摘要
目的探讨男性人群血清骨特异性碱性磷酸酶（BAP）、血清骨钙素（sOC）和血清Ⅰ型胶原氨基末端肽（sNTX）与BMD的相互关系。方法用ELISA方法测定309名20-80岁男性志愿者的血清骨特异性碱性磷酸酶（sBAP）、血清骨钙素（sOC）和血清Ⅰ型胶原氨基末端肽（sNTX）,用DEXA（双能X线吸收法）测定腰椎正位（AP）L1-L4总体、腰椎侧位、股骨颈、Wards区（华氏区）及髋部总体的面积BMD。结果（1）直线相关分析显示,sOC、sNTX与腰椎正位总体BMD呈负相关,r分别为-0.007,-0.100。BAP与腰椎正位总体、腰椎侧位、髋部总体、股骨颈及Wards区BMD均负相关,r分别为-0.190、-0.087、-0.175、-0.128、-0.128（P〈0.05）。（2）校正年龄、体重指数和吸烟的影响后,sOC和各部位BMD相关性消失;sNTX与腰椎正位总体BMD;BAP与腰椎正位总体、髋部总体、股骨颈及Wards区BMD相关性仍存在,r分别为-0.164、-0.171、-0.148、-0.191、-0.105（P〈0.05）。（3）以50岁为切点,将所有样本按年龄分两段,偏相关分析显示50岁以前sOC、sNTX和BAP与各部位BMD无显著相关;50岁以后除腰椎侧位外,BAP与腰椎正位总体、髋部总体、股骨颈及Wards区BMD负相关,偏相关系数分别为-0.206、-0.256、-0.183、-0.126（P〈0.05）。sOC与各部位BMD无显著相关,sNTX与腰椎正位总体显著负相关,偏相关系数为-0.202（P〈0.05）。（4）按BMD分组,方差分析显示50岁以上年龄匹配男性骨质疏松组BAP高于正常对照组与低骨量组,NTX高于正常对照组（P〈0.05）。（5）分别以各部位BMD为应变量,年龄、BMI、吸烟（每日吸烟数量×烟龄）、BAP、sOC和sNTX为自变量,进行多元逐步线性回归分析。年龄、体重指数为各部位BMD的独立决定因子;吸烟为腰椎正位总体、髋部总体及Wards区BMD的独立决定因子。BAP为腰椎正位总体,髋部总体,股骨颈及Wards区BMD的独立决定因子,解释其BMD变化的百分数分别为16.5%、18.0%、13.4%、10.8%。（P均〈0.05）;sNTX为腰椎正位总体BMD的独立决定因子,解释腰椎正位总体BMD变化的15.7%。结论（1）校正年龄、体重指数和吸烟后,50岁以上男性BAP与腰椎正位总体、髋部总体、股骨颈及Wards区BMD,sNTX与腰椎正位总体BMD均呈负相关,BAP与sNTX均为50岁以上男性BMD的独立决定因子。（2）50岁以上男性骨质疏松组BAP显著高于正常对照组与低骨量组,NTX高于正常对照组,较高的骨代谢转换水平与较低的BMD相关联。（3）年龄、体重指数与吸烟均为各部位BMD的独立影响因素。
Objective To study the relationships of serum osteocalcin （sOC）, serum cross-linked N-telopeptide of collagen type I （sNTX） ,serum bone alkaline phosphatase （BAP） with bone mineral density （BMD） in normal men aged 20 - 80 years old. Method sOC,sNTX and BAP were measured using ELISA, areal BMD at anteroposterior （AP） lumbar spine, supine lateral lumbar spine, and hip using DXA （QDR 4500 A）, in 309 normal males. Results （ 1 ） BMD values at all sites were negatively correlated with BAP（ r = - 0. 087 - - 0. 190, P 〈 0.05 ） ; BMD value at anteroposterior （AP） lumbar spine was negatively correlated with sOC and sNTX （ r = - 0.007, - 0.100, P 〈 0.05） ;（2） After adjusted age,weight and smoking, BMD values at all sites but supine lateral lumbar spine were yet negatively correlated with BAP（ r = - 0. 105 - - 0. 191, P 〈 0.05） ; BMD value at anteroposterior （AP） lumbar spine was negatively correlated with sNTX （ r = - 0. 164, P 〈 0.05） ; no correlations were found between sOC values and BMD values at all sites. （3） Men over 50 were stratified by BMD, BAP value of men with OP higher than the other groups. （4） Multiply regression analysis was made, taking BMD values at all sites as dependent variables, age, BMI, BAP, sOC, sNTX, smoking age and quantity as independent variables. Age and BMI enter all regression equation of BMD in all sites; smoking enters the regression equation of BMD at anteroposterior （AP） lumbar spine and hip region and Ward＇s region; BAP enters the ones of BMD, which explains the percentages of variance of BMD 16.5%, 18.0%, 13.4 and 10.8% respectively at anteroposterior （AP） lumbar s pine, supine lateral lumbar spine,total hip, femoral neck and Ward＇s region, sNTX enters the one of BMD,which accounts for the percentages of variance of BMD 15.7% at anteroposterior （AP） lumbar spine （all P 〈 0.05 ）. Conclusion （1） BMD values at all sites are negatively correlated with BAP; After adjusted age, weight and smoking, BMD values at all sites but supine lateral lumbar spine are negatively correlated with BAP. BMD value at anteropostcrior （AP） lumbar spine is negatively correlated with sNTX among men over 50. （2） Among men over 50, BAP values of those with OP are higher than those with bone loss and the control group, sNTX values of tho~ with OP higher than the control group, suggesting correlation between higher bone metabolism level and bone loss. （3） Age, BMI and smoking are the independent risk factors of BMD values at all sites in males.
出处
《中国骨质疏松杂志》
CAS
CSCD
2007年第11期783-787,768,共6页
Chinese Journal of Osteoporosis
关键词
骨特异性碱性磷酸酶
骨钙素
Ⅰ型胶原氨基末端肽
骨密度
年龄
Serum osteocalcin
Serum cross-linked N-telopeptide of type I collagen
Serum bone alkaline phosphatase
Bone mineral density,Age
