摘要
目的了解上海地区绝经前女性中特发性骨质疏松症患者骨密度、骨转换指标及其他临床特点。方法 2005年9月至2016年12月在上海市第一人民医院骨质疏松门诊就诊的1043名绝经前女性中,选取资料齐全、符合入组标准条件的特发性骨质疏松症患者、继发性骨质疏松症患者及骨量正常者共99名,分为特发性骨质疏松症组(28例)、继发性骨质疏松症组(15例)及正常对照组(56名)3组。采用回顾性统计分析记录所有研究对象的一般资料,生化指标[钙(Ca)、磷(P)、25(OH)D]、骨密度(bone mineral density,BMD)、骨转换指标(bone turnover marker,BTM)、骨折史等临床资料。结果 (1)特发性骨质疏松症组腰椎、股骨颈及全髋BMD均明显低于正常对照组(t=-3.794,P<0.01;t=-4.080,P<0.01;t=-5.632,P<0.01)。两组间钙、磷、25(OH)D水平比较差异无统计学意义(t=0.120,P>0.05;t=0.121,P>0.05;t=0.004,P>0.05)。特发性骨质疏松症组血清骨钙素(osteocalcin,OC)、血清Ⅰ型胶原羧基端肽(type 1 collagen carboxy terminal peptide,β-CTX)水平与正常对照组相比有升高趋势,但差异无统计学意义(t=1.605,P>0.05;t=1.543,P>0.05)。(2)继发性骨质疏松症组腰椎BMD显著低于特发性骨质疏松症组(P=0.035),股骨颈及全髋BMD差异无统计学意义(P=0.298、0.223)。继发性骨质疏松症组血清OC、血清β-CTX水平均显著高于正常对照组(P=0.020,P<0.01);继发性骨质疏松症组血清OC水平与特发性骨质疏松症组差异无统计学意义(P>0.05),血清β-CTX水平均显著高于特发性骨质疏松症组(P<0.01)。结论女性特发性骨质疏松症患者发病与Ca、P、25(OH)D缺乏无关,遗传性因素或许为发病的主要原因,而骨代谢的高转换状态可能为其发病的主要机制。
Objective To observe the clinical characteristics of idiopathic osteoporosis among premenopausal women. Methods28 idiopathic osteoporosis patients,15 secondary osteoporosis patients and 56 normal cases were selected from 1043 premenopausal women according to the inclusion criteria in Shanghai First People＇s hospital between September 2005 and December 2016. Subjects were divided into three groups： idiopathic osteoporosis group,secondary osteoporosis group and control group. Retrospective statistical analyses were performed for basic clinical characteristics,bone turnover markers,bone mineral density（ BMD） and fracture data. Results BMD of the lumbar spine,femoral neck and hip in the idiopathic osteoporosis group were significantly lower than that of the control group（ t =-3. 794,P〈0. 01; t =-4. 080,P〈0. 01; t =-5. 632,P〈0. 01）. There were no significant differences in the levels of calcium,phosphorus and vitamin D between the idiopathic osteoporosis group and the control group（ t = 0. 120,P〈0. 05; t = 0. 121,P〈0. 05; t = 0. 004,P〈0. 05）. There was a trend of lower levels of OC and β-CTX in the idiopathic osteoporosis group than that of the control group,but the differences were not statistically significant（ t = 1. 605,P〈0. 05; t = 1. 543,P〈0. 05）. BMD of the lumbar spine in the secondary osteoporosis group was significantly lower than that in the idiopathic osteoporosis group（ P = 0. 035）. However,there were no significant differences in BMD of the femoral neck and hip between the secondary osteoporosis group and the idiopathic osteoporosis group（ P = 0. 298,0. 223）. The levels of OC and β-CTXin the secondary osteoporosis group were higher than that in control group（ P = 0. 020,P〈0. 01）. There was no significant difference in the level of OC between the secondary osteoporosis group and the idiopathic osteoporosis group（ P〈0. 05）. The level of β-CTX in the secondary osteoporosis group was higher than that in the idiopathic osteoporosis group（ P〈0. 01）. Conclusion The pathogenesis of idiopathic osteoporosis in premenopausal women may not be related to the levels of Ca,P and 25 OHD,and the high turnover of bone metabolism might be the main cause of the disease.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2018年第2期235-238,258,共5页
Chinese Journal of Osteoporosis
关键词
骨质疏松
绝经后
特发性骨质疏松症
骨密度
骨转换指标
Osteoporosis, postmenopausal
Idiopathic osteoporosis
Bone mineral density
Bone turnover marker
