某燃煤型氟病区儿童血清骨吸收生物标志浓度变化

探讨某燃煤型氟中毒病区8~14岁儿童血清骨吸收标志物Ⅰ型胶原交联氨基末端肽(NTX)和抗酒石酸酸性磷酸酶5b(TRACP-5b)的浓度及其与年龄的关系,为氟骨症的发病机制研究提供数据资料.方法 整群随机抽取贵州省六盘水市燃煤型氟病区陡菁乡的2所小学8~14岁在校儿童为暴露组(123人),随机抽取非病区花嘎乡某小学学生为对照组(64人),调查氟斑牙情况并检测血清NTX和TRACP-5b的浓度.结果 氟病组儿童氟斑牙检出率为94.3%,对照组儿童未检出氟斑牙.氟病组血清NTX、TRACP-5b浓度13.39(69.99,32.63),280.32(152.06,651.63) nmol/L]低于对照组.氟病组儿童血清NTX在青春早期、青春中期浓度为13.04(10.76,15.64)、14.82(12.15,18.26) nmol/L,低于对照组的15.73(14.36,18.61)、16.45(15.45,22.02) nmol/L(Z值分别为-4.12,-5.40,P值均<0.05);氟病儿童血清TRACP-5b在青春前期、青春早期和青春中期浓度为276.74(237.63,312.75)、270.14(242.82,321.97)、305.95(259.78,339.87) nmol/L,低于对照区的370.88(304.47,452.84)、353.30(262.05,393.19)、420.22 (376.96,544.60) nmol/L,差异均有统计学意义(Z值分别为-3.03,-2.66,-3.10,P值均<0.05).病区儿童血清NTX、TRACP-5b浓度与氟斑牙程度负相关(r值分别为-0.51,-0.37,P值均<0.01).结论 氟中毒能降低不同年龄段病区儿童血清骨吸收标志物NTX和TRACP-5b的浓度,其中TRACP-5b对氟暴露可能较NTX敏感,但具体机制仍有待进一步研究.

Variations of serum bone resorption biomarkers of children of the coal-burning fluorosis area

Objective To investigate the concentration of serum bone resorption markers NTX and TRACP-5 b of children aged 8-14 years in a coal-burning fluorosis area and its relationship with age, and to provide population data for the study of pathogenesis of skeletal fluorosis. Methods Totally 123 children of 8-14 school-age in the two primary schools in Doujing Township,Shuicheng County, Liupanshui City, Guizhou Province were randomly selected as the exposed group. According to the matching principle, 64 children were randomly selected as a control from a primary school in a non-disease area Huaga Town. The dental fluorosis was investigated, and the concentrations of serum NTX and TRACP-5 b were measured. Results The detection rate of dental fluorosis in the fluorosis area was 94.3% and 0 in the control area. The concentrations of serum NTX in fluorosis area children were 13.04( 10.76, 15.64), 14.82( 12.15, 18.26) nmol/L in the early adolescence and middle-aged period, which lower than the control area 15.73( 14.36, 18.61), 16.45( 15.45, 22.02) nmol/L( P<0.05);The serum TRACP-5 b levels in children with fluorosis were 276.74( 237.63, 312.75), 270.14( 242.82, 321.97), 305.95( 259.78, 339.87) nmol/L in prepubertal, early adolescence and middle youth, lower than the control area 370.88( 304.47, 452.84), 353.30( 262.05, 393.19), 420.22( 376.96, 544.60) nmol/L( Z =-3.03,-2.66,-3.10, P<0.05). Serum NTx and TRACP-5 b in fluorosis area were negatively correlated with dental fluorosis in children( r =-0.51,-0.37, P< 0.01). Conclusion Fluorosis can reduce the concentrations of serum bone resorption markers NTX and TRACP-5 b in children of different age groups. TRACP-5 b may be more sensitive to fluoride exposure than NTX, but the specific mechanism remains to be further studied.