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目的了解绝经后跌倒骨折妇女及跌倒无骨折妇女人群血液循环中骨硬化蛋白与血清骨代谢标志物、骨密度之间的关系,探讨骨硬化蛋白是否可作为一种新的预测脆性骨折的生化标志物。方法采用横向前瞻性研究,对50例健康的未绝经女性(A组)、50例绝经后跌倒股骨颈骨折妇女(B组)及50例绝经后跌倒无骨折妇女(C组)进行评估,评估内容包括血清骨硬化蛋白水平、骨代谢标志物及骨密度。结果骨代谢标志物如Ⅰ型胶原交联C-端肽(CTX)、CTXⅡ、骨特异性碱性磷酸酶(b-ALP)、前胶原1型N端前肽(P1NP)、核因子κB受体激活因子(RANK)和核因子κB受体激活因子配体(RANKL)在3组间差异均有统计学意义(P<0.05,P<0.01);相较于A组,B组及C组的骨硬化蛋白水平升高(P<0.05,P<0.01)、骨钙素水平降低(P<0.01),但B、C两组间骨硬化蛋白水平和骨钙素水平差异无统计学意义。股骨颈、全髋、转子间及L1~L4部位的骨密度在3组之间差异有统计学意义(P<0.01),B组中骨密度较A、C两组降低(P<0.01)。在所有研究对象中,骨硬化蛋白水平与股骨颈骨密度(r=-0.228,P=0.004)、转子间骨密度(r=-0.199,P=0.002)和全髋骨密度(r=-0.273,P<0.001)均呈负相关。结论绝经后妇女中骨折人群与未骨折人群血清骨硬化蛋白水平差异无统计学意义,提示血清骨硬化蛋白水平无法预测脆性骨折风险。
Objective To investigate the relationship between serum levels of bone sclerosis and bone morphogenetic protein (BMP) and bone mineral density (BMD) in blood circulation of women with falls and non-fractures after falling menopause, and to explore whether osteosclerotic protein can be used as a new biomarker for predicting fragility fractures Things. Methods Fifty healthy women without postmenopausal women (Group A), 50 women with femoral neck fracture who fell after menopause (Group B) and 50 women without fracture after menopause (Group C) were assessed by a prospective prospective study. Contents include serum osteocalcin levels, markers of bone metabolism and bone mineral density. RESULTS: Bone metabolism markers such as CTX, CTXⅡ, b-ALP, P1NP and NFκB There were significant differences in RANK and RANKL between the three groups (P <0.05, P <0.01). Compared with group A, group B and group C (P <0.05, P <0.01), osteocalcin level decreased (P <0.01), but there was no significant difference between B and C groups in the level of osteocalcin and osteocalcin. The bone mineral density in the femoral neck, total hip, intertrochanter and L1 ~ L4 was significantly different among the three groups (P <0.01). The bone mineral density in group B was lower than that in group A and C (P <0.01). In all the subjects, the level of osteocalcin was positively correlated with femoral neck BMD (r = -0.228, P = 0.004), inter BMD (r = -0.199, P = 0.002) and total hip BMD , P <0.001) were negatively correlated. Conclusions The serum levels of sclerostin in fractured and non-fractured postmenopausal women are not statistically different, suggesting that the serum level of sclerostin can not predict the risk of brittle fracture.