杨华 郭勇

[摘要] 目的 调查北京城镇中老年人25-羟维生素D3、甲状旁腺素、骨钙素与骨密度的相关性。 方法 采用美国DTX-200型双能X线骨密度仪，检测北京大兴区成年男性428例、女性778例的非优势前臂桡骨远端1/3处的骨密度。采用电化学发光免疫分析法测定25-羟维生素D3[25（OH）D3]、甲状旁腺素、血清骨钙素N端中分子片段（N-terminal-midfragment of osteocalcin，N-MID）。采用SPSS24.0统计学软件分析不同性別、年龄段组25（OH）D3、甲状旁腺素、血清骨钙素N端中分子片段、非优势前臂桡骨远端1/3处的骨密度水平。 结果25（OH）D3水平在不同性别间存在显著差异（P<0.01）；甲状旁腺素性别间无统计学差异（P>0.05）；血清骨钙素N端中分子片段50～69岁年龄段不同性别间存在显著差异（P<0.01）；非优势手臂桡骨远端1/3处骨密度性别间无统计学差异（P>0.05）；非优势手臂桡骨远端1/3处骨密度与25-羟维生素D3[25（OH）D3]、甲状旁腺素呈正相关，非优势手臂桡骨远端1/3处骨密度与年龄、血清骨钙素N端中分子片段呈负相关。 结论 北京中老年人女性普遍缺乏维生素D。25-羟维生素D3[25（OH）D3]、甲状旁腺素、血清骨钙素N端中分子片段与骨密度可综合评价骨质疏松症各阶段。

[关键词] 25-羟维生素D3；甲状旁腺素；血清骨钙素N端中分子片段；骨质疏松；骨密度

[中图分类号] R580；R683 [文献标识码] A [文章编号] 1673-9701（2018）02-0004-04

[Abstract] Objective To investigate the correlation between 25-hydroxyvitamin D3[25（OH）D3]， parathyroid hormone（PTH）， osteocalcin and bone mineral density（BMD）. Methods The bone density of the distal 1/3 of non-dominant forearm radius in 428 males and 778 females from Daxing District of Beijing were measured by the United States DTX-200 dual-energy X-ray absorptiometry. 25（OH）D3， PTH and serum N-terminal-mid fragment of osteocalcin（N-MID） were measured by electrical chemiluminescent immunoassay（ECLIA）. Difference in 25（OH）D3， PTH， serum N-MID and BMD between gender and age groups were analyzed using SPSS（version 24.0）. Results The difference in 25（OH）D3 level between gender was significant（P<0.01）. No statistical difference between gender was found in PTH（P>0.05）. There was significant gender difference in serum N-MID between gender during 50-69 age group（P<0.01）. While there was no gender difference in BMD of the distal 1/3 of non-dominant forearm radius（P>0.05）. The BMD at 1/3 of the distal radius of non-dominant arm was positively correlated with 25（OH）D3 and PTH， while was negatively correlated with age and serum N-MID. Conclusion There is a general lack of vitamin D in middle-aged and elderly female in Beijing. 25（OH）D3， PTH， serum N-MID and BMD can provide comprehensive evaluation of all stages of osteoporosis.

[Key words] 25-hydroxyvitamin D3； Parathyroid hormone； Serum N-terminal-mid fragment of osteocalcin； Osteoporosis； Bone mineral density

在人口老龄化的趋势下，骨质疏松症患病率与日俱增。作为骨代谢标志物主要包括血清骨钙素N端中分子片段（N-terminal-midfragment of osteocalcin，N-MID）、甲状旁腺素（Parathyroid hormone，PTH）、25-羟维生素D3[25（OH）D3]等[1]，这类指标可以反映成骨细胞与破骨细胞的活性以及骨代谢转换水平，其研究进展正日益受到人们的关注。维生素D水平对骨骼健康和能力维持具有重要作用，血清25（OH）D3是反映机体维生素D状态的一项重要指标。……