背景:研究发现1型原胶原N-端前肽(P1NP)和β-胶原特殊序列(β-CrossLaps)2种骨代谢标记物与骨质疏松存在密切的相关性,骨代谢标记物与骨密度的联合检测对诊断骨质疏松症有一定临床意义,是预测骨折的理想指标,能弥补骨密度检查的不足。目的:介绍20年来国内外关于骨代谢标记物在治疗骨质疏松症的药物功效监测和骨折风险的预测这两方面的应用,探讨骨代谢标记物1型原胶原N-端前肽和β-胶原特殊序列在骨质疏松症治疗效果评估中的检测意义及在骨质疏松性骨折风险评估中的价值。方法:以骨代谢标记物(Serum bone metabolic markers);骨质疏松症(Osteoporosis);骨密度(Bone mineral density)为检测词,检索CNKI数据库和SCI数据库2000至2014年相关研究文献,筛选后纳入44篇符合标准的文献进行综述。结果与结论:文章分析了血清骨代谢标记物1型原胶原N-端前肽和β-胶原特殊序列的来源与检测机制,对比检测血清骨代谢标记物1型原胶原N-端前肽、β-胶原特殊序列水平变化在骨质疏松症疗效评估中的优势。血清骨代谢标记物不仅可以反映骨代谢的动态平衡状况,而且其水平的改变显著早于骨密度的变化,特别是血清骨代谢标记物1型原胶原N-端前肽和β-胶原特殊序列对骨质疏松症的早期诊断、抗骨质疏松药物疗效判定都有重要价值。
BACKGROUND:Procolagen type 1 N-terminal propeptide (P1NP) and β-colagen special sequence(β-CrossLaps) are two bone metabolic markers that are closely related to osteoporosis. Combined detection of bone metabolic markers and bone mineral density is of clinical significance for the diagnosis of osteoporosis. Bone metabolic markers are ideal indicators to predict fractures, which can compensate for the lack of bone density test. OBJECTIVE:To introduce the application of bone metabolic markers in the monitoring of drug efficacy on the treatment of osteoporosis as wel as in the prediction of fracture risks in recent 20 years and to explore the clinical values of P1NP and β-CrossLaps to assess the therapeutic efficacy on osteoporosis and risks for osteoporotic fractures. METHODS:A computer-based search of CNKI and SCI databases were performed for relevant articles published from 2000 to 2014 using the keywords of “serum bone metabolic markers; osteoporosis; bone mineral density” in Chinese and English, respectively. Finaly, 44 articles meeting the inclusive criteria were reviewed. RESULTS AND CONCLUSION:This paper analyzes the source and detection mechanisms of P1NPand β-CrossLaps and then compares their advantages in the therapeutic effect assessment of osteoporosis. Serum bone metabolic markers cannot only reflect the dynamic changes of bone metabolism, but also have earlier changes than the bone mineral density. Both P1NPand β-CrossLaps are very important for assessing the early diagnosis of osteoporosis as wel as anti-osteoporosis drug efficacy.