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目的了解中老年人骨代谢生化指标随年龄变化的特点,分析骨代谢生化指标在临床应用中的价值。方法测定410例中老年患者腰椎正位骨密度,同时检测所有患者空腹血清骨钙素、血清碱性磷酸酶及晨尿吡啶啉,尿吡啶啉用肌酐校正。按年龄段和不同骨密度组对男性和女性的骨代谢生化指标值分别进行统计分析。结果按年龄分析,中老年男性骨钙素随年龄增长下降,尿吡啶啉/肌酐随年龄增长上升,中老年女性骨钙素和尿吡啶啉/肌酐在50～69岁时明显升高。70岁以后又趋于下降,并与同年龄的老年男性的骨钙素、尿吡啶啉/肌酐值相近。而血清碱性磷酸酶不论男性或女性均在正常范围,各年龄段差异无显著性。按骨密度分析,中老年男性骨质疏松组和骨量减低组的骨钙素低于正常组,而尿吡啶啉/肌酐高于正常组,中老年女性骨质疏松组和骨量减低组的骨钙素和尿吡啶啉/肌酐均明显高于正常组。而同性别骨质疏松组和骨量减低组的骨钙素和尿吡啶啉/肌酐值差异无显著性。各骨密度组的血清碱性磷酸酶差异无显著性。结论血清骨钙素、尿吡啶啉/肌酐分别是反映骨形成和骨吸收特异性和敏感性较高的指标,有助于原发性骨质疏松症的早期诊断。
Objective To understand the characteristics of biochemical markers of bone metabolism in the elderly with age, and to analyze the value of biochemical markers of bone metabolism in clinical application. Methods The bone mineral density of lumbar vertebra was measured in 410 middle-aged and elderly patients. Fasting serum osteocalcin, serum alkaline phosphatase and morning urine pyridine and urine creatinine were detected simultaneously in all patients. The biochemical indexes of bone metabolism in male and female were statistically analyzed by age group and different BMD groups. Results According to age analysis, osteocalcin in middle-aged and elderly men decreased with age, urine pyridine / creatinine increased with age, and osteocalcin and urinary creatinine were significantly increased in middle-aged and elderly women aged 50-69 years. After 70 years of age and tends to decline, and with the same age of the elderly men of osteocalcin, urinary pyridine / creatinine values are similar. Serum alkaline phosphatase in both men and women are in the normal range, no significant difference in all age groups. According to the analysis of bone mineral density, osteocalcin in osteoporosis group and osteopenia group was lower than that in normal group, but urine pyridine / creatinine was higher than that in normal group, osteoporosis group and osteopenia group Osteocalcin and urinary pyridine / creatinine were significantly higher than the normal group. The same sex osteoporosis group and osteopenia group osteocalcin and urinary pyridine / creatinine difference was not statistically significant. There was no significant difference in serum ALP between BMD groups. Conclusions Serum osteocalcin and urinary pyridine / creatinine, respectively, reflect the specificity and sensitivity of bone formation and bone resorption, which is helpful for the early diagnosis of primary osteoporosis.