IGF-1 as an early marker for low bone mass or osteoporosis in premenopausal and postmenopausal women
IGF-1 as an early marker for low bone mass or osteoporosis in premenopausal and postmenopausal women
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DOI：
10.1007/s00774-007-0799-z
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发表时间：
2008-03-01
影响因子：
3.3
通讯作者：
Chen, Jia-lun
中科院分区：
文献类型：
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作者：
Liu, Jian-min;Zhao, Hong-yan;Chen, Jia-lun
为了找出以下哪些参数——胰岛素样生长因子 1 (IGF-1)、骨保护素 (OPG)、瘦素、骨钙素 (OC) 的血清水平和 I 型胶原 N 末端端肽 (NTx) 的尿排泄量，可以作为通过双能 X 射线骨密度测定 (DXA) 诊断的女性骨质减少/骨质疏松症的早期标志物，282 例绝经前和通过 DXA 测量 222 名 20-75 岁绝经后妇女的腰椎 (LS) 和股骨颈 (FN) 骨矿物质密度 (BMD)，以及 IGF-1、OPG、瘦素、OC 和尿液 NTx 的血清浓度。通过接受者操作特征 (ROC) 分析来测试最早标记的特征。确定曲线下面积 (AUC)、敏感性和特异性参数。结果显示，血清IGF-1和瘦素水平变化最早，这两种标志物在30岁时分别显着降低（P < 0.0001）或升高（P = 0.020）。然而，在ROC分析中，IGF-1是唯一能够区分低骨量/骨质疏松女性与正常女性的早期参数（P < 0.0001）。如果以低于其峰值1.5 SD的血清IGF-1水平作为分界点，则可以识别患有低骨量/骨质疏松症的女性，敏感性为73%，特异性为67%。在绝经前女性亚组分析中，低骨量女性（30/282，10.6%）年龄较大（38.2 +/- 1.7 vs. 34.5 +/- 0.5 岁；P = 0.026），血清 IGF-1 水平较低（215.1 +/- 22.4 vs. 278.8 +/- 9.4 ng/ml；P = 0.02），并且瘦体重（33.1 +/- 0.6 vs. 34.8 +/- 0.2 kg；P = 0.010）比正常人少。控制年龄后，血清 IGF-1 水平与瘦体重呈微弱但仍显着的正相关（r = 0.17，P < 0.001）。总之，测量年轻女性血清 IGF-1 可能有助于早期识别那些有低骨量和骨质疏松症风险的人。
To find out which of the following parameters-serum levels of insulin-like growth factor 1 (IGF-1), osteoprotegerin (OPG), leptin, osteocalcin (OC), and urinary excretion of N-terminal telopeptide of type I collagen (NTx), can be used as an early marker for osteopenia/osteoporosis in women diagnosed by dual-energy X-ray absorptiometry (DXA), 282 premenopausal and 222 postmenopausal women aged 20-75 years were investigated by the measurement of bone mineral densities (BMDs) at lumbar spine (LS) and femoral neck (FN) by DXA, together with serum concentrations of IGF-1, OPG, leptin, OC, and urinary NTx. The characteristics of the earliest marker(s) were tested with the receiver operating characteristic (ROC) analysis. The area under the curve (AUC), sensitivity, and specificity parameters were determined. It was revealed that serum levels of IGF-1 and leptin changed the earliest, with both markers significantly decreasing (P < 0.0001) or increasing (P = 0.020), respectively, at age 30. However, in ROC analysis, IGF-1 was the only early parameter that had the capacity to differentiate the low bone mass/osteoporosis women from the normal ones (P < 0.0001). If the serum level of IGF-1 at 1.5 SD below its peak was adopted as a cutoff point, it could identify women with low bone mass/osteoporosis with a sensitivity of 73% and specificity of 67%. In the premenopausal women subgroup analysis, the low bone mass women (30/282, 10.6%) were older (38.2 +/- 1.7 vs. 34.5 +/- 0.5 years; P = 0.026), with lower serum levels of IGF-1 (215.1 +/- 22.4 vs. 278.8 +/- 9.4 ng/ml; P = 0.02) and less lean mass (33.1 +/- 0.6 vs. 34.8 +/- 0.2 kg; P = 0.010) than the normal ones. After controlling for age, the serum level of IGF-1 had a weak, but still significant, positive correlation with lean mass (r = 0.17, P < 0.001). In conclusion, measurement of serum IGF-1 in young women may help in the early identification of those at risk for developing low bone mass and osteoporosis.