Nonenzymatic collagen cross-links induced by glycoxidation (pentosidine) predicts vertebral fractures
Nonenzymatic collagen cross-links induced by glycoxidation (pentosidine) predicts vertebral fractures
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DOI：
10.1007/s00774-007-0784-6
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发表时间：
2008-01-01
影响因子：
3.3
通讯作者：
Nakamura, Toshitaka
中科院分区：
文献类型：
--
作者：
Shiraki, Masataka;Kuroda, Tatsuhiko;Nakamura, Toshitaka
胶原蛋白中的晚期糖基化终产物（AGE）已被报道会降低骨的力学性能。然而，目前还没有关于骨折风险与临床样本中胶原蛋白的糖氧化（非酶）交联水平之间关系的数据。本观察性研究共选择了432名未接受任何骨质疏松症药物治疗的日本老年女性，并随访了5.2 +/- 3.3（平均值+/- SD）年。椎体骨折和骨密度在基线时进行评估，然后每隔1- 2年或在任何症状出现时进行评估。两种类型的胶原代谢产物在基线测量：尿N-末端肽的I型胶原（NTX），吡啶交联的标记物，和尿戊糖苷，非酶胶原交联AGEs产生。共观察到72例受试者发生97例偶发椎体骨折。采用考克斯风险模型进行的简单回归分析显示，除了传统的危险因素（年龄、腰椎骨密度和椎体骨折数量）外，对数转换的尿NTX和戊糖苷是椎体骨折发生率时间依赖性的重要危险因素。然而，在调整其他传统危险因素后，尿中戊糖苷排泄（危害比，1.33; 95%CI，1.01-1.76，P = 0.04）是发生椎体骨折的重要预测因子。目前的数据表明，AGE相关的胶原交联是椎骨骨折的新风险。
Advanced glycation end products (AGE) in collagen have been reported to decrease the mechanical property of bone. However, there are no available data on the relation between fracture risk and levels of glycoxidative (nonenzymatic) cross-links of collagen in clinical samples. A total of 432 Japanese elderly women who were not receiving any drug treatment for osteoporosis were selected and followed for 5.2 +/- 3.3 (mean +/- SD) years for this observational study. Vertebral fractures and bone mineral density were assessed at baseline and then at 1- to 2-year intervals or at indication of any symptom. Two types of collagen metabolites were measured at baseline: urinary N-terminal telopeptide of type I collagen (NTX), a marker of pyridinium cross-link, and urinary pentosidine, a nonenzymatic collagen cross-link produced by AGEs. A total of 97 incident vertebral fractures on 72 subjects were observed. Simple regression analysis using Cox's hazards model showed that log-transformed urinary NTX and pentosidine are significant risk factors for time-dependent incidence of vertebral fractures, in addition to the traditional risk factors (age, lumbar bone mineral density, and number of prevalent vertebral fractures). However, urinary excretion of pentosidine (hazard ratio, 1.33; 95% CI, 1.01-1.76, P = 0.04) was a significant predictor of incident vertebral fracture after adjustment for other traditional risk factors. The present data suggest that AGE-related collagen cross-link is a novel risk for vertebral fracture.