Clinical significance of bone metabolic markers in the diagnosis and treatment of senile osteoporosis

Hu Xiao-jun; Kuang Rong-bin

doi:10.3969/j.issn.2095-4344.2015.07.006

Abstract：BACKGROUND:Osteoporosis is not a simple quantitative bone problem. Assessment of osteoporosis is related to age, gender, bone metabolism, bone formation and bone biomechanical dynamics. Tartrate-resistant acid phosphatase 5b (TRACP 5b) and bone alkaline phosphatase (BAP) are two important indicators reflecting bone resorption and bone formation, respectively. <br> OBJECTIVE:To investigate the clinical significance of bone metabolic markers in the diagnosis and treatment of senile osteoporosis, and to explore its correlation with bone mineral density changes. <br> METHODS:Total y 100 elderly patients with osteoporosis were enrol ed, including 30 cases of 65-70 years old, 40 cases of 71-75 years old, and 30 cases of 76-80 years old. Patients with diabetes, cancers and other bone disorders were excluded. At admission, al patients were measured four bone biochemical markers, including TRACP 5b, BAP, N-terminal midfragment osteocalcin and 25-hydroxyvitamin D. According to the test values of TRACP 5b and BAP, patients were divided into TRACP 5b upregulation group and BAP upregulation group. The correlation of bone mineral density and four biochemical markers with sex and age was analyzed, and intergroup and intragroup differences in four biochemical markers were compared. <br> RESULTS AND CONCLUSION:The bone mineral densities of the lumbar vertebra and hip were decreased with age (P<0.05);the bone mineral densities of the lumbar spine and Ward’s triangle in the male patients were higher than those in the female patients. The values of TRACP 5b, BAP, N-terminal midfragment osteocalcin were increased with age (P<0.05), while the level of 25-hydroxyvitamin D was decreased with age (P<0.05). Compared with the male patients, the levels of TRACP 5b, BAP and N-terminal midfragment osteocalcin were higher in the female patients, but the level of 25-hydroxyvitamin D was lower in the female patients. After anti-osteoporosis treatment, these four biochemical markers were al improved in the two groups. These findings indicate that the detection of bone metabolic markers contributes to explain whether the main function of osteoblasts or osteoclasts is present in the body, thereby guiding the clinical use of targeted anti-osteoporosis drugs and providing a scientific basis for the clinical treatment and monitoring of osteoporosis.