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目的探讨不同海拔地区女性青少年血清骨碱性磷酸酶(BAP)、Ⅰ型前胶原羧基端前肽(PICP)和骨钙素(OC)的特点及其差异,为临床运用提供基础数据。方法 2003年6月至2005年10月采用分层整群抽样方法,从西藏拉萨(海拔3500m)、西藏那曲(海拔4500m)和辽宁锦州(海拔28m)的大、中、小学随机抽取12～<19岁健康女性青少年共1093名,进行身高及血清BAP、PICP和OC测定。结果拉萨组和那曲组血清BAP、PICP和OC总体水平均高于锦州组,组间差异有统计学意义(P<0.01);拉萨组3个生化标志物显著高于那曲组(P<0.01或P<0.05)。3组血清BAP、PICP和OC均在12～<13岁时出现高峰,且随年龄增长迅速下降,但锦州组3个生化标志物随年龄变化趋势较拉萨组和那曲组平缓。血清BAP、PICP和OC水平均与身高密切相关(r=0.56、0.48、0.43,P<0.01)。结论不同海拔女性青少年血清BAP、PICP和OC随年龄变化特点基本一致,但高原藏族青少年血清BAP、PICP和OC高于平原汉族青少年。应建立针对高原藏族青少年的骨形成标志物的正常参考值。
Objective To investigate the characteristics and differences of serum bone alkaline phosphatase (BAP), type Ⅰ procollagen carboxyterminal propeptide (PICP) and osteocalcin (OC) in female adolescents at different altitudes and provide the basic data for clinical application. Methods From June 2003 to October 2005, stratified cluster sampling was used to randomly select 12 large and medium-sized primary schools from Lhasa, Tibet (3500m above sea level), Nagqu (4500m above sea level) and Jinzhou, Liaoning (28m above sea level) A total of 1093 healthy 19-year-old female adolescents underwent height and serum BAP, PICP and OC measurements. Results The serum levels of BAP, PICP and OC in Lhasa group and Naqu were higher than those in Jinzhou group (P <0.01). The three biochemical markers in Lhasa group were significantly higher than that in Naqu group (P <0.01 or P <0.05). Serum levels of BAP, PICP and OC both peaked at 12 ~ <13 years and decreased rapidly with age. However, the three biochemical markers in Jinzhou group showed a trend of being milder than that of Lhasa and Naqu. Serum BAP, PICP and OC levels were closely related with height (r = 0.56,0.48,0.43, P <0.01). Conclusion Serum levels of BAP, PICP and OC in female adolescents at different altitudes are basically the same with age, but serum BAP, PICP and OC in Tibetan adolescent are higher than those in plain Han nationality. A normal reference value should be established for bone formation markers for adolescent Tibetan plateau.