绝经后妇女血清骨钙素水平及其它相关因素与骨质疏松关系的研究

应用放射免疫法和单光子骨密度测定法测定了１１３例绝经前后妇女的血清骨钙素水平（ＢＧＰ）、尺桡骨平均骨密度（ＢＭＤ），并测定了甲状旁腺激素（ＰＴＨ）、降钙素（ＣＴ）、雌二醇（Ｅ２）等多种骨代谢参数。结果：绝经后妇女血清ＢＧＰ升高，绝经５年内升高最为明显，ＢＭＤ逐渐下降，ＢＧＰ与ＢＭＤ呈正相关，骨转换水平升高。提示绝经后妇女因缺乏雌激素存在骨质丢失。这一过程可能是在多种因素参与下，骨形成和骨吸收之间不平衡所致。

Study on the relationship among serum bone glu-protein level, the other relative factors and osteoporosis of postmenopausal women.

Despite 50 years of investigation,it is still unclear whether the major cause of bone loss in women with postmenopausal osteoporosis is decreased bone formation absolutely or increased bone resorption. To study the pathogenesis of postmenopausal osteoporosis,we measured serum bone gluprotein (BGP),parathyroid hormone (PTH),calcitonin(CT),estrogen (E2), alkaline phosphatase (AKP)and other bone metabolic parameters among 113 normal pre-postmenopausal women. The mean level of serum BGP in normal premenopausal women is 6.46±1.57ng/ml.Serum BGP concentration is increased in postmenopausal women compared with the control. The difference between normal postmenopausal (over 10 years)and premenopausal women isn't significant. Positive correlation existed between serum BGP and BMD (r=0.315, P<0.01),AKP(r=0.598, P<0.01),fasting urinary calcium/creatine (r=0.326,P<0.01). This suggested bone turnover increased after menopausal and associcated with bone loss. E2 is significantly decreased and positive correlation (r=0.294,P<0.01) with BMD after menopausal.This showed that E2 defficiency is the important cause of bone loss in postmenopausal woman.Serum PTH and CT level is decreased in postmenopausal women, also. This demonstrated that there is CT defficiency and an increased sensitivity to endogenous circulating PTH in normal postmenopausal women.PTH and CT is not the only factor but really participated the process of postmenopausal osteoporosis. We conclude that the bone loss after menopausal is neither decreased hone formation absolutely nor increased bone resorption.It is the result that increased bone turnover and out of balance between bone formation and bone resorption. The higher the level of bone turnover, the greaterthe difference between resorption and formation and the faster is the postmenopausal bone loss.