绝经前期妇女血清PINP、ICTP和25-OH-VitD3水平的变化及其与BMD的相关性分析

目的：观察绝经前期妇女血清PINP、ICTP和25-OH-VitD3水平的变化,分析其与骨密度（BMD）的相关性。方法：采用双能X线吸收法（DEXA）对67例绝经前期健康女性进行第（1～4）腰椎（L1-4）、左、右髋部（股骨近段＋股骨颈）的BMD测定,并根据BMD测定结果分为BMD正常组和BMD降低组。用放射免疫分析（RIA）测定血清Ⅰ型前胶原氨基端前肽（PINP）、Ⅰ型胶原交联羧基末端肽（ICTP）和25-羟维生素D3（25-OH-VitD3）,分析与各部位BMD的相关性。结果：①19例出现BMD降低（28.4%）,两组间腰椎及左、右髋部BMD差异显著（P〈0.01）;②BMD减低组的PINP和ICTP[分别为（56.9±18.2）μg/L和（3.78±0.83）μg/L]高于BMD正常组[分别为（43.8±15.1）μg/L和（3.45±0.98）μg/L],其中PINP差异显著（P〈0.05）,25-OH-VitD3水平两组间无显著性差异[分别为（25.6±7.8）ng/ml和（27.4±9.2）ng/ml,P〉0.05];③PINP与L1-4、左股骨近段、左股骨颈的BMD呈正相关（r=0.274～0.402,P〈0.05）,ICTP及25-OH-VitD3与BMD无明显相关性（r=-0.226～0.083,P〉0.05）,PINP与25-OH-VitD3呈一定程度的正相关（r=0.395,P〈0.05）。结论：绝经前期妇女有骨转换增高趋势,BMD检查联合骨转换标志物测定有利于识别绝经前期高风险发生骨质疏松的妇女,以指导OP预防性治疗。

Study on the Changes of Serum Levels of PINP, ICTP and 25-OH-VitD3 in Pre-menopausal Women and Their Relationship with BMD Changes

Objective To study the changes of serum levels of procollagen type Ⅰ N-terminal propeptide（PINP）, pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen （ICTP） and 25-OH-VitD3 in premenopausal women and their relationship with changes of bone mineral density （BMD）. Methods BMD （at L1-L4 and hip region） was examined with dual energy X-ray absorptiometer （DEXA） and serum levels of PINP, ICTP, 25-OH-VitD3 were determined with RIA in 67 pre-menopausal women. Results ①Of the 67 women tested, 19 （28.4%） were found to be with low BMD. The mean BMD values in this group were significantlylower than those in the other 48 women. ②The serum levels of PINP and ICTP in the 19 women with lower BMD （56.9±18.2μg/L and 3.78±0.83μg/L respectively） were much higher than those in the other 48 women （43.8±15.1μg/L and 3.45±0.98μg/L respectively, for PINP, P〈0.05, for ICTP, P〉0.05）. The serum 25-OH-VitD3 levels in the two groups of pre-menopausal women were not significantly different （25.6±7.8ng/ml vs 27.4±9.2ng/ml, P〉0.05）. ③PINP levels were positively correlated with BMD values （r=0.274-0.402, P〈0.05）, but ICTP and 2.5-OH-VitD3 levels were not significantly correlated with BMD levels （r=-0.226-0.083, P〉0.05）. PINP levels were weakly positively correlated with 25-OH-VitD3 levels （r=0.395, P〈0.05）. Conclusion There was tendency of increasing rate of bone turnover in pre-menopausal women, which might lead to development of osteoporosis. Early detection with BMD and serum markers of bone resorption （e.q. ICTP） measurement would be highly valuable for implement of prophylactic measures.