目的探讨50-60岁绝经后骨折女性25羟维生素D3和骨密度、骨代谢指标的关系。方法选择2014年7月至2015年9月因骨折在我院骨科行手术治疗的50-60岁绝经后女性90例,检测患者腰椎和股骨近端部位骨密度并分为骨质疏松组、骨量减少组及骨量正常组。检测患者身高、体重及25羟维生素D3、骨碱性磷酸酶、骨钙素、I型胶原羧基末端肽、I型原胶原羧基末端肽及尿Ⅰ型胶原氨基末端肽等骨代谢指标。结果血清25羟维生素D3水平随着骨密度降低而降低(P〈0.05);血清骨碱性磷酸酶、骨钙素、I型胶原羧基末端肽、I型原胶原羧基末端肽及尿I型胶原氨基末端肽水平随着血清25羟维生素D3水平降低而升高(P〈0.05);血清25羟维生素D3水平随着年龄增加而降低(P〈0.05)。结论在50-60岁绝经后女性骨折患者中,血清25羟维生素D3水平与骨密度存在正性相关关系;血清25羟维生素D3与血清骨碱性磷酸酶、骨钙素、I型胶原羧基末端肽、I型原胶原羧基末端肽及尿I型胶原氨基末端肽水平存在负性相关关系。50-60岁绝经后女性应及时补充维生素D,并随着绝经年限的增加而适当增加,可以增加骨量,从而可能减少各种并发症的发生。
Objective To investigate the change in 25-hydroxyvitamin D3 levels and its relationship with BMD and bone turnover markers in postmenopausal women aged 50-60 years with fractures.Methods A total of 90 cases of postmenopausal women aged50-60 years treated for fracture in our hospital from July 2014 to September 2015 were selected.BMD was measured at lumbar spine and proximal femur by dual energy X-ray absorptiometry produced by GE medical system in USA.The cases were divided into three groups according to BMD:osteoporosis group,osteopenia group and normal group.In all the patients measurements undertaken included height,weight and bone metabolism markers,including 25-hydroxyvitamin D3,bone isoenzyme of alkaline phosphatase(BALP),Osteocalcin(OC),C-terminal crosslinking telopeptides of type I collagen(s-CTX),Type I procollagen carboxyterminal peptide(PICP),and N-terminal crosslinking telopeptides of type I collagen(u-NTX).Results Serum level of 25-hydroxyvitamin D3 decreased with the decrease of BMD(P 〈 0.05).Serum level of 25-hydroxyvitamin D3 decreased with the increase of BALP,0C,s-CTX,PICP and u-NTX(P 〈0.05).Serum level of 25-hydroxyvitamin D3 decreased with the increase of age(P 〈0.05).Conclusion There was a significant positive correlation between 25-hydroxyvitamin D3 and BMD.Meanwhile there was a significant negative correlation between 25-hydroxyvitamin D3 and bone turnover markers(ie.BALP,OC,s-CTX,PICP and u-NTX).Vitamin D3 supplement should be promptly given to postmenopausal women between 50 and 60 years of age in order to increase bone mass and prevent the incidence of complications.