[1]闫玉珠,赵和平,王冀邯,等.骨质疏松患者抗苗勒管激素与骨标志物和雌激素的相关性研究[J].现代检验医学杂志,2017,32(05):78-82.[doi:10.3969/j.issn.1671-7414.2017.05.017]
　YAN Yu-zhu,ZHAO He-ping,WANG Ji-han,et al.AMH in Osteoporosis:Correlation with Bone Biochemical Markers and Estrogen[J].Journal of Modern Laboratory Medicine,2017,32(05):78-82.[doi:10.3969/j.issn.1671-7414.2017.05.017]
点击复制

骨质疏松患者抗苗勒管激素与骨标志物和雌激素的相关性研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年05期
页码:
78-82
栏目:
论著
出版日期:
2017-11-02

文章信息/Info

Title:
AMH in Osteoporosis:Correlation with Bone Biochemical Markers and Estrogen
文章编号:
1671-7414(2017)05-078-05
作者:
闫玉珠1; 2; 赵和平2; 王冀邯2; 陈 葳1; 3
1.西安交通大学医学院,西安 710061; 2.西安交通大学附属红会医院检验科,西安 710054; 3.西安交通大学医学院第一附属医院检验科,西安 710061
Author(s):
YAN Yu-zhu1; 2; ZHAO He-ping2; WANG Ji-han2; CHEN Wei1; 3
1.Medical College of Xi'an Jiaotong University,Xi'an 710061,China; 2.Department of Clinical Laboratory,Honghui Hospital of Xi'an Jiaotong University, Xi'an 710054,China; 3.Department of Clinical Laboratory,the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine,Xi'an 710061,China
关键词:
抗苗勒管激素;  骨质疏松;  骨密度;  雌激素;  骨标志物
分类号:
R591; R392.11
DOI:
10.3969/j.issn.1671-7414.2017.05.017
文献标志码:
A
摘要:
目的 研究未绝经女性骨质疏松患者血清抗苗勒管激素(anti-Mullerian hormone,AMH)与骨代谢指标:Ⅰ型原胶原氨基端延长肽(TPINP),β胶原特殊序列(β-CTX),25-羟基维生素D[25(OH)D],甲状旁腺激素(PTH),血清骨钙素(OC)及雌激素(E2)的相关性,为防治骨质疏松提供依据。方法 选取2014年12月～2016年3月在西安市红会医院骨质疏松门诊首次就诊的未绝经女性患者159例,根据骨密度(BMD)值将患者分为骨质疏松组(43例),骨量减少组(56例),骨量正常组(60例)。用罗氏电化学发光免疫分析仪测定血清中AMH,E2,TPINP,OC,β-CTX,25(OH)D和PTH水平。组间两两比较采用独立样本t检验,各指标与AMH相关性采用Pearson相关分析,通过ROC曲线分析AMH对骨量减少的诊断价值。结果 骨质疏松组、骨量减少组AMH,E2平均水平明显低于骨量正常组(t=-6.183～-0.956,P=0.000～0.040),差异有统计学意义,且三组AMH呈先增高后降低趋势; 骨质疏松组TPINP,OC,β-CTX,PTH明显高于骨量正常组(t=3.159～5.973,P=0.000～0.010),差异有统计学意义。骨质疏松组25(OH)D与骨量减少组、骨量正常组比较(t=-0.938～-0.469,P=0.351～0.640),差异无统计学意义。相关分析显示:AMH和BMD(r=0.422,P=0.000)呈正相关,和TPINP(r=-0.184,P=0.020),β-CTX(r=-0.173,P=0.030),OC(r=-0.238,P=0.003)呈负相关,但与E2(r=0.150,P=0.059),25(OH)D(r=0.036,P=0.652),PTH(r=-0.140,P=0.078)无相关性; ROC分析显示:骨质疏松组、骨量减少组和骨量正常组比较,AMH的ROC曲线下面积(AUC)为0.728(95%CI:0.652～0.795),AMH敏感度为78.79%,特异度为63.33%。结论 AMH是预测骨量减少的良好指标。
Abstract:
Abstract:Objective To assess the serum level of anti-Mullerian hormone(AMH)in premenopausal women with osteoporosis and its correlation with bone biochemical markers and estrogen(E2).Methods From December 2014 to March 2016,159 subjects of premenopausal women in theosteoporosis outpatient clinic of Xi'an Honghui Hospital were selected.According to the bone mineral density(BMD),the patients were divided into osteoporosis group(43 cases),osteopenia group(56 cases),bone mass normal group(60 cases).AMH,E2,TPINP,OC,β-CTX,25(OH)D and PTH were measured by automatic electrochemiluminescence immunoassay system(ECLIA).T-test and Pearson correlation analysis were used to describe the statistics.The date with statistical significance were analyzed by receiver operating characteristic(ROC)curve.Results The serum AMH level in osteoporosis and osteopenia groups were respectively lower than the normal group(t=-6.183～-0.956,P=0.000～0.040).The TPINP,OC,β-CTX and PTH in osteoporosis were much higher than the normal group(t=3.159～5.973,P=0.000～0.010),all of them was a statistical significance.The 25(OH)D had no statistical significance between the three groups(t=-0.938～-0.469,P=0.351～0.640).The serum AMH level of three groups firstly increased(20～25)and then decreased(>25)with age increasing.AMH was positively correlated with BMD(r=0.422,P=0.000),but negatively correlated with TPINP(r=-0.184,P=0.020),β-CTX(r=-0.173,P=0.030),OC(r=-0.238,P=0.003).There were no correlation with E2(r=0.150,P=0.059),25(OH)D(r=0.036,P=0.652),PTH(r=-0.140,P=0.078).The area under the ROC curve was 0.728.Conclusion The serum AMH level was a better parameter for predicting low bone mass.

参考文献/References:

[1] 杨媛慧,杜 静,陈卫东.骨质疏松症患者骨代谢生化指标检测的临床意义[J].现代检验医学杂志,2014,29(3):27-29. Yang YH,Du J,Chen WD.Clinical biochemical markers of bone metabolism in patients with osteoporosis[J].Journal of Modern Laboratory Medicine,2014,29(3):27-29.
[2] Hannan MT,Mangano KM,Sahni S.Do nutrients influence bone health? A commentary on new findings in the field[J].J Bone Miner Res,2015,30(6):967-969.
[3] Pathak JL,Bakker AD,Luyten FP,et al.Systemic inflammation affects human osteocyte-specific protein and cytokine expression[J].J Calcif Tissue Int,2016,98(6):596-608.
[4] Nguyen HT,von Schoultz B,Nguyen TV,et al.Sex hormone levels as determinants of bone mineral density and osteoporosis in Vietnamese women and men[J].J Bone and Mineral Metabolism,2015,33(6):658-665.
[5] 徐金龙,王依屹,蒋国静,等.血清抗苗勒氏管激素检测在多囊卵巢综合征中的临床应用[J].国际检验医学杂志,2017,38(1):35-36. Xu JL,Wang YY,Jiang GJ,et al.The clinical application of detecting anti Mullerian hormone in the patients with PCOS[J].International Journalof Laboratory Medicine,2017,38(1):35-36.
[6] Lashen H,Dunger DB,Ness A,et al.Peripubertal cha-nges in circulating antimullerian hormone levels in girls[J].J Fertil Steril,2013,99(7):2071-2075.
[7] Anderson RA,Cameron DA.Pretreatment serum anti-müllerian hormone predicts long-term ovarian function and bone mass after chemotherapy for early breast cancer[J].J Clin Endocrinol Metab,2011,96(5):1336-1343.
[8] Andersen CY,Byskov AG.Estradiol and regulation of anti-müllerian hormone,inhibin-A,and inhibin-B secretion:analysis of small antral and preovulatory human follicles' fluid[J].J Clin Endocrinol Metab,2006,91(10):4064-4069.
[9] Salmon NA,Handyside AH,Joyce IM.Oocyte regulation of anti-müllerianhormone expression in granulosa cells during ovarian follicle development in mice[J].J Dev Biol,2004,266(1):201-208.
[10] Krege JH,Lane NE,Harris JM,et al.PINP as a biological response marker during teriparatide treatment for osteoporosis[J].J Osteoporos Int,2014,25(9):2159-2171.
[11] Botella S,Restituto P,Monreal I,et al.Traditional and novel bone remodeling markers in premenopausal and postmenopausal women[J].J Clin Endocfinol Metab,2013,98(11):1740-1748.
[12] 唐颂军,宋力轶,朱文峰,等.骨转换标志物PINP和β-CTX的测定在预测骨质疏松性骨折中的价值[J].实用临床医药杂志,2015,19(21):17-19. Tang SJ,Song LY,Zhu WF,et al.Clinical value of serum PINP and β-CTX detection in evaluationof fragile hip fracture in patients with osteoporosis[J].Journal of Clinical Medicine in Practice,2015,19(21):17-19.
[13] Ma C,Shuai B,Shen L,et al.Serum carcinoembryonic antigen-related cell adhesion molecule 1 level in postmenopausal women: correlation with β-catenin and bone mineral density[J].J Osteoporos Int,2016,27(4):1529-1535.
[14] 王 双,李 军,李思源,等.骨钙素在2型糖尿病合并骨质疏松中意义的研究[J].中国骨质疏松杂志,2017,23(4):469-472. Wang S,Li J,Li SY,et al.The significance of osteocalcin in type2 diabetic patients with osteoporosis[J].Chinese Journal of Osteoporosis,2017,23(4):469-472.
[15] 王其飞,薛 涛,张清华,等.PTH基因多态性与骨质疏松性骨折的相关性研究[J].实用骨科杂志,2017,23(3):240-243. Wang QF,Xue T,Zhang QH,et al.Association between PTH gene polymorphism and osteoporotic fracture[J].Journal of Practical Orthopedics,2017,23(3):240-243.
[16] Wojtusik J,Johnson PA.Vitamin D regulates anti-mullerian hormone expression in granulosa cells of the hen[J].J Biol Reprod,2012,86(3):91.

相似文献/References:

[1]丁亚丽.子宫内膜异位综合征患者血清 AMH和 IGF-1水平表达对不孕症术后妊娠的影响[J].现代检验医学杂志,2021,36(01):120.[doi:10.3969/j.issn.1671-7414.2021.01.030]
　DING Ya-li.Effect of Serum AMH and IGF-1 Expression Levels on Postoperative Pregnancy in Infertility Patients with Endometriosis Syndrome[J].Journal of Modern Laboratory Medicine,2021,36(05):120.[doi:10.3969/j.issn.1671-7414.2021.01.030]
[2]侯爱琴,刘 华,呼改琴.早发性卵巢功能不全患者血清ER，AMH 及Cathepsin B 表达水平及临床意义[J].现代检验医学杂志,2022,37(05):128.[doi:10.3969/j.issn.1671-7414.2022.05.025]
　HOU Ai-qin,LIU Hua,HU Gai-qin.Expression Level of ER, AMH and Cathepsin B in Serum of Patients with Premature Ovarian Insufficiency and Their Clinical Significance[J].Journal of Modern Laboratory Medicine,2022,37(05):128.[doi:10.3969/j.issn.1671-7414.2022.05.025]

备注/Memo

备注/Memo:
基金项目(YJ2017017)。 作者简介:闫玉珠(1988-),女,硕士在读,检验医师,从事临床化学研究,Tel:029-62818662,E-mail:312858826@qq.com。 赵和平(1967-),男,本科,主任技师,从事临床免疫学研究,Tel:029-62818662,E-mail:redcrossjyk@163.com,共同第一作者。 通讯作者:陈 葳,女,博士生导师,教授,从事临床检验诊断学,E-mail:chenwei808@mail.xjtu.edu.cn。
更新日期/Last Update: 1900-01-01