Assessment of bone metabolic biochemical indexes measurement in gynecological clinical practice / 中华检验医学杂志

ABSTRACT

Objectives　To evaluate prospectively the bone markers of serum osteocalcin (BGP),bone-specific alkaline phosphatase (BAP),C-terminal peptide of type I collagen (CICP),urinary pyridinoline (PYD),urinary calcium to creatinine value (uCa/Cr),and hydroxyprolin to creatinine ratio (uHOP/Cr),and to assess their responsiveness to subtle changes of bone metabolism,and furthermore to compare which of the bone markers are more sensitive to estrogen shortage caused by menopause.Methods　Markers of above bone formation and bone resorption were measured in 146 women classified into three groups group I 51 normal premenopausal women,group II42 postmenopausal women,and group III 53 bilateral ovariectimized women.Correlation analysis was made between these indexes and bone mineral density (BMD).Results　The mean values of the four bone markers of BGP,BAP,CICP,PYD in group II and III were significantly higher than those in group I (P<0.05).All correlations between the biochemical markers of BGP,BAP,CICP and PYD for bone turnover were highly significant and exhibited a significant connection to BMD.The best correlation was found between BGP and PYD,BGP and BAP.However,the levels of Ca/Cr and HOP/Cr made no difference in the three groups,and there was no correlation with any other indexes.Conclusion　In postmenopausal women (natural menopause and surgical menopause) suffering from severe E2 dificiency,BGP,BAP,CICP and PYD are significantly increased,indicating a clear correlation between E2 diffciency and these markers of bone turnover,so they are clinically useful in the assessment of bone turnover during changes of the estrogen status that modify the metabolic activity of the skeleton.But the traditional markers of Ca/Cr and HOP/Cr have limitations in gynecological practice because of lack of sensitivity and specificity.