Increase in serum bone gamma-carboxyglutamic acid protein with aging in women. Implications for the mechanism of age-related bone loss.

Because it is unclear whether age-related bone loss results from increased bone resorption, decreased bone formation or both, we measured the serum level of bone Gla-protein (BGP), a specific marker for bone turnover, in 174 women, ages 30 to 94 yr. Serum BGP increased linearly with aging (r = 0.44, P less than 0.001) from 4.4 +/- 0.4 (mean +/- SE) in the 4th decade to 8.9 +/- 0.9 ng/ml in the 10th decade. This increase correlated inversely (P less than 0.001) with concomitant decreases in bone mineral density at the lumbar spine, midradius, and distal radius. Using partial correlation coefficients, serum BGP still correlated positively with age (r = 0.31, P less than 0.001) after creatinine clearance was fixed but not with creatinine clearance (r = -0.04, NS) when age was fixed. Urinary hydroxyproline (r = 0.29, P less than 0.001), an index of bone resorption, and serum alkaline phosphatase (r = 0.31, P less than 0.001), an index of bone formation, also increased with age and these increases correlated with increases in serum BGP (r = 0.39, P less than 0.001 and r = 0.43, P less than 0.001, respectively). Serum immunoreactive parathyroid hormone concentrations (r = 0.39, P less than 0.001) and urinary cyclic AMP excretion (r = 0.38, P less than 0.001) increased, suggesting that PTH secretion increased with age; these increases correlated significantly with increases in serum BGP. A subgroup of 32 women who were found to have vertebral fractures, hip fractures, or both had significantly higher values for serum BGP than the remainder. These data suggest that overall bone turnover increases in women with aging and, especially considering the concomitant decrease in skeletal mass, do not support the view that age-related bone loss results primarily from decreased bone formation.     

Osteocalcin and bone remodelling in Paget's disease of bone, primary hyperparathyroidism, hypercalcaemia of malignancy and involutional osteoporosis

We have measured classic markers of bone turnover, serum alkaline phosphatase (sAP), urinary hydroxyproline/creatinine ratio (uOH-Prol/creatinine) and osteocalcin (sBGP), in two bone disorders characterized by an increase in bone remodelling, namely Paget's disease of bone and primary hyperparathyroidism (PHPT) and in two other bone diseases characterized by an increase in bone resorption without the concomitant increase in bone formation, hypercalcaemia of malignancy (HM) and involutional osteoporosis (IO). Serum BGP was increased in patients with Paget's disease of bone (6.7 +/- 3.1; n = 25; p less than 0.01) and in PHPT patients (8.3 +/- 5.3; n = 20; p less than 0.005) with respect to control patients (4.2 +/- 1.2 ng/ml; n = 12). Two subgroups of patients with high and normal levels of sBGP were found in both pathologies. Serum BGP was decreased in HM patients (2.1 +/- 1.7; n = 9; p less than 0.01) and in IO patients (1.9 +/- 1.4; n = 31; p less than 0.001). Two subgroups of patients with normal and low sBGP values were found in these two last disorders. A positive linear correlation was found between sBGP and sAP (y = 14.6x + 73.7; r = 0.44; p less than 0.05) and between sBGP and uOH-Prol/creatinine (y = 0.008x + 0.007; r = 0.67; p less than 0.001) in Paget's disease of bone.(ABSTRACT TRUNCATED AT 250 WORDS)     

Estimation of bone turnover evaluated by 47Ca-kinetics. Efficiency of serum bone gamma-carboxyglutamic acid-containing protein, serum alkaline phosphatase, and urinary hydroxyproline excretion.

Bone gamma-carboxyglutamic acid-containing (Gla) protein (BGP, osteocalcin) is a noncollagenous protein of bone present in plasma and removed by the kidney. Plasma BGP has been shown to be elevated in patients with certain bone diseases. The present study evaluates serum BGP (S-BGP), serum alkaline phosphatase (S-AP), and urinary hydroxyproline excretion (U-OHP) in diseases with differing bone turnover rates, and compares the accuracy of these measurements for estimating bone mineralization (m) and resorption (r) rates. S-BGP, S-AP, U-OHP, and creatinine clearance (Clcr) were measured in patients with primary hyperparathyroidism (n = 13), hyperthyroidism (n = 6), and hypothyroidism (n = 6). Bone mineralization and resorption rates were calculated from a 7-d combined calcium balance and 47Ca turnover study. A highly significant correlation (r = 0.69, P less than 0.001) was found between S-BGP and m. Multiple regression analysis disclosed a partial correlation between S-BGP and m when Clcr was taken into account (r = 0.82, P less than 0.001), and between S-BGP and Clcr when m was taken into account (r = -0.62, P less than 0.005). In accordance with this, a stronger correlation (r = 0.89, P less than 0.0001) was found between S-BGP X Clcr and m than between S-BGP and m. A less significant correlation was found between S-AP and m (r = 0.45, P less than 0.05). Furthermore, U-OHP showed a highly significant positive correlation to r (r = 0.78, P less than 0.001). Thus, in the studied disorders of calcium metabolism, individual serum levels of BGP depend on both mineralization rate and renal function. Serum levels of BGP corrected for alterations in renal function are superior to uncorrected S-BGP and to S-AP levels in the estimation of bone mineralization rates.     

Assessment of bone turnover in postmenopausal osteoporosis by measurement of serum bone Gla-protein

Controversy persists regarding the abnormality of bone turnover responsible for bone loss in women with postmenopausal osteoporosis. To evaluate this, we measured serum bone Gla-protein (BGP), a specific marker for bone turnover, in 62 untreated patients with postmenopausal osteoporosis. Results were compared with those in 142 normal women and were expressed as standard deviations from the age-adjusted predicted mean (Z score). Serum BGP was increased (+0.48 S.D., p = 0.002) in the osteoporotic patients; 9.7% of patients were greater than 2 S.D. above but none were greater than 2 S.D. below the normal mean. Moreover, when data from normal postmenopausal women (ages 51 to 75 years) and the osteoporotic patients were merged, significant negative correlation existed (r = -0.36, p less than 0.001) between serum BGP and bone density of the lumbar spine assessed by dual photon absorptiometry. Serum alkaline phosphatase, a less specific marker for bone formation, was also increased (+0.96 S.D., p less than 0.001) in the osteoporotic patients. The data suggest that overall bone turnover is increased in patients with postmenopausal osteoporosis and do not support the concept that an absolute decrease in bone formation is the major cause of the bone loss.     

Plasma bone Gla protein concentrations in healthy adults. Dependence on sex, age, and glomerular filtration

Plasma bone Gla protein (BGP) was determined by radio-immunoassay in 266 healthy adults, men (n = 132) and women (n = 134), aged 20-79 years. In the women aged 30-69 years, plasma BGP increased significantly with age (r = 0.44, p less than 0.001), and a particularly steep increase was seen from 1.1 +/- 0.5 (mean +/- 1 SD) in the fifth decade to 2.0 +/- 1.4 nmol/l in the seventh decade. In men, aged 30-69 years, no correlation was found between plasma BGP and age (r = -0.07, NS). Plasma bone Gla protein is removed from the circulation mainly by the kidneys and the increased plasma BGP in the women could be caused by decreased renal clearance. The interrelationship was analysed by means of partial correlation. When creatinine clearance was held constant in women, BGP still correlated positively with age (r = 0.40, p less than 0.001), but not with creatinine clearance (r = 0.003, NS) when age was fixed. Plasma BGP was significantly increased above normal in 35 patients with chronic renal failure (10.2 +/- 14.6 nmol/l). Non-linear regression analysis showed that plasma BGP was within the normal range when 24-h creatinine clearance was greater than 30 ml/min, and large increases in plasma BGP did not occur until the 24-h creatinine clearance was below 20 ml/min. We conclude that, in normal subjects and patients with mild to moderate renal failure, plasma elevations of BGP reflect increased bone turnover rather than decreased renal clearance.     

Changes in cortical thickness of the clavicle and serum bone gamma-carboxyglutamic acid-containing protein in the elderly in an island community in western Japan

The cortical thickness of the clavicle (CTC), concentrations of bone gamma-carboxyglutamic acid-containing (Gla) protein (s-BGP, osteocalcin), alkaline phosphatase (s-ALP), calcium (s-Ca) and inorganic phosphorus (s-P) in serum, and calcium/creatinine (u-Ca/Cr) and inorganic phosphorus/creatinine (u-P/Cr) ratios in urine were examined in 211 subjects aged over 40 years in Oshima Island in Nagasaki prefecture. CTC decreased and s-BGP increased with age in both sexes, especially in women. Serum BGP was significantly higher in women than in men at the ages of 50's and over. Serum ALP in women increased until the ages of 60's. Serum Ca at the ages of 50's and s-P at the ages of 60's and over were higher in women than in men. As the increase in s-BGP is reported to be coincident with active bone formation, our findings do not support the view that age-related bone loss, especially in women, primarily results from decrease in bone formation.     

Measurements of whole body retention of diphosphonate and other indices of bone metabolism in 125 normals: dependency on age, sex and glomerular filtration

Measurements of 24-h whole body retention of 99m-Tc-MDP (WBR) has been performed in 125 normal volunteers, together with determinations of serum alkaline phosphatase, urinary hydroxyproline excretion and creatinine clearance. WBR decreased slightly from the 3rd to the 4th decade, after which it increased gradually in the older age-groups. Serum alkaline phosphatase followed an identical pattern, while the urinary hydroxyproline excretion demonstrated a marked but temporary rise in the post-menopausal age-groups. Finally, the creatinine clearance decreased gradually in the older age groups. Analysis of variance demonstrated that WBR varied independently with serum alkaline phosphatase and creatinine clearance, while no relationship between WBR and the hydroxyproline excretion was found. It seems likely that the increasing retention of diphosphonate in elderly persons reflects rising osteoblastic activity as well as decreasing glomerular filtration.     

Intra-individual variation of some analytes in serum of patients with chronic renal failure

Biological intra-individual variation in the concentration of 15 biochemical analytes in serum was estimated for 17 patients with chronic renal failure (CRF) and compared with results for apparently healthy individuals. The ratio of the average intra-individual variation in CRF patients to that in normal subjects was 1.5 to 2.0 for sodium, chloride, calcium, and creatinine; 1.2 to 1.5 for hemoglobin, total protein, albumin, globulin, uric acid, cholesterol, and alpha-amylase. The intra-individual CVs for urea, high-density-lipoprotein cholesterol, triglycerides, and alkaline phosphatase did not differ significantly between groups. The intra-individual variation of calcium and the concentration of creatinine in serum correlate significantly (r = 0.661, p less than 0.01). Individual values showed a gaussian distribution for all analytes. There was no time dependence of the intra-individual variation during a three-week interval, except for calcium and cholesterol. The estimated biological component of intra-individual variation and the analytical variation can be used to derive decision-making criteria in monitoring CRF.     

Quantitative Determination of Putrescine,Cadaverine, Spermine and Spermidixe

Plasma bone Gla protein (BGP) was determined by radio-immunoassay in 266 healthy adults, men (n=132) and women (n = 134), aged 20–79 years. In the women aged 30–69 years, plasma BGP increased significantly with age (r = 0.44. p<0.001). and a particularly steep increase was seen from 1.1 ± 0.5 (mean±1 SD) in the fifth decade to 2.0 ± 1.4 nmol/l in the seventh decade. In men, aged 30–69 years, no correlation was found between plasma BGP and age (r= ?0.07, NS). Plasma bone Gla protein is removed from the circulation mainly by the kidneys and the increased plasma BGP in the women could be caused by decreased renal clearance. The interrelationship was analysed by means of partial correlation. When creatinine clearance was held constant in women, BGP still correlated positively with age (r = 0.40. p<0.001). but not with creatinine clearance (r=0.003, NS) when age was fixed. Plasma BGP was significantly increased above normal in 35 patients with chronic renal failure (10.2±14.6 nmol/l). Non-linear regression analysis showed that plasma BGP was within the normal range when 24-h creatinine clearance was greater than 30 ml/min, and large increases in plasma BGP did not occur until the 24-h creatinine clearance was below 20 ml/min. We conclude that, in normal subjects and patients with mild to moderate renal failure, plasma elevations of BGP reflect increased bone turnover rather than decreased renal clearance.     

1,25-Dihydroxyvitamin D stimulation test for osteoblast function in normal and osteoporotic postmenopausal women.

The cause of bone loss in postmenopausal osteoporosis--decreased bone formation or increased bone resorption--is controversial. Synthesis of bone--Gla protein (BGP), a specific osteoblast product, is stimulated by 1,25-dihydroxyvitamin D3 [1,25(OH)2D] in vitro. Thus, increases in serum BGP levels during 1,25(OH)2D administration might provide a useful dynamic index of osteoblast function. We compared 14 postmenopausal osteoporotic women with 12 age-matched postmenopausal normal women before and during 6 d of 1,25(OH)2D administration (2.0 micrograms/d). Serum BGP levels were similar at baseline and increased during treatment in both groups (P less than 0.001). However, trend analysis showed a greater (P less than 0.01) increase in the osteoporotic women. These data do not support the hypothesis that defective osteoblast function is the major cause of bone loss in postmenopausal osteoporosis.     

男性2型糖尿病患者病程与骨密度和骨代谢指标关系的研究

目的　评价男性 2型糖尿病患者病程与骨密度和骨代谢指标的变化的关系。方法　同时测定2 4例正常人和 6 2例男性 2型糖尿病患者的骨密度 (BMD)、血骨钙素 (BGP)、骨型特异性碱性磷酸酶 (BAP)、Ⅰ型胶原氨基末端肽 (NTx)、甲状旁腺素 (PTH)、血钙、血磷和血浆白蛋白。根据病程将糖尿病分为Ⅰ组 :病程 <5年 ,31例 ;Ⅱ组 :病程 5～ 10年 ,2 0例 ;Ⅲ组 :病程 >10年 ,11例。结果　与正常对照组 (K组 )比较 ,Ⅰ组和Ⅱ组患者BMD、BGP、BAP、PTH和NTx差异无显著意义 (P >0 0 5 ) ;Ⅲ组糖尿病BMD明显下降 ,P <0 0 5 ;BGP、BAP、NTx和PTH显著增高 ,P <0 0 1。结论　病程 (大于 10年 )是男性 2型糖尿病患者骨质疏松症的重要危险因素。     

Diurnal rhythm in serum activity of wheat-germ lectin-precipitable alkaline phosphatase: temporal relationships with the diurnal rhythm of serum osteocalcin

Serum levels of osteocalcin (S-OC) and lectin-precipitable alkaline phosphatase activity (S-LAP) are sensitive markers of osteoblastic activity. Diurnal variation has been found for S-OC but has not been reported for S-LAP. We measured S-LAP and serum total alkaline phosphatase (S-TAP) in samples drawn every 60 min during a 24-h study period in nine normal subjects and correlated the findings with the diurnal variation in S-OC. A significant (p less than 0.05) diurnal variation in S-LAP characterized by peaks at 1430 hours and 2330 hours and nadir at 0630 hours was found. Peak levels were 30% higher than nadir level (p less than 0.05). S-TAP also varied significantly (p less than 0.05) with nadir at 0630 hours, showing a difference of 23% between peak and nadir levels (p less than 0.05). Significant cross-correlation was found between S-OC and S-LAP and S-TAP when these lagged 4 h after S-OC: r = 0.51 (p less than 0.02) and r = 0.65 (p less than 0.003), respectively. In other words, changes in S-LAP and S-TAP preceded changes in S-OC by 4 h. There were no significant cross-correlations between the non-lectin-precipitable fraction of AP and S-OC. In conclusion, S-LAP varies in a diurnal rhythm closely related with the diurnal rhythm of S-OC. The almost similar patterns in the diurnal serum levels of these two osteoblastic products strongly suggest that osteoblastic activity fluctuates rhythmically during the day in humans.     

Serum osteocalcin levels in hyperthyroidism before and after antithyroid therapy

Hyperthyroidism is characterized by accelerated bone turnover, caused from direct stimulation of bone cells by increased thyroid hormones. In this study, we aimed to investigate serum osteocalcin levels as a bone formation marker, before antithyroid (propylthiouracil) therapy at hyperthyroid stage and after antithyroid therapy at euthyroid stage of the patients. Twenty four hyperthyroid patients (18 females, 6 males) and 20 (13 females, 7 males) healthy controls were included into this study. Blood and urine samples were taken before medical treatment at hyperthyroid state, and after the antithyroid therapy until the patients reached the euthyroid state. Serum alkaline phosphatase, osteocalcin, calcium, phosphorus, Free T3, Free T4, TSH and urine calcium/creatinine levels were assessed. We found a significant decrease in serum osteocalcin (p=0.006), urinary calcium/creatinine (p=0.004), and serum phosphorus (p=0.038) levels in euthyroid state in comparison to hyperthyroid state. The increases in serum bone formation marker osteocalcin and bone resorption marker urinary calcium/creatinine levels in hyperthyroid state compared to euthyroid state in our study confirmed that hyperthyroid patients have high bone turnover. We conclude that, hyperthyroid patients has high bone turnover of formation and resorption even after attainment of euthyroidism. Osteocalcin and urine calcium/creatinine are sensitive markers in documenting bone remodeling during treatment of hyperthyroidism.     

骨代谢生化指标测定在妇科临床中的应用价值

目的：探讨四项骨代谢酶免疫生化指标：血骨钙素（BGP）、骨碱性磷酸酶（BAP）、I型 前胶原羧基肽（CICP）、尿呲啶酚（PYD）及传统的Ca/Cr及HOP／Cr比值对由于雌激素缺乏引起的高骨转换及骨量减少的诊断意义。并了解上述哪些指标对绝经引起的雌激素缺乏更敏感。方法：测定51名绝经前妇女（I组）,42名绝经后妇女（II组）,和53例双侧卵巢切除术（OVX）患者（III组）的上述各项指标,同时对各项生化指标间作相关分析。并与超声骨密度值（BMD）作相关分析。结果：绝经后组与卵巢切除术组的大部分酶免疫骨生化指标均显著高于绝经前组,与BMD的下降变化一致。但传统的HOP／Cr及Ca/Cr各组间无差异。相关性：所有病例中,BGP、BAP、CICP、PYD间均有相关性,尽管r值较低,但统计学分析差异有显著意义（P＜0.01）。其中BGP与BAP,BGP与PYD／Cr间相关性较好。BMD与BGP、BAP、CICP及PYD呈明显负相关。Ca/Cr及HOP／Cr与所有其他指标无相关。结论：BGP、BAP、CICP、PYD等骨代谢生化指标是反映绝经后（自然绝经及手术后绝经）妇女由于雌激素降低导致的高骨转换及骨量减少的敏感指标,在妇科临床中有较好的应用前景。而传统的Ca/Cr、HOP／Cr测定由于方法的不敏感、不特异而在妇科临床中应用受到限制。     

Osteocalcin and urinary hydroxyproline/creatinine ratio in the differential diagnosis of primary hyperparathyroidism and hypercalcaemia of malignancy

Osteocalcin (serum bone-Gla protein, sBGP), serum alkaline phosphatase (sAP) and urinary hydroxyproline/creatinine ratio (uOH-Prol/creatinine) have been measured in 21 patients with primary hyperparathyroidism (PHPT) and in nine patients with hypercalcaemia of malignancy (HM). A positive linear correlation between sBGP and uOH-Prol/creatinine ratio (y = 0.023 + 0.0025x; r = 0.705; p less than 0.01) and between sBGP and sAP (y = 35.6 + 2.14x; r = 0.430, p less than 0.05), have been observed in the PHPT patients. No correlation was found in the HM patients. PHPT patients have been grouped according to their uOH-Prol/creatinine ratio (group A: uOH-Prol/creatinine greater than 0.034; group B: uOH-Prol/creatinine less than or equal to 0.034). Group A presented sBGP higher than the control group (11.06 +/- 5.7 vs. 4.2 +/- 1.2 ng/ml; p less than 0.001) (mean +/- SD). Group B presented sBGP similar to the control group (4.4 +/- 1.96 ng/ml) (mean +/- SD). Group A presented serum calcium (sCa) higher than group B (3.11 +/- 0.28 vs. 2.78 +/- 0.09 mmol/l; p less than 0.01) (mean +/- SD). In HM patients uOH-Prol/creatinine ratio was elevated as compared with the control group (0.074 +/- 0.036 vs. 0.024 +/- 0.004; p less than 0.001) (mean +/- SD), but sBGP was normal or low (range: indetectable-5.1 ng/ml). The simultaneous estimations of sBGP and uOH-Prol/creatinine ratio improve the differential diagnosis between these two forms of hypercalcaemia: high uOH-Prol/creatinine ratio with concomitant high sBGP point to the presence of PHPT. Elevated uOH-Prol/creatinine ratio with normal or low sBGP suggest the existence of HM.(ABSTRACT TRUNCATED AT 250 WORDS)     

血液中视黄醇结合蛋白与胱抑素C、肌酐清除率相关性研究

目的 探讨血液中视黄醇结合蛋白（RBP）的检测与肌酐清除率（Ccr）、胱抑素C（CysC）的相关性及对肾小球滤过功能评价的临床意义.方法 检测114例患者和126例健康人血液中RBP、CysC、Cr及尿Cr,并计算肌酐清除率（Ccr）,分析患者与健康对照者血中RBP与CysC、Cr、Ccr水平的差异及RBP与CysC、Cr、Ccr的相关性.结果 患者和健康对照血液中RBP、Cr、CysC、Ccr水平均有显著性差异（P〈0.01）;血液中RBP水平与Cr、CysC、Ccr水平均有相关性,有统计学意义.结论 血液中RBP的变化和CysC及Ccr有明显的相关性,是值得推荐的评价肾小球滤过功能的良好指标.     

Evaluation of urinary hydroxypyridinium crosslink measurements as resorption markers in metabolic bone diseases

Analyses of the urinary concentration relative to creatinine of the collagen crosslinks, pyridinoline (Pyd) and deoxy-pyridinoline (Dpd) were made in 47 patients with metabolic bone diseases to assess the validity of these assays as indicators of bone resorption. The mean values for patients with Paget's disease of bone, primary hyperparathyroidism and osteomalacia were significantly higher (P less than 0.001) than those for age-matched healthy individuals. During treatment of Paget's disease with bisphosphonates, there was a steady decline in the urinary concentration of the crosslinks to the normal range; this change occurred earlier than for serum alkaline phosphatase. There were significant correlations (P less than 0.01) between the concentrations of both crosslinks and the corresponding values for hydroxyproline. At lower crosslink concentrations, however, these relationships were less marked due to large variations in hydroxyproline values. The results show that measurements of urinary Pyd and Dpd provide clinically applicable indices of bone resorption that are more specific than other markers.     

Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function

BACKGROUND: To determine the potential sensitivity of several renal function tests for detecting early changes in renal function, we compared the within-individual (W-I) variation over 5 months of serum creatinine, serum cystatin C, and creatinine clearance. METHODS: On 31 healthy subjects, blood and timed urine specimens were collected once each month to get 6 collections. Creatinine (enzymatic) in serum and urine and cystatin C (immunonephelometric) in serum were measured and glomerular filtration rate (GFR) by creatinine clearance and the Modification of Diet in Renal Disease (MDRD) equation were calculated. To compare W-I variations between different creatinine methods, we also measured creatinine by both enzymatic and kinetic alkaline picrate methods on 15 sets of frozen samples. RESULTS: For the 31 volunteers, the mean W-I variations for serum creatinine (5.8%) and cystatin C (5.4%) were both much lower than the W-I variation of creatinine clearance (18.7%). As expected, the MDRD GFR had a similar W-I variation (6.7%) to that of serum creatinine and its values were markedly different than GFR by creatinine clearance. On the 15 sets of frozen samples, the W-I variation of creatinine measured by the enzymatic method (CV 5.2%) was slightly less than by the picrate method (CV 6.2%). CONCLUSIONS: The low W-I variation of both serum cystatin C and serum creatinine suggests that serial measurements of either would detect a changes in renal function earlier than would GFR by creatinine clearance or MDRD equation, which allows reporting only for GFRs<60 ml/min/1.7 m(2). While we measured only creatinine clearance, the large variability, difficulty, and cost of all clearance measurements make them impractical for routine monitoring of patients.     

甲状腺功能亢进患者治疗前和治疗早期骨代谢参数的改变 关于甲状腺功能亢进患者骨吸收骨形成研究的结果对指导临床治疗的意义

目的了解甲状腺功能亢进(甲亢)患者治疗前和治疗早期骨矿物质代谢的变化,探讨其对骨代谢参数改变的影响机制。方法选择42例甲亢治疗前和治疗早期患者,采用放射免疫法测定了血清骨钙素(BGP)、I型胶原羧基末端肽(ICTP)、甲状旁腺素(PTH-M)及相关生化指标,并与32例健康对照者进行比较。结果甲亢治疗前血碱性磷酸酶(AKP)、骨钙素(BGP)、I型胶原羧基末端肽(ICTP)均值显著高于对照组(P<0.001)。治疗后血AKP、BGP显著下降(P<0.001)其均值仍高于对照组(P<0.05)。ICTP明显低于治疗前(P<0.001)与对照组比较差异无显著(P>0.05)。相关分析显示,血BGP与ICTP正相关,血TT3与BGP、AKP、ICTP呈正相关,血sTSH与BGP、ICTP呈负相关。结论甲亢治疗前过量甲状腺激素加速骨转换,以破骨细胞活动占优势,使骨吸收显著大于骨形成,是甲亢骨病主要原因,甲亢治疗早期,骨吸收快速降低,骨形成仍高,以成骨细胞活动占优势,有利于骨重建。     

老年男性血清睾酮水平变化与骨代谢生化指标的关系

目的探讨老年男性血清睾酮水平变化与骨代谢生化指标的关系。方法106例研究对象根据年龄分为60岁~、70岁~及80岁以上三组,检测各研究对象血清睾酮、骨钙素(BGP)、Ⅰ型胶原羧基肽(PICP)、碱性磷酸酶(ALP)及尿脱氧吡啶啉(DPD)值,进行比较及相关分析。结果随增龄血清睾酮逐渐下降,血清BGP、PICP及ALP也下降,尿DPD逐渐升高(P<0.05 orP<0.01);血清睾酮水平与BGP正相关(r=0.57,P<0.05),与DPD负相关(r=-0.49,P<0.05)。结论随增龄,老年男性骨代谢呈负平衡,且与雄激素的逐渐下降密切相关。