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目的:测定绝经后妇女血清基质金属蛋白酶-13(MMP-13)和抑制因子(TIMP-1)水平,并探讨其与骨密度数值和骨代谢指标的关系。方法:选取武汉地区120名48岁至65岁绝经后女性,用酶联免疫吸附试验(ELISA)测定血清MMP-13、TIMP-1以及雌二醇(E2)、骨保护蛋白(OPG)、骨保护蛋白配体(OPGL),Ⅰ型原胶原N端前肽(PINP)和Ⅰ型胶原交联C末端肽(CTX)的水平,计算TIMP-1/MMP-13比值,用双能X线吸收法(DEXA)测定腰椎正位,股骨颈,华氏区和大粗隆的骨密度(BMD)。同时,按照WHO标准将入选女性分为骨密度正常组、低骨量组和骨质疏松组。结果:①骨质疏松组中血清MMP-13的数值(44.25±1.21)μg/L高于正常组(27.08±1.41)μg/L(P<0.05),而TIMP-1的数值(134±116)μg/L低于正常组(146±130)μg/L。②骨质疏松组中血清MMP-13与骨密度、血清E2、OPGL数值存在明显负相关性(P<0.05),和OPG、PINP和CTX存在明显正相关性(P<0.05)。③低骨量组中MMP-13略高于骨质疏松组中数值,并且两者比较差异无统计学意义(P>0.05),但是明显高于正常组(P<0.05),同时与骨密度和E2、OPG、OPGL、PINP和CTX存在明显相关性(P<0.05)。结论:血清MMP-13和MMP-13/TIMP-1比值与绝经后骨质疏松症妇女和绝经后低骨量组妇女骨代谢指标具有关联性。血清MMP-13水平升高和MMP-13/TIMP-1比值升高可能为绝经后骨质疏松症和绝经后妇女早期骨代谢转换过程增快的表现。
OBJECTIVE: To determine the serum levels of matrix metalloproteinase-13 (MMP-13) and inhibitor of metalloproteinase-1 (TIMP-1) in postmenopausal women and to explore their relationship with bone mineral density and bone metabolism. Methods: A total of 120 postmenopausal women aged 48 to 65 years in Wuhan were enrolled. Serum levels of MMP-13, TIMP-1, estradiol (E2), osteoprotegerin (OPG) The ratio of TIMP-1 / MMP-13 was calculated by comparing the levels of OPGL, PINP and CTX. (DEXA) was used to determine the lumbar spine, femoral neck, Fahrenheit area and greater trochanter BMD. At the same time, the women were divided into normal BMD group, low BMD group and osteoporosis group according to WHO standard. Results: ① The serum level of MMP-13 in the osteoporosis group (44.25 ± 1.21) μg / L was significantly higher than that in the normal group (27.08 ± 1.41) μg / L (P <0.05) ) μg / L was lower than the normal group (146 ± 130) μg / L. ② There was a significant negative correlation between serum MMP-13 and bone mineral density (BMD), serum E2 and OPGL (P <0.05) and OPG, PINP and CTX in osteoporosis group (P <0.05). ③ In the low bone mass group, MMP-13 was slightly higher than that in the osteoporosis group, and there was no significant difference between the two groups (P> 0.05), but significantly higher than that in the normal group (P <0.05) And E2, OPG, OPGL, PINP and CTX were significantly correlated (P <0.05). Conclusion: The ratio of serum MMP-13 to MMP-13 / TIMP-1 is correlated with the bone metabolism in postmenopausal women and postmenopausal women with low bone mass. Increased serum MMP-13 levels and elevated MMP-13 / TIMP-1 ratio may be an early manifestation of the early metabolic process of bone metabolism in postmenopausal osteoporosis and postmenopausal women.