟组BAP、OC、CTX及DPD比值均高于愈合组(P<0.05)。结论骨折术后骨生化标志物均有增加,延迟组第12周OC及CTX明显增加,术后12周OC及CTX的检测可初步预测骨折延迟愈合是否发生。     

应用生化标志物评价神经毒物的效应

预防中毒性疾病,首先要求减少与毒物的接触,识别机体的遗传易感性,　并尽早发现不可逆性损害前的有关生理生化改变。尽管在环境医学领域应用神　经毒性生物标志物意义重大,但应用标志物评价接触、效应及易感性研究却比　其他领域进展缓慢,其中主要影响因素为神经系统功能的复杂性、神经毒作用　的多重性、靶细胞分子的多样性及取材困难。此外,也可能与长期慢性接触所　致神经毒作用的迟发性,抑或在停止接触很长时间后才发生神经毒效应有关。　　　　最近,有关易感性、神经内分泌和脑损害的神经毒性标志物已见于其他综　述,故本文仅…     

植物异黄酮对更年期妇女骨密度和骨代谢血清生化指标的影响

目的:研究植物异黄酮(葛根异黄酮和大豆异黄酮)对更年期妇女骨密度和骨代谢生化指标的影响。方法:将96例身体健康的更年期女性随机分为5组,安慰剂组、钙儿奇-D组、葛根异黄酮组、大豆异黄酮组和钙儿奇-D+大豆异黄酮组。服药3个月后,比较各处理组用药前后血清钙(Ca)、血清碱性磷酸酶(ALP)、骨钙素(BGP)和骨密度(BMD)等指标的变化情况。结果:服药后血清Ca有升高的趋势,其中钙儿奇-D和葛根异黄酮组的血清Ca比服药前显著升高(P<0.05);服药后血清ALP葛根异黄酮和大豆异黄酮组有上升趋势;服药后血清BGP(除了安慰剂组)各组有增加的趋势,其中钙儿奇-D组的血清BGP明显增加。结论:植物异黄酮可以使更年期妇女血清Ca升高,使血清ALP和BGP处于较活跃的水平。     

中老年女性骨代谢生化指标对早期骨质疏松症的临床诊断价值研究

目的通过分析中老年女性骨密度及骨代谢生化指标,观察其对于诊断骨质疏松症的临床价值。方法选取2014年3月-2017年3月在该院体检的162例中老年女性为研究对象,检测其腰椎L2-L4和左侧股骨近端(包括Neck、Troch、Ward三角区)骨密度以及血清中的骨钙素、碱性磷酸酶和尿中的吡啶啉(肌酐校正)。根据受检者不同的年龄段和骨密度对他们的骨代谢生化指标进行比较分析。结果中老年女性中患有骨质疏松的占51.2%;50~69岁的中老年女性血清中骨钙素和尿中吡啶啉(肌酐)的含量较高,超过70岁后则开始减少;不同年龄段的中老年女性血清中碱性磷酸酶的含量基本相同。骨质疏松组和骨量减少组的中老年女性血清中骨钙素含量和尿中吡啶啉(肌酐)含量高于正常组,但两组的血清中骨钙素含量和尿中吡啶啉(肌酐)含量基本相同,不同骨密度组的血清中碱性磷酸酶含量也基本相同。结论早期诊断骨质疏松症对减少中老年女性损害极其重要,而血清中的骨钙素、尿中的吡啶啉(肌酐)能够特异的反映骨吸收和形成,是诊断骨质疏松症的重要指标。     

Vitamin K supplementation does not significantly impact bone mineral density and biochemical markers of bone in pre- and perimenopausal women

Because of its role in osteoblastic metabolism, vitamin K has been studied with respect to bone. However, there has been limited research examining the influence of long-term vitamin K supplementation on bone mineral density (BMD). Therefore, the purpose of this study was to assess the impact of 6 months of vitamin K supplementation on BMD and biomarkers of bone in pre- and perimenopausal women. Based on previous work, we hypothesized that vitamin K would improve BMD and biochemical markers of bone formation. A double-blind, placebo-controlled, randomized trial is an effective way to study the impact of long-term supplementation. Thus, 14 pre- and perimenopausal women, 25 to 50 years of age, were randomly assigned to an experimental group (E) that received 600 μg/d of vitamin K in the form of phylloquinone (K₁) or a control group (C) that received identical-looking placebo tablets. Regional BMD and percent body fat, measured by dual-energy x-ray absorptiometry, and serum osteocalcin and urinary N-telopeptide levels were all assessed at 0, 3, and 6 months. When BMD was measured across time, C had a significant increase (P = .011) in greater trochanter BMD compared to E. The E group had a nonsignificant increase (P = .067) in shaft BMD compared to the C group. There was no significant difference between E and C in serum osteocalcin concentrations over time. Urinary N-telopeptide levels increased significantly over time in E compared to C (P = .008). Six months of 600 μg/d vitamin K₁ supplementation did not improve regional BMD in this group of pre- and perimenopausal women.     

The interest of biochemical markers of bone turnover for monitoring treatment of postmenopausal osteoporosis

BACKGROUND: Postmenopausal osteoporosis is especially female pathology, whose incidence increases with age. AIM: The purposes of this study are to evaluate the level of bone turnover by the determination of markers of bone formation (PAL, BAP) and marker of bone resorption (CTX) in the osteoporotic women, to study the correlations between bone biochemical markers, clinical parameters and radiological measurements and to assess the interest of biochemical markers therapeutic monitoring after 6 months of antiresorptive treatment. METHODS: The authors report a prospective study of 134 osteoporotic women classified in two groups according to the presence of osteoporotic fracture. Patients of the first group G1 (n=102) with fractures, were treated by the bisphosphonates (risedronate), whereas the ones of the second group G2 (n=32) without fractures, were submited to calcic supplementation and vitamin D. RESULTS: The analyses showed that the femoral and lumbar BMD were statistically lower in the presence of osteoporotic fractures. However, the values of CTX were statistically higher in the patients of G1 group compared to those of the G2 group (0,708 +/- 0,332 ng/ml versus 0,514 +/- 0,225 ng/ml). The CTX were statistically correlated with the femoral and lumbar BMD (r = -0,21, p<0,05 and r= -0,348, p<0,001). The hypovitminosis were observed in 50,98% (52/102) of women with ostéoporotic fractures, whereas it was only 25% (8/32) in women without fractures. After 6 months of treatment by the bisphosphonates, the PAL, the BAP and the CTX have decreased with an average of, respectively, 19%, 46,5% and 62,9%. These variations were significantly more important in G1 group. CONCLUSION: The biochemical markers of bone turnover, in particular those of the resorption (CTX), can predict the postmenopausal woman's bone loss evaluated by BMD, the risk of fractures and the efficiency of the bone treatments.     

No effect of copper supplementation on biochemical markers of bone metabolism in healthy adults

The influence of Cu supplementation of the usual diet for 6 weeks on biochemical markers of bone turnover and on putative indices of Cu status was investigated in healthy adults (twelve male and twelve female) aged 22-46 years, who participated in a double-blind placebo-controlled repeated crossover study. The study consisted of three 6-week supplementation regimens of 3 mg CuSO4, 3 mg Cu-glycine chelate (CuGC), and 6 mg CuGC, each separated by placebo periods of equal length. During baseline and on the last day of each dietary period, fasting morning first-void urine and fasting blood serum, plasma and erythrocytes were collected. The habitual dietary Cu intakes in males and females were approximately 1.4 and 1.1 mg/d respectively. Females had significantly higher (50%) plasma caeruloplasmin (Cp) protein concentrations than males at baseline. Cu supplementation had no effect on erythrocyte superoxide dismutase (SOD, EC 1.15.1.1) activity or plasma Cp protein (putative indices of Cu status) in the total group. Similarly, serum osteocalcin (a marker of bone formation), urinary creatinine (Cr) concentration, urinary pyridinoline: Cr or deoxypyridinoline: Cr excretion (markers of bone resorption) were unaffected in either the total group or in males and females separately, by any Cu supplementation regimen. It is concluded that Cu supplementation of the usual diet in healthy adult males and females had no effect on biochemical markers of bone formation or bone resorption over 6-week periods.     

大豆异黄酮对去卵巢大鼠血脂及骨生化指标的影响研究

探讨大豆异黄酮对去卵巢大鼠血清中血脂指标、骨代谢生化指标及激素水平的影响。选择 4月龄的Wistar大鼠 ,根据体重随机分为 6组。除 1组行单纯开腹手术外 ,其它 5组均切除双侧卵巢 ,分别为 :去卵巢对照组 ;高剂量大豆异黄酮组 ;中剂量大豆异黄酮组和低剂量大豆异黄酮组 ;雌激素组。喂养 16周后 ,处死大鼠 ,分离血清进行分析指标的测定。结果发现 :给予去卵巢大鼠大豆异黄酮后 ,血清中高密度脂蛋白(HDL)含量与去卵巢对照组相比有所增高 (P <0 0 5 ) ;总胆固醇 (TC)、甘油三酯 (TG)指标下降 ;骨吸收指标显著降低 ,骨形成指标骨钙素水平与去卵巢组比有所提高 ;同时 ,大鼠切除卵巢后 ,体内雌激素水平显著下降。结果显示 :大豆异黄酮对去卵巢大鼠的血脂有一定的调节作用 ,对骨吸收有显著的抑制作用     

Follow-up study on effects of height velocity and puberty onset on biochemical markers of bone turnover

In order to clarify the factors which affect bone metabolism at a young age, we investigated the relationships among the change of biochemical markers of bone turnover, the height velocity (HV) and puberty onset in healthy Japanese children. One hundred and twelve children (61 boys and 51 girls) were recruited at the fourth grade level in the elementary school (9 years old) and followed for 6 years. Serum bone specific alkaline phosphatase (B-ALP), serum tartrate-resistant acid phosphatase (TR-ACP), urine hydroxyproline (Hyp) and urine calcium (Ca) were measured as the biochemical markers of bone turnover. Bone mineral density of calcaneus was also measured by ultrasound method at the first grade (12 years old) and the third grade (14 years old) of junior high school. Heights and weights of all subjects were measured every April and the HV were calculated between each year. Puberty onset was defined as the time when pubic hair appeared in boys and as the time when menarche started in girls by self-administered questionnaire. All the biochemical markers of bone metabolism except for urine Ca had a significant positive relationship with HV. The values of the markers were highest of the time when the HV was maximum. In girls, the values of the biochemical markers remained high before menarche and then decreased significantly within three years after menarche, suggesting that bone turnover changed rapidly from high turnover type to low turnover type after menarche. On the other hand, in boys, high turnover type remained for a few years after puberty onset. Bone mineral density of calcaneus by ultrasound method increased significantly in boys between the two years in junior high school, but the increase was unclear except for broadband ultrasound attenuation (BUA) in girls in the same period.     

Effect of phylloquinone supplementation on biochemical markers of vitamin K status and bone turnover in postmenopausal women

While current intakes of phylloquinone (vitamin K1) in many populations are believed to be sufficient to maintain normal blood coagulation, these may be insufficient to cover the requirements for optimal bone metabolism. Therefore, the objective of the present study was to investigate the effect of increasing phylloquinone intakes above the usual dietary intake for 6 weeks on biochemical markers of vitamin K status and bone turnover in postmenopausal women. Thirty-one postmenopausal women completed this 3 x 6-week randomised cross-over study, in which volunteers were supplemented with 0 (placebo), 200, and 500 microg phylloquinone/d. In addition, the volunteers were given 10 microg vitamin D3/d throughout the study period. With increasing phylloquinone intake, the concentration of serum gamma-carboxylated and under-gamma-carboxylated osteocalcin was significantly increased and decreased, respectively, in a dose-dependent manner (P < 0.001). Mean serum phylloquinone concentration was significantly (P < 0.001) higher with daily supplementation with 500 microg phylloquinone/d compared with that during either of the placebo or 200 microg phylloquinone/d supplementation periods, which did not differ (P = 0.15). Serum total osteocalcin was significantly (P < 0.001) increased in response to daily supplementation with 500 (but not 200) microg phylloquinone compared with placebo. Serum bone-specific alkaline phosphatase as well as the urinary markers of bone resorption (N-telopeptide cross-links of collagen, pyridinoline and deoxypyridinoline) and urinary gamma-carboxyglutamate were unaffected by phylloquinone supplementation. In conclusion, while daily supplementation with 200 and 500 microg phylloquinone/d for 6 weeks increased vitamin K status in postmenopausal women, it had no effect on bone turnover.     

Effects of the long-term use of depot medroxyprogesterone acetate as hormonal contraceptive on bone mineral density and biochemical markers of bone remodeling

PURPOSE AND METHOD: Our objective is to evaluate the effects of the long-term use of depot medroxyprogesterone acetate (DMPA) as a method of contraception on bone mineral density (BMD) and bone remodeling. Forty women (21-44 years old) who used DMPA for contraception for <1, 1-2 and >5 years, in addition to 20 age-matched healthy women (nonusers), participated in this study. Lumbar spine BMD (LS-BMD) was measured by dual-energy X-ray absorptionmetry. Serum osteocalcin (OC), a bone formation marker, was measured by enzyme amplification sorbent immunoassay. Urinary deoxypyridinoline (DPD), a bone resorption marker, was determined by enzyme immunoassay. RESULTS: Serum OC and urinary DPD levels in women who used DMPA for <1, 1-2 and >5 years were significantly increased compared to the corresponding levels in nonusers. The increase of both biomarkers was more pronounced with longer duration of use. LS-BMD was significantly decreased in women on long-term DMPA use compared to LS-BMD in nonusers. The mean percentage decrease of LS-BMD in women who used DMPA for 1-2 and >5 years was 9% and 11.8%, respectively. LS-BMD was negatively correlated with serum OC and urinary DPD in women who used DMPA. On the other hand, LS-BMD and bone turnover were not significantly different between women who used DMPA for <1 year and nonusers. CONCLUSION: Long-term use of DMPA (>2 years) had a significant adverse effect on BMD and induced increased bone turnover, as evidenced by a significant increase in biochemical indices of bone formation and resorption. The measurement of LS-BMD and of biomarkers of bone turnover may be recommended in women aged above 40 years and who used DMPA for a long duration (2-5 years).