女性初潮前后骨代谢生化因子与雌激素、瘦体重相关分析

目的:探讨女性骨代谢生化因子骨钙素(OC)、骨碱性磷酸酶(BAP)和抗酒石酸酸性磷酸酶(TRAP)在初潮前后的变化特征及其相关影响因素。方法:以平均年龄(11.4±0.6)岁的115名小学女生为对象,测量其身高(H)、体重(W)、脂肪含量(FM)、瘦体重含量(LM),血清雌二醇(E2)、睾酮(T)、性激素结合蛋白(SHBG)及血清OC、BAP和TRAP。随访获得实验对象的初潮时间,以测量时相距初潮的时间作为自变量,拟合骨代谢生化因子及相关指标的回归曲线方程。采用偏相关方法检测骨代谢生化标志物与其影响因素之间的相关性。结果:初潮前呈上升趋势的OC、BAP在初潮时显著下降,而TRAP从初潮前至初潮一直下降。从初潮前至初潮,H与BAP(r=0.22,P=0.001)、OC(r=0.21,P=0.002)和TRAP(r=0.14,P=0.04)显著相关,E2、LM与BAP(E2:r=0.2,P=0.003;LM:r=0.15,P=0.029)、OC(E2:r=0.34,P<0.0001;LM:r=0.30,P<0.0001)也显著相关,与TRAP无明显相关。结果表明:女性初潮时骨代谢速度明显减慢,身高增长与骨代谢密切相关,雌激素和瘦体重含量是骨组织代谢的相关影响因素。

The Relation of Bone Turnover Markers to Estradiol, Lean Body Mass in Pubertal Girls around the Menarche

Objective To investigate the changing characteristics of BAP(bone-specific alkaline phosphatase),OC(osteocalcin),and TRAP(tartrat-resistant acid phosphatase) and the related regulating factors in girls around the menarche.Methods One hundred and fifteen girls voluntarily participated in this study.Their body height(H),weigh(W),fat mass(FM),lean mass(LM),serum estradiol(E2),testosterone(T)and sex hormone binding globulin(SHBG) as well as BAP,OC and TRAP were determined.Results Increased serum BAP and OC before menarche decreased at menarche,and decreased serum TRAP before menarche continued to decrease at menarche.H closely correlated with BAP(r = 0.22,P = 0.001),OC(r = 0.21,P = 0.002)and TRAP(r = 0.14,P = 0.04),while serum E2,LM significantly associated with BAP(E2:r = 0.2,P = 0.003;LM:r = 0.15,P = 0.029) and OC(E2:r = 0.34,P < 0.0001;LM:r = 0.30,P < 0.0001) without significant correlation to TRAP.Conclusion It was suggested that level of bone metabolism around the menarche decreased,and growth of body height was associated with bone metabolism,in which estradiol and mechanical strains were the two important regulating factors.