骨代谢指标在骨质疏松患者椎体变形中的意义

背景：骨质疏松常导致胸腰段椎体变形,鉴于骨代谢指标可灵敏的反映个体骨转换过程,结合骨密度可减少漏诊,预测骨折风险,提前干预可降低重度椎体畸形的发生率.目的：分析骨代谢指标在骨质疏松患者椎体变形中的意义.方法：将157例老年人骨质疏松患者按是否存在椎体变形分为椎体变形组和椎体形态正常组,椎体变形组中根据骨密度的不同分为骨密度正常和骨密度减低亚组,进行骨密度和总Ⅰ型胶原氨基端前肽、β胶原特殊序列、N端骨钙素骨代谢指标进行检测,比较了2组间及椎体变形组内骨密度正常和骨密度减低亚组间各骨代谢指标的差异.结果与结论：椎体变形组总Ⅰ型胶原氨基端前肽、β胶原特殊序列、N端骨钙素水平较椎体形态正常组增高（P＜0.05）;骨密度正常亚组总Ⅰ型胶原氨基端前肽与β胶原特殊序列水平较骨密度减低亚组增高（P＜0.05）,N端骨钙素在2亚组间差异无显著性意义（P＞0.05）.结果表明骨质疏松患者中椎体变形者总Ⅰ型胶原氨基端前肽、β胶原特殊序列、N端骨钙素的骨代谢水平高于无椎体变形者,在存在椎体变形的患者中,骨密度正常者总Ⅰ型胶原氨基端前肽、β胶原特殊序列的骨代谢水平高于骨密度降低者,骨代谢水平增高结合骨密度及椎体变形可用于骨质疏松的诊断和椎体脆性骨折的预测.

Bone metabolism in patients with osteoporotic vertebral deformation

BACKGROUND： Osteoporosis often leads to thoracolumbar deformation, since bone metabolism indicators are sensitive to reflect conversion process of individual bone, it can reduce misdiagnosis and predict fracture risk when combined with bone mineral density, thus early reducing the incidence of severe vertebral deformity. OBJECTIVE： To analyze the significance of bone metabolism in patients with osteoporotic vertebral deformation METHODS： A total of 157 elderly patients with osteoporosis were divided into vertebral deformation group and normal vertebrae group according to the presence of vertebral deformation. In the vertebral deformation group, the patients were further assigned into normal bone mineral density subgroup and reduced bone mineral density subgroup. Bone mineral density and N-telopeptides of type I collagen, β-Crosslaps, osteocalcin were tested in each group. Finally we compared the differences of bone metabolism between each group. RESULTS AND CONCLUSION： N-telopeptides of type I collagen, β-Crosslaps and osteocalcin in vertebral deformation group were higher than that in normal group （P 〈 0.05）. N-telopeptides of type I collagen and β-Crosslaps in normal bone mineral density subgroup were higher than that in reduced bone mineral density subgroup （P 〈 0.05）, there was no significant difference between the two subgroups （P 〉 0.05）. The results showed that vertebral deformation group has a higher level of bone metabolism than normal group, normal bonemineral density subgroup expresses higher levels of N-telopeptides of type I collagen and β-Crosslap than reduced bone mineral density subgroup in vertebral deformation group. The higher level of bone metabolism combined with bone mineral density and vertebral deformation can contribute to diagnose osteoporosis and predict vertebral fragile fractures.