Biochemical markers of bone turnover predict bone loss in perimenopausal women but not in postmenopausal women-the Japanese Population-based Osteoporosis (JPOS) Cohort Study
Biochemical markers of bone turnover predict bone loss in perimenopausal women but not in postmenopausal women-the Japanese Population-based Osteoporosis (JPOS) Cohort Study
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DOI：
10.1007/s00198-005-0052-3
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发表时间：
2006-07-01
影响因子：
4
通讯作者：
Yoneshima, H.
中科院分区：
文献类型：
--
作者：
Iki, M.;Morita, A.;Yoneshima, H.
简介：骨转换生化标志物对不同年龄段健康女性人群骨密度变化的预测价值尚未完全确定。研究方法：我们对从日本三个地区的居民中随机选择的1，283名基线年龄为15-79岁的女性进行了为期6年的随访，并检查了1，130名无疾病或服用影响骨代谢药物的受试者。在随访期间，通过双能X线骨密度仪测定脊柱、全髋关节和桡骨远端三分之一骨密度的年变化，并在基线时使用不同水平的生化标志物（包括血清骨钙素（OC）和骨特异性碱性磷酸酶）进行组间比较（骨ALP）、游离和总（tDPD）形式的免疫反应性脱氧吡啶啉和I型胶原交联的C末端肽（CTX）。结果如下：在对年龄、身高、体重、膳食钙摄入量、规律锻炼和当前吸烟的影响进行调整后，在随访期间，OC、骨ALP、CTX或tDPD水平升高的45岁或以上绝经前妇女在大多数骨骼部位的骨丢失均显著大于水平较低的妇女。在前3年随访期间，观察到模型的最大决定系数是CTX与髋关节骨丢失之间的相关性（42.8%）。将这些受试者与基线时的围绝经期女性合并，在该合并组中，那些在随访时仍有月经的受试者表现出显着但较温和的相关性，而那些在随访期间进入更年期的受试者则表现出明显的相关性。然而，绝经后不到5年或10年的早期绝经后妇女表现出的相关性主要限于桡骨远端，其他绝经后人群几乎没有相关性。结论：骨转换的生化标志物可以预测绝经过渡期妇女的骨丢失，但不能预测绝经后妇女的骨丢失。
Introduction: The predictive value of biochemical markers of bone turnover for subsequent change in bone density in a population sample of healthy women with a wide range of ages has not been fully established. Methods: We followed 1,283 women aged 15-79 years at baseline selected randomly from the inhabitants of three areas in Japan for 6 years, and examined 1,130 subjects with no disease or administration of drugs affecting bone metabolism. The annual change in bone density at the spine, total hip, and distal one third of the radius was determined during the follow-up period by dual x-ray absorptiometry and was compared among the groups using different levels of biochemical markers at baseline, including serum osteocalcin (OC) and bone-specific alkaline phosphatase (bone ALP), free and total (tDPD) forms of immunoreactive deoxypyridinoline, and type I collagen crosslinked C-terminal telopeptide (CTX) in urine. Results: Premenopausal women aged 45 years or older with elevated levels of OC, bone ALP, CTX, or tDPD showed significantly greater bone loss at most skeletal sites during the follow-up period than those with lower levels, after adjustment for the effects of age, height, weight, dietary calcium intake, regular exercise, and current smoking. The greatest coefficient of determination of the model was observed in the association between CTX and bone loss at the hip during the first 3 years of follow-up (42.8%). These subjects were pooled with perimenopausal women at baseline, and those who still menstruated at follow-up in this pooled group showed significant but more modest associations, whereas those who entered menopause during the follow-up period showed clear associations. However, early postmenopausal women with less than 5 or 10 years since menopause showed an association that was limited mostly to the distal radius, and other postmenopausal groups had virtually no association. Conclusion: Biochemical markers of bone turnover may predict bone loss in women undergoing menopausal transition but may not predict bone loss in postmenopausal women.