Response of biochemical markers of bone turnover to hormone replacement therapy: Impact of biological variability
Response of biochemical markers of bone turnover to hormone replacement therapy: Impact of biological variability
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DOI：
10.1359/jbmr.1998.13.7.1124
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发表时间：
1998-07-01
影响因子：
6.2
通讯作者：
Eastell, R
中科院分区：
文献类型：
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作者：
Hannon, R;Blumsohn, A;Eastell, R
骨转换的生化标志物可能有助于监测接受激素替代治疗（HRT）的患者。本研究的目的是通过比较一大组标志物对HRT的反应及其受试者内变异性来评估标志物在监测HRT中的效用。我们测量了11名绝经后妇女在24周内对经皮雌二醇的反应。我们测量了同一时期11名未经治疗的健康绝经后妇女的标记物的受试者内变异性。24个小溪治疗后，骨形成标志物的平均减少范围从I型前胶原C-末端前肽（PICP）的19%到I型前胶原N-末端前肽（PINP）的40%。骨吸收标志物的平均降低范围从抗酒石酸酸性磷酸酶（TRAP）的10%到C-末端交联端肽的67%。从未治疗组的受试者内变异性计算的最小显著变化（LSC，p< 0.05）用于定义响应。骨钙素的LSC为21%，骨碱性磷酸酶为28%，PICP为24%，PINP为21%，I型胶原端肽为28%，TRAP为17%，尿钙为90%，羟脯氨酸为75%，总脱氧吡啶啉为47%，游离吡啶啉为36%，游离脱氧吡啶啉为26%，N端交联端肽为70%，C端交联端肽为132%，治疗24周后，使用PINP和骨钙素（各9例）、游离脱氧吡啶啉（各8例）和总脱氧吡啶啉（各7例）发现了最大的响应者。腰椎骨矿物质密度定义4例患者为应答者。检测反应的能力在标记物之间不同，并且不依赖于对治疗的反应的幅度。
Biochemical markers of bone turnover may be useful to monitor patients taking hormone replacement therapy (HRT), The aim of this study was to assess the utility of markers in monitoring HRT by comparing the response of a large panel of markers to HRT with their within subject variability. We measured the response of markers to transdermal estradiol in 11 postmenopausal women over 24 weeks. We measured the within subject variability of markers in 11 untreated healthy postmenopausal women over the same period. The mean decrease in markers of bone formation after 24 creeks treatment ranged from 19% for procollagen type I C-terminal propeptide (PICP) to 40% for procollagen type I N-terminal propeptide (PINP). The mean decrease in markers of bone resorption ranged from 10% for tartrate-resistant acid phosphatase (TRAP) to 67% for C-terminal cross-linked telopeptide, The least significant change (LSC at p< 0.05), calculated from the within subject variability in the untreated group, was used to define response. LSC for osteocalin was 21%, bone alkaline phosphatase 28%, PICP 24%, PINP 21%, type I collagen telopeptide 28%, TRAP 17%, urinary calcium 90%, hydroxyproline 75%, total deoxypyridinoline 47%, free pyridinoline 36%, free deoxypyridinoline 26%, N-terminal cross-linked telopeptide 70%, and C-terminal cross-linked telopeptide 132%, The greatest Plumber of responders after 24 weeks of treatment were found using PINP and osteocalcin (9 each), and free deoxypyridinoline (8 each) and total deoxypyridinoline (7 each). Lumbar spine bone mineral density defined four patients as responders. The ability to detect a response differs between markers and is not dependent on the magnitude of response to therapy.