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Background Osteoporosis is a bone mass decreased, decreased bone density, the microscopic structure of the bone degeneration is characterized by causing increased brittleness bone fractures increased the risk of a systemic skeletal disease characterized by the elderly especially is a common disease of postmenopausal women. Serious complication of osteoporosis is fractures, a fall or a slight external force caused, causing activity limitation in patients with elderly patients often also complicated by cardiovascular and cerebrovascular diseases, and greatly reduce the quality of life and even death. Determination of bone mineral density in patients rely mainly on the diagnosis and treatment monitoring of osteoporosis, traumatic, objectivity and sensitivity of an effective means to become widely used, but because of the the bone change does not reflect the short-term, it also limitations. diagnosis is low, so the patients lack of treatment compliance, not effectively prevent osteoporosis and its complications. Occurred in the same bone reconstruction unit conversion process of bone resorption and bone formation tightly coupled, the number of bone mass depends on the balance of bone resorption and formation in the same reconstruction units, when this balance is disrupted, the bone mineral and bone matrix in proportion, is the result of changes in bone metabolism, bone metabolism changes will inevitably bring about changes in biochemical markers of bone cell level. In recent years more and more researchers bone biochemical markers are widely used in the treatment of metabolic bone disease tracking and differential diagnosis. Although the biochemical markers of bone metabolism in early diagnosis of osteoporosis, treatment monitoring, efficacy evaluation and guidance medication plays an important value, and the high specificity of serum BGP, PINP, BAP, TRACP-5b, urinary DPD, urinary CTX indicators, sensitive strong, but due to lack of follow-up sample data support a variety of reasons, such as the economy, public education, clinical practice, its clinical application is still relatively small, the low rate of diagnosis of osteoporosis patients, poor adherence to treatment, bone osteoporosis fracture rate, the high rate of fractures, especially in the high incidence of female patients. Changes in the parameters of bone metabolism in elderly patients with osteoporotic fractures with young and middle-aged high-energy injury due to fracture patients what?? These questions are worth further explore why older women fractures high incidence; Furthermore, can effectively prevent menopause of osteoporosis and the incidence of complications, in addition to early diagnosis, the timing of treatment is also very important, if patients do not pay attention to serious loss even after a fracture occurs, then before the anti-osteoporosis treatment time, bone mass anti osteoporosis treatment effect is the effect of early preventive treatment? research purposes. understand the changes in the characteristics of middle-aged patients with bone metabolic markers in analysis of the differences and clinical diagnostic evaluation of bone biochemical markers in osteoporosis in men and women value. Different fracture parameters of bone metabolism in patients change differences, understand the role of bone biochemical markers of osteoporotic fracture monitoring. 2. Establish animal models of osteoporosis in postmenopausal early preventive treatment evaluation of postmenopausal osteoporosis bone mass, bone metabolic markers and bone tissue morphology changes characteristics to provide early detection and treatment of the effective prevention of postmenopausal osteoporosis basis. Method 1. Choose the Second Affiliated Hospital of Guangzhou Medical College in June 2009 June 2010 orthopedic inpatient 240 cases for the study, ages 25-90 years of age, was measured in all patients with lumbar spine bone mineral density, simultaneous detection of all patients fasting serum bone-specific phosphatase, serum tartrate-resistant acid phosphatase-5b. Grouping: ① press in the elderly (≥ 40 years of age grouping (group of osteoporosis, reduced bone mass group, bone mass in normal group) ③ fractures reason Packet damage young fracture group (high energy, low-energy injury) age grouping ② bone density elderly fracture group). Value statistical analysis of biochemical markers of bone metabolism for men and women respectively. . Ovariectomized rat subjects zoledronic acid injection forming drugs, to elect the 44-month-old female SD (Spraque-Dawley) rats were randomly divided into four groups of sham control group (sham group) castration control group (ovx group), the castration the early preventive group (ovx1 group), late castration treatment the group (ovx2), sham group, castrated control group to the placebo treatment, the other two groups, respectively, in castration three days, one month given zoledronic acid zoledronic acid injection (ZOL) 500μg/kg single intravenous injection; each group, respectively, before the start of the trial, bone mineral density was measured after 1 month and 3 months after and determination were collected serum Ⅰ procollagen amino-terminal propeptide (PINP), tartrate-resistant acid phosphatase-5b (TRACP-5b) value changes after experimental light microscope to observe changes in the rat femur pathology, image analysis system observed the histomorphometry static indicators index trabecular bone area percentage (TBV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp) changes. Results 1. BAP age of middle-aged men decreased serum TRACP-5b increases with age, but were lower than females (p lt; 0.05); older women BAP and TRACP-5b was significantly higher than that in the 60 to 69 years of age other age groups (p lt; 0.05), and tends to decrease after the age of 70. Male osteoporosis and osteopenia group BAP lower than normal bone mass than normal bone mass group (p lt; 0.05), and serum TRACP-5b; women with osteoporosis and osteopenia group of serum BAP and TRACP -5b were higher than normal bone mass group (p lt; 0.05). The the osteoporosis group of female serum BAP TRACP-5b were higher than male patients with fracture of the measured values ??(t = 2.672 p lt; 0.05). The low-energy induced elderly fracture patients serum TRACP-5b levels higher than the high-energy TRACP-5b levels, young and middle-fracture patients, elderly fractures serum BAP value lower than the levels of the young and middle-aged fracture group, there were significant differences. 2 castrated control group at 1 month after femur BMD, serum PINP and TRACP-5b, TBV, Tb.Th and Tb.Sp indicators change and normal control group there is a significant difference (p lt; 0.05 ); castration 3 days that line ZOL treatment group and the sham-operated group mineral density, bone metabolism, bone morphology indicators compare changes without significant difference (p gt; 0.05); 1 month after the start ZOL treatment only partially restored bone mineral density, serum PINP TRACP5b value change and early prevention group has a significant difference (p lt; 0.05) between bone tissue morphology indicators of changes in value between the control group and early prevention group, there are different degrees of difference, and the The trabecular bone degeneration connection. Conclusions. Serum BAP and TRACP-5b reflect bone formation and resorption high specificity and sensitivity indicators to help in the early diagnosis of primary osteoporosis be prevented early. 2 is recommended that postmenopausal women on a regular basis to detect biochemical markers of bone metabolism, anti-osteoporosis therapy should be considered abnormal bone turnover markers; the elderly fracture after bone formation less able than young people strong, is not conducive to the healing of fractures, monitoring elderly or fracture in patients with bone biochemical markers, not only to improve the diagnosis of osteoporosis, and to guide fracture patients anti-osteoporosis treatment, rational use of drugs to reduce osteoporosis and its complications. 3 ovariectomy success so constructed that the animal model of postmenopausal osteoporosis. 4 bone metabolic markers can be used for monitoring the efficacy of anti-resorptive therapy; castrated rats early preventive treatment, can inhibit the loss of bone mass, slow trabecular bone degeneration and restore bone density, for the control of post-menopausal women The rapid loss of bone mass, providing a theoretical basis.
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