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目的分析不同水平的血浆同型半胱氨酸(Hcy)与骨密度及骨转化标志物的相关性,进一步探讨Hcy在骨质疏松发生中的作用及其潜在临床价值。方法收集2013年3月至2014年5月临汾市人民医院体检中心体检者中120例,根据骨密度分组:骨质疏松组40例,骨量减少组40例,正常骨量组40例;并以血浆Hcy检测结果分组:高Hcy组66例,正常Hcy组54例。观察患者的血脂、体质指数(BMI)、丙氨酸氨基转移酶(ALT)等相关临床指标,并分析Hcy与骨密度(脊柱及髋部平均值)及骨转化标志物I型前胶原N末端前肽(PINP)、抗酒石酸酸性磷酸酶(TRAP)的关系。结果 (1)骨质疏松组Hcy明显高于骨量正常组(P<0.05),骨量减少组Hcy与骨量正常组比较差异无统计学意义(P>0.05)。(2)高Hcy组PINP值低于正常Hcy组(P<0.01)。(3)高Hcy组TRAP值高于正常Hcy组(P<0.01)。血浆Hcy水平与骨密度值呈负相关(r=-0.404,P<0.01),与PINP呈负相关(r=-0.404,P<0.01),与TRAP呈正相关(r=0.908,P<0.01)。结论血浆Hcy水平与骨密度及骨转化标志物均存在明显相关性。
Objective To analyze the correlation between different levels of plasma homocysteine (Hcy) and bone mineral density (BMD) and markers of bone turnover, and to explore the role of Hcy in osteoporosis and its potential clinical value. Methods One hundred and twenty patients were collected from the physical examination center of Linfen People’s Hospital from March 2013 to May 2014. According to the BMD, 40 cases were divided into osteoporosis group, 40 cases with osteopenia group and 40 cases with normal bone mass group. Plasma Hcy test results were grouped: high Hcy group 66 cases, normal Hcy group 54 cases. The serum levels of lipid, body mass index (BMI), alanine aminotransferase (ALT) and other related clinical indicators were observed. The relationship between Hcy and bone mineral density (average spine and hip) and bone morphogenetic marker type I procollagen N-terminal Propeptide (PINP), tartrate-resistant acid phosphatase (TRAP). Results (1) Hcy in osteoporosis group was significantly higher than that in normal bone mass group (P <0.05). There was no significant difference in Hcy between osteopenia group and normal bone mass group (P> 0.05). (2) The PINP in high Hcy group was lower than that in normal Hcy group (P <0.01). (3) TRAP in high Hcy group was higher than that in normal Hcy group (P <0.01). Plasma Hcy levels were negatively correlated with BMD (r = -0.404, P <0.01) and negatively correlated with PINP (r = -0.404, P <0.01) . Conclusion The plasma Hcy level has obvious correlation with bone mineral density and bone turnover markers.