IL-6、TNF-α在老年骨质疏松症中的临床价值探讨

目的：探讨细胞因子与骨代谢生化指标在老年骨质疏松症发病机制中的重要作用及相互关系。方法：采用放射免疫分析检测85例老年骨量减少和骨质疏松患者血清白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）和骨钙素（BGP）的水平和骨密度检测,同时与青中年和老年健康人比较。结果：发现老年骨质疏松患者骨吸收指标IL-6和TNF-α水平随病情加重而增高,与不同年龄对照组比较有显著性差异（P〈0.05,P〈0.01）。骨形成指标BGP则不同程度降低,均与青中年对照组有明显差异（P〈0．05）。骨量减少组骨密度值明显低于青中年对照组（P〈O.01）,而老年骨质疏松组骨密度明显低于骨量减少组（P〈0,05）。结论：骨质疏松患者从骨量减少到骨质疏松的病理过程中,骨转化呈现骨吸收增加而骨形成减少的变化规律。IL-6、TNF-α与BGP可作为骨质疏松症的观察指标和辅助诊断的项目。     

2型糖尿病患者骨代谢生化指标的临床意义

目的 :探讨 2型糖尿病患者骨代谢生化指标的临床意义。方法 :对 4 0例 2型糖尿病患者及 31例正常人进行血骨钙素 (BGP)、钙 (Ca)、碱性磷酸酶 (ALP) ;尿脱氧吡啶啉 (DPD)、Ca、肌酐 (Cr)测定。结果 :糖尿病组血清BGP较正常对照组明显降低 (P <0 0 5 ) ;尿DPD/Cr比值 ,Ca/Cr比值显著高于正常对照组 (P <0 .0 5 ,P <0 .0 5 ) ;血清Ca、ALP两组无统计学差异。结论 :2型糖尿病患者骨代谢异常引发骨量减少、骨质疏松与骨形成减少和骨吸收增加有关 ;血BGP、尿DPD/Cr、Ca/Cr可作为早期诊断糖尿病骨量减少、骨质疏松敏感的骨代谢生化指标。     

60岁以上老年男性血清骨钙素RIA及其临床意义

自八十年代国外建立骨钙素(BGP)RIA测定方法以来，血清BGP已成为研究骨代谢疾病特别是骨质疏松症的最敏感，特异的生化指标。随着人们健康水平的提高，我国老年人的比例逐年增多，目前国内外对于老年病尤其是老年性骨质疏松症的研究给予了极大的关注。为此，我们观察了236例60岁以上老年男性血清BGP水平，现报告如下。     

胰岛素样因子、睾酮及骨代谢指标预测老年男性骨质疏松性骨折的意义

背景：老年男性骨质疏松的发病率随着国内人口老龄化趋势的加剧逐年提升,骨质疏松患者容易发生骨折,对患者的生命安全造成严重威胁,但目前临床上仍缺少有效的筛选措施预防骨质疏松的发生。 目的：探究胰岛素样因子、睾酮及骨代谢指标水平在预测老年男性骨质疏松性骨折中的临床意义。 方法：选取骨质疏松症男性患者120例作为观察组,另选择同时期收治的非骨质疏松症体检健康的男性人群120例作为对照组,两组受试者在年龄及体质量指数等方面比较差异无显著性意义,具有可比性。对两组受试者抽血检测胰岛素样因子、血清睾酮及骨代谢指标的水平。 结果与结论：观察组患者腰椎侧位骨密度和左股骨颈骨密度均显著低于对照组(P < 0.05);观察组患者血液中胰岛素样因子和血清睾酮水平显著低于对照组(P < 0.05);观察组患者Ⅰ型胶原C端异物肽和Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平也显著高于对照组(P < 0.05);两组患者骨钙素(BGP)、血清钙、血清磷水平相比差异无显著意义(P > 0.05)。结果提示,通过检测老年男性血清中睾酮、胰岛素样因子及部分骨代谢指标的水平,可早期预测骨密度,为筛查老年男性骨质疏松症的高危状态起到一定的预测作用,具有一定的参考价值。 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

男性老年骨质疏松症患者血清IL-6、BGP和T含量变化及临床意义

目的:探讨老年骨质疏松症患者血清白细胞介素-6(IL-6)、骨钙素(BGP)和睾酮(T)含量的变化及临床意义。方法:应用放射免疫分析对46例老年骨质疏松症患者进行了血清IL-6、BGP和T水平测定,并与35名正常健康人作比较。结果:老年骨质疏松症患者血清IL-6水平明显高于正常健康人(P<0.01),而BGP、T水平明显低于正常人(P<0.01)。结论:测定老年骨质疏松症患者血清中IL-6、BGP和T水平为临床诊断治疗提供了一个有价值的数据。     

甲亢患者尿DPD、血清BGP水平变化与骨代谢的关系

目的 :探讨甲状腺功能亢进对骨代谢的影响。方法 :本文对 4 1例甲状腺功能亢进症患者及 4 8例正常人对照用化学发光法测定尿脱氧吡啶啉 (DPD)、FT3、FT4,放射免疫法测定血清BGP。结果 :甲亢组尿DPD水平及血清FT3、FT4、骨钙素 (BGP)水平均明显升高 (p <0 0 1)。结论 :表明甲状腺功能亢进与骨代谢密切相关     

男性老年骨质疏松症患者血清IL-8、CT、BGP和T含量变化及临床意义

目的:探讨男性老年骨质疏松症患者血清IL-8、降钙素(CT)、骨钙素(BGP)和睾酮(T)含量的变化及临床意义.方法:应用放射免疫分析对33例男性老年骨质疏松症患者进行了血清IL-8、CT、BGP和T检测,并与35名正常人组作比较.结果:男性老年骨质疏松症患者血清IL-8水平非常显著地高于正常人组(P＜0.01),而C...     

甲状腺功能亢进症与骨代谢相关性分析

目的:观察甲状腺功能亢进症(甲亢)对患者骨密度及骨代谢相关指标的影响。方法:采用双能X线骨密度仪测定200例甲亢患者及50名正常对照人群的腰椎、桡骨远端及髋部骨密度(BMD),并测定血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)、甲状旁腺素(PTH)、降钙素(CT)及骨钙素(osteocalcin,BGP)等指标。比较两组间骨密度、血清骨代谢指标的差异并分析甲亢与骨代谢之间的相关性。结果:病例组骨密度Z值及血CT均明显低于正常对照组(P<0.05),ALP、BGP、PTH明显高于正常对照组(P<0.05),Ca、P差异无统计学意义(P>0.05)。相关分析显示,甲亢患者骨密度值与游离三碘甲腺原氨酸(FT3)明显相关,与游离甲状腺素(FT4)、促甲状腺素(TSH)有相关趋势,与病程无关。结论:甲亢患者骨代谢紊乱,呈现骨吸收大于骨形成的趋势,容易导致骨量丢失,且骨量丢失的程度与病情严重程度有关,与病程无明显相关。     

IL-6及Sgp80、Sgp130与Graves'病及其骨代谢关系的临床研究

目的:探讨IL-6及其可溶性受体(Sgp80、Sgp130)与Graves'病(GD)及其骨代谢的关系.方法:对78例GD患者的血清行双抗体放射免疫分析检测血清IL-6,ELISA检测血清Sgp80、Sgp130.采用双能X线骨密度测定仪测定骨密度.结果:未治疗组、部分缓解组、缓解组的血清IL-6、Sgp130均明显高于正常对照组(P＜0.05),未治疗组、部分缓解组的血清Sgp80明显高于缓解组和正常对照组(P＜0.05).血清Sgp80与FT3、FT4、血磷(P)、血骨钙素(BGP)、尿羟脯胺酸(HYP)均成正相关.结论:血清IL-6及Sgp80、Sgp130与GD及其骨代谢的发病密切相关,血清Sgp80可作为观察GD治疗情况的重要指标,GD患者的皮质骨、松质骨有均等机会发生骨量丢失,骨形成与骨吸收的增加可能均为原发性的,而非骨形成继发于骨吸收.     

骨代谢标志物在老年骨质疏松症诊疗中的意义

背景:骨质疏松症并非一个简单的骨定量的问题。骨质疏松症的评估是年龄、性别、骨代谢、骨形成和骨生物力学动态结果。抗酒石酸酸性磷酸酶5b和骨碱性磷酸酶分别反映的是骨吸收和骨形成的两个重要指标。目的:分析骨代谢标志物在老年骨质疏松症诊疗中的临床意义以及其与骨密度的相关性。方法:选取老年骨质疏松症患者100例,年龄分布:65-70岁30例、71-75岁40例、76-80岁30例;排除合并糖尿病、肿瘤及其他影响骨质状况疾病。所有患者入院后检测骨生化4项,包括:抗酒石酸酸性磷酸酶5b、骨碱性磷酸酶、骨钙素N端中分子片段以及25-羟维生素D。据检测结果患者分成抗酒石酸酸性磷酸酶5b升高组和骨碱性磷酸酶升高组,分别行抗骨质疏松症治疗3个月。分析患者骨密度和骨生化4项检查结果与性别、年龄的相关性;进行两组治疗前后骨生化4项差异性比较及组间差异性比较。结果与结论:腰椎和髋关节骨密度随年龄增加而降低(P0.05);男性组的腰椎和股骨颈Word三角区骨密度测量值较女性组高。抗酒石酸酸性磷酸酶5b、骨碱性磷酸酶、骨钙素N端中分子片段随年龄增加在人体内含量升高(P0.05),而25-羟维生素D随年龄增加在人体内含量降低(P0.05);女性骨质疏松症患者抗酒石酸酸性磷酸酶5b、骨碱性磷酸酶、骨钙素N端中分子片段在人体内含量较男性患者高,而25-羟维生素D在人体内含量较男性患者低。两组患者使用抗骨质疏松症药物治疗后骨生化4项指标均较治疗前有改善。结果提示,骨代谢标志物检测能明确患者体内是以成骨细胞功能为主和还是以破骨细胞功能为主,以便指导临床针对性使用抗骨质疏松症药物,为临床治疗骨质疏松症和监测疗效提供科学依据。     

Bone tissue metabolism in men with ankylosing spondylitis

PurposeThe aim of the study was the composite estimation of bone tissue metabolism in ankylosing spondylitis (AS) after having taken into account such factors as a high risk of incidence of osteoporosis in patients with AS and potential danger of permanent immobility.Material and MethodsSixty- six patients with established diagnosis of AS and 63 healthy individuals in the control group were included into the study. To measure bone mineral density (BMD) the dual energy X-ray absorptiometry (DEXA) method was used. Additionally, biochemical markers of osteoporosis such as bone fraction of an alkaline phosphatase (BALP), osteocalcin (BGP) and deoxypyridinoline (Dpd) as well as many inflammatory markers of disease activity have been determined.ResultsIn our study with AS had significantly diminished bone mineral density, as compared with health controls. The presence of osteopenia/osteoporosis was associated with longer duration of the disease and with higher age. In the overall group of AS patients bone degradation marker, Dpd, correlated with serum concentration of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and C-reactive protein (CRP), and inversely with BMD measured in the forearm. However, no direct association could be revealed between lower bone density and markers of inflammation or inflammatory cytokines, except of IL-6 witch was significantly higher in AS patients with osteoporosis/ osteopenia than those without.ConclusionsOur results indicate that disease duration and higher age are risk factors for osteoporosis in patients with AS. Inflammation might contribute to the accelerated bone loss in AS through stimulation of bone degradation.     

Influence of Infliximab on Cytokines Network and Markers of Bone Remodeling in Rheumatoid Arthritis Patients

Purpose

Our aim was to determine the effects of infliximab on bone mineral metabolism in rheumatoid arthritis (RA) patients and analyze the relationship between inflammatory markers of acute phase thought to play a major role in bone remodeling.

Materials and Methods

36 patients with established RA were investigated. All patients underwent physical examination and blood and urinary analysis at baseline, 2 weeks, 14 weeks, 6 months and 12 months after the initiation of treatment. The serum levels of: tumor necrosis factor alpha (TNF-alpha), tumor necrosis factor alpha receptor 1 (TNFR1), TNFR2, interleukin 6 (IL-6), IL-17, IL-23 and markers of bone remodeling such as osteocalcin (BGP), deoxypyridynoline (Dpd), and N-telopeptide of type I collagen (NTx) were measured by ELISA.

Results

The results showed significant decrease of all the above cytokines levels in RA patients in comparison with those after 2 weeks of treatment. After 6 months, the markers of bone formation and resorption decreased compared to baseline values. We found positive correlation between the levels of NTx and the levels of IL-6, IL-17 and TNFR1, and between the levels of Dpd and IL-6 and Dpd and TNFR2, whereas negative correlation between BGP and IL-23. After 12 months the positive association was found at the BGP level and IL-6 as well as Dpd and the level of IL-6. We also observed a positive relation between Dpd and TNF-alpha and negative between BGP and TNFR1.

Conclusion

We suggest that infliximab treatment may limit the risk of osteoporosis in RA patients.     

Bone mass and biochemical parameters in metabolic bone diseases

We studied the relationship between the bone mass and biochemical parameters in 175 normal premenopausal, 72 normal postmenopausal and osteoporotic postmenopausal women, between 20 and 88 years old, and in 40 patients with hyperthyroidism, and 23 patients with primary hyperparathyroidism, between 13 and 64 years old. The bone mineral density (BMD) of the spine (L2-L4) and proximal femur (femoral neck) was measured by dual-energy X-ray absorptiometry using a QDR-1000, Hologic. The bone mineral content (BMC) of the radius was measured by single photon absorptiometry (SPA) using a model 2780, Norland. Serum PTH, BGP and calcitonin (CT) were determined by radioimmunoassay. The BMD of the spine (L2-L4), and the proximal femur in postmenopausal women were negatively correlated with age. The mean BMD in patients with postmenopausal osteoporosis was significantly lower than that in normal postmenopausal women. In postmenopausal women, age was positively correlated with BGP, PTH, CT and negatively correlated with P. In patients with osteoporosis, the BMD of the spine was negatively correlated with serum BGP. The BMC of radius in patients with hyperthyroidism decreased significantly compared with that in the controls, and was negatively correlated with F-T3. The BMC of the radius in patients with primary hyperparathyroidism was significantly lower than that in the controls, and was negatively correlated with serum BGP and serum calcium. The measurements of biochemical parameters such as serum BGP, ALP and PTH may be useful in the assessment of metabolic bone diseases.     

甲亢患者骨密度及骨代谢生化指标的临床观察

测定甲亢患者的骨密度及骨代谢生化指标,探讨甲亢患者骨质疏松发生的机理.应用双能X线骨密度仪(DEXA),检查149例甲亢患者骨密度(BMD)变化,同时测定其中81例患者血清FT3、FT4、碱性磷酸酶(ALP)、骨钙素(BGP)、尿游离脱氧吡啶啉(D-pyd)的水平.结果显示甲亢时骨密度减低发生率30.2%,骨质疏松发生率24.1%.与对照组比较,甲亢患者各项骨代谢指标均明显升高.结论:甲亢时各项骨代谢指标均明显升高,呈高转换性骨质疏松.在治疗甲亢时应注意检测患者的骨密度,以便尽早发现骨质疏松.     

Evaluation of interleukin-1 and -6 in the etiopathogenesis of idiopathic osteoporosis and osteopenia in children

INTRODUCTION: The aim of the study is to determine whether serum concentrations of interleukin (IL)-1and IL-6 correlate with indices of bone mineral metabolism in children with idiopathic osteoporosis and osteopenia. MATERIAL/METHODS: The study comprised 62 patients aged 6-18 years (20 with idiopathic osteoporosis, 22 with idiopathic osteopenia, and 20 controls). In 10 children, investigations were repeated after one year of treatment. Serum concentrations of IL-1alpha, IL-1beta, IL-1 receptor antagonist (IL-1ra), as well as IL-6 and its soluble receptor (IL-6sR) were determined by the ELISA method. In patients with decreased bone mass, selected calcium-phosphorus metabolism indices and bone turnover markers were assessed. RESULTS: Higher values of IL-6 were recorded in those with idiopathic osteoporosis than in controls (2.79 vs. 1.43; p<0.05). In these patients there was also a tendency towards higher values of IL-6sR (p=0.05). IL-1alpha and IL-1beta were not markedly elevated in any of the patients. No significant differences between groups regarding IL-1ra were observed. Negative correlation between IL-6, IL-1alpha, cytokine/receptor indices, and spinal bone mineral density was determined. Positive correlation was found between IL-alpha, IL-1/IL-1ra, and parathormon as well as between IL-1alpha, IL-6sR, and bone formation markers.markers. Increase in bone mass after treatment was accompanied by a decrease in IL-6sR. CONCLUSIONS: The higher serum levels of IL-6 in children with idiopathic osteoporosis/osteopenia and the decrease in IL-6sR after treatment reveal an involvement of IL-6 in the etiopathogenesis of these disturbances. The results suggest that IL-1 may also participate in the primary decrease of bone mass in children.     

中老年女性骨代谢指标与骨质疏松的相关性研究

目的 分析骨代谢指标与骨质疏松的关系,为骨质疏松的防治提供流行病学依据。方法 采取随机分层抽样方法,选取2018年1月~5月来我院健康体检的30~90岁的成年女性400名。采用双能X线吸收测量仪（DEXA）测量腰椎及左侧股骨骨密度,由调查人员对所有体检对象进行问卷调查,同时收集清晨空腹血检测血常规、肝肾功、骨吸收指标TRAP-5b、CTX、 N-MID及骨形成指标BAP、PⅠNP等资料,进行统计学分析。结果 ①我院30岁以上女性骨质疏松的检出率为55.28%;②骨质疏松人群平均年龄为（63.54±9.40）岁,大于骨量减少人群的（49.42±9.51）岁和骨量正常人群的（44.14±6.71）岁,差异有统计学意义（P＜0.05）;年龄与骨密度存在相关性;③骨质疏松人群TRAP-5b、CTX、BAP水平大于骨量减少和骨量正常人群,均与骨密度存在相关性;N-MID、PⅠNP在骨质疏松人群、骨量减少和骨量正常人群中比较,差异无统计学意义（P＞0.05）,与骨密度无相关性;④年龄升高是骨质疏松的危险因素,而超重和肥胖可能是骨质疏松的保护因素。⑤以年龄＞55岁来预测骨质疏松的敏感性和特异性分别为82.52%,81.48%;而以BAP＞17.7 μg/L来预测骨质疏松的敏感性和特异性分别为53.84%,73.65%。结论 中老年女性骨质疏松的检出率较高,年龄升高是骨质疏松的危险因素,骨密度与骨代谢指标TRAP-5b、CTX、BAP呈负相关。     

甲状腺功能异常患者骨代谢变化的探讨

为探讨甲状腺功能改变对骨代谢的影响 ,对 91例甲亢 ,37例甲减及 5 1名健康对照者用免疫放射 (IR MA)法测骨钙素 (BGP)及甲状旁腺素 (PTH) ,用镅 - 2 41单光子跟骨密度仪测骨密度 (BMD)。结果发现 ,BGP含量 :甲亢组明显高于对照组 (P <0 .0 0 1) ,甲减组明显低于对照组 (P <0 .0 0 1) ;PTH含量 :甲亢组低于对照组 (P <0 .0 5 ) ,甲减组明显高于对照组 (P <0 .0 0 1) ;骨密度测定 :甲亢与甲减组骨质疏松发病率均明显高于对照组 (P <0 .0 0 1)。甲亢与甲减组骨质疏松发病年龄前移 ,甲减组 5 5岁以上都有骨质疏松。BGP和PTH改变明显早于骨密度变化 ,可作为甲状腺功能异常时骨代谢变化的灵敏指标 ,特别用于疗效观察