血清骨碱性磷酸酶水平与老年骨质疏松症患者骨容积的相关性

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摘要目的探讨血清骨碱性磷酸酶(bone alkaline phosphatase，BALP)水平与老年骨质疏松症(osteoporosis，OP)患者骨容积的相关性。方法选择2019年6月至2020年6月新疆维吾尔自治区人民医院73例老年OP患者，调查并记录患者基线资料，其中男22例，女51例；年龄63~82岁，平均年龄(71.25±4.31)岁。检测患者血清骨代谢标志物［血钙、血磷、BALP、骨钙素(bone gla protein，BGP)］，影像学检查测量骨容积、骨密度，均接受钙剂和/或维生素D等药物治疗24周，比较治疗前、治疗24周血清骨代谢标志物、骨容积、骨密度变化，分析骨代谢与骨容积、骨密度的相关性，对比不同资料患者骨容积，重点分析BALP与骨容积的相关性。结果治疗前、治疗24周，血钙、血磷水平比较差异无统计学意义(P＞0.05)；治疗24周，血清BALP水平较治疗前降低，血清BGP水平、骨容积、骨密度升高，差异有统计学意义(P＜0.05)；经Pearson相关性分析显示，血钙、血清BALP水平与骨容积、骨密度呈负相关(r＝－0.294、－0.776，P＜0.05)，血磷、血清BGP水平与骨容积、骨密度呈正相关(r＝0.322、0.640，P＜0.05)；不同性别、年龄、血钙、血磷患者骨容积比较，差异无统计学意义(P＞0.05)；血清BALP水平高表达患者骨容积小于血清BALP水平正常的患者，血清BGP水平低表达患者骨容积小于血清BGP水平正常患者，差异有统计学意义(P＜0.05)；经多元线性回归分析结果显示，血清BALP、BGP水平异常表达可能与OP患者骨容积有关，BALP水平过表达、BGP水平低表达均可能是OP患者骨容积降低的影响因子(P＜0.05)。结论老年OP患者骨容积、骨密度可经治疗得到改善，患者骨容积、骨密度改善情况不佳可能与BALP过表达有关，BALP过表达与骨容积呈负相关，随着血清BALP升高，患者骨容积降低。

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	杨英
	王庆
	彭溢

关键词 ：骨质疏松症, 骨碱性磷酸酶, 骨容积, 骨代谢标志物, 相关性

Abstract：

Objective To investigate the correlation between serum bone alkaline phosphatase (BALP) level and bone volume in elderly patients with osteoporosis (OP).
Methods 73 elderly patients with OP from the People’s Hospital of Xinjiang Uygur Autonomous Region from June 2019 to June 2020 were selected，and the baseline data of patients were investigated and recorded.There were 22 males and 51 females aged 63 to 82 years，with an average age of (71.25±4.31) years.The serum markers of bone metabolism，including blood calcium，blood phosphorus，BALP and bonegla protein (BGP) of patients were detected.Bone volume and bone mineral density were measured by imaging examination.All patients were treated with calcium and/or vitamin D for 24 weeks，the changes of serum markers of bone metabolism，bone volume and bone mineral density were compared before and 24 weeks after treatment.The correlation of bone metabolism with bone volume and bone mineral density was analyzed.The bone volume of patients with different data was compared，and the correlation between BALP and bone volume was mainly analyzed.Results There was no statistical significant difference in the comparison of serum calcium and phosphorus levels before and 24 weeks after treatment (P＞0.05).After 24 weeks of treatment，the serum BALP level was lower than that before treatment，and the serum BGP level，bone volume and bone mineral density were higher than those before treatment.There was a statistical significant difference (P＜0.05)；Pearson correlation analysis showed that blood calcium and serum BALP levels were negatively correlated with bone volume and bone mineral density (r＝－0.294、－0.776，P＜0.05)，blood phosphorus and serum BGP levels were positively correlated with bone volume and bone mineral density (r＝0.322、0.640，P＜0.05).There was no statistical significant difference in the comparison of bone volume between patients with different gender，age，blood calcium and phosphorus (P＞0.05).The bone volume of patients with high serum BALP level was less than that of patients with normal serum BALP level，and the bone volume of patients with low serum BGP level was less than that of patients with normal serum BGP level.There was a statistical significant difference (P＜0.05).By multiple linear regression analysis，the results showed that the abnormal expression of serum BALP and BGP might be related to the bone volume of OP patients，the overexpression of BALP and low expression of BGP might be the influencing factors of bone volume reduction in OP patients (P＜0.05).
Conclusion The bone volume and bone mineral density of elderly OP patients can be improved by treatment，and the poor improvement of bone volume and bone mineral density may be related to the overexpression of BALP.The overexpression of BALP is negatively correlated with bone volume.With the increase of serum BALP，the bone volume is decreased.

Key words： osteoporosis bone alkaline phosphatase bone volume bone metabolic markers correlation

基金资助:自治区卫生健康青年医学科技人才专项科研项目(WJWY—202030)

通讯作者: 彭溢

作者简介: 杨英(1983－ )，女，副主任医师，新疆维吾尔自治区人民医院干部保健中心，jonesandsimmons@163.com

引用本文:

杨英，王庆，彭溢. 血清骨碱性磷酸酶水平与老年骨质疏松症患者骨容积的相关性[J]. 实用骨科杂志, 2023, 29(3): 219-.
Yang Ying，Wang Qing，Peng Yi. Correlation Between Serum Bone Alkaline Phosphatase Level and Bone Volume in Elderly Patients with Osteoporosis. sygkzz, 2023, 29(3): 219-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I3/219

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