Evaluation of P1NP/βCTX ratio as a bone turnover indicator

• Main Authors: Lin, Chia-Hung, 林佳弘
• Other Authors: Hsu, Wen-Syang
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/mz735a

碩士 === 國立交通大學 === 機械工程系所 === 108 === Bone metabolism will release bone turnover markers, which can be mainly divided into: bone formation marker released during bone formation; bone resorption marker released during bone resorption, which reflect the rate of bone formation and resorption, respectively. Bone formation marker P1NP and bone resorption marker βCTX are the most commonly used reference analytes. Most of the previous references separately discussed two markers. In 2017, one reference proposed the use of P1NP/βCTX ratio, but only used to discuss the happening of bone fracture. Including sex, osteoporosis, here we use previous reference data to explore whether P1NP/βCTX ratio can be used as an indicator in other bone status. This study will also attempt to develop non-invasive P1NP, βCTX detection. Combining blood testing, to investigate whether there is a positive correlation between the ratio of saliva and blood P1NP/βCTX. . Totally 9 references (12 groups) classified P1NP/βCTX by bone fracture. 2 references have already discussed P1NP/βCTX. Among them, only 7 groups’ non-fracture groups had at least 5% higher P1NP/βCTX than the fracture groups. Therefore, P1NP/βCTX cannot be applied to all references that classify bone fractures. Currently, there is no reference using age or osteoporosis to distinguish from P1NP/βCTX. There are 5 references classified P1NP/βCTX by sex. P1NP/βCTX did not change significantly in male in different ages. Female P1NP/βCTX were decreased by at least 10% when menopause (50-55). There are 3 references classified P1NP/βCTX by osteoporosis, and the P1NP/βCTX in the osteoporosis group had at least 5% higher P1NP/βCTX than the P1NP/βCTX in the non-osteoporosis group. It shows that P1NP/βCTX is an effective indicator for distinguishing osteoporosis. In our testing, the subjects are consisted of 6 taking anabolic drugs, 4 taking anti-resorptive drugs, and 10 healthy subjects. Blood test results showed that the P1NP concentration (85.39 - 717.9 ng/ml) of subjects taking anabolic drugs is larger than healthy subjects (46.31 - 82.37 ng/ml), and larger than anti-resorptive drugs subjects (13.04 - 26.12 ng/ml). The mean βCTX (0.721 ng/ml, 0.339 - 1.44 ng/ml) of the anabolic drugs subjects is larger than healthy subjects (0.43 ng/ml, 0.302 - 0.611 ng/ml), and larger than anti-resorptive drugs subjects (0.152 ng/ml, 0.088 - 0.191 ng/ml). And there is no significant difference between male and female P1NP and βCTX in healthy subjects Almost every anabolic drugs subjects’ P1NP/βCTX is larger than healthy subjects. At the same time, they are all larger than those taking anti-resorptive. The P1NP and βCTX concentrations in healthy subjects are 23% and 10% higher than those in 3 references, respectively. The P1NP/βCTX is 6.7% higher than that in the references. In the saliva part. In the P1NP, the concentration of the subjects taking metabolic drugs is 0.528-1.544 ng/ml, the concentration of the subjects taking anti-resorptive is 0.551-1.531 ng/ml, and the concentration of the healthy subjects is 0.505-1.351 ng/ml. It determines that saliva contain P1NP, and P1NP in saliva can be measured by existing tools. After statistical analysis, the difference of salivary P1NP in the subjects taking different drugs and with or without drugs is not obvious. Existing tools are unable to measure βCTX in saliva of all subjects, but are able to confirm that saliva contained βCTX and its concentration is less than 100 pg/ml. Therefore, in the detection of non-invasive bone turnover markers, the detection of salivary βCTX is still need to be improved first. Keywords: bone turnover markers、P1NP、βCTX、non-invasive detection