骨代谢生化指标临床应用专家共识(2023修订版)

中国骨质疏松杂志2023年4月第29卷第4期Chin」0 steopors,April2023.Vd29,No.4Published online www.wanfangdata.com.en doi:10.3969/j.issn.10067108.2023.04.001469·专家共识·骨代谢生化指标临床应用专家共识(2023修订版)《中国骨质疏松杂志》骨代谢专家组《中国骨质疏松杂志》社，北京100102中图分类号：R336文献标识码：A文章编号：10067108(2023)04-046908摘要：骨代谢生化指标的临床应用，为骨质疏松的诊断、鉴别诊断、预测骨折风险及抗骨质疏松治疗疗效评价提供了分子生物学依据，并在骨质疏松流行病学研究、发病机制、骨质疏松药物开发研究方面具有重要意义。由于骨代谢生化指标检测特异性强、灵敏度高，其应用日趋广泛。该文检索了大量中外文献，编审了《骨代谢生化指标临床应用专家共识》(2023修订版)，对骨代谢生化指标的分类，骨代谢生化指标的方法学以及生物学意义、骨代谢指标的检测变异等进行了论述。关键词：骨代谢生化指标：钙磷代谢调节指标：甲状旁腺素：降钙素：维生素D,:25羟基维生素D,:1,25-双羟基维生素D,:钙：磷：骨形成标志物：碱性磷酸酶骨特异性碱性磷酸酶：骨钙素：I型前胶原C端前肽：I型前胶原N-端前肽：骨保护素：骨吸收标志物：抗酒石酸酸性磷酸酶：I型胶原交联C末端肽：I型胶原交联N末端肽：尿吡啶啉：尿脱氧吡啶啉：激素：细胞因子：生长激素：雌激素：睾酮：白细胞介素：白细胞介素6：转化生长因子B:肿瘤坏死因子：胰岛素样生长因子：实验分析变异Expert consensus on clinical application of biochemical indicators of bone metabolism 2023Revision)Bone Metabolism Expert Group of (Chinese Journal of OsteoporosisChinese Journal of Osteoporosis,Beijing 100102,ChinaCorresponding author:ZHANG Mengmeng,Email:zhmm5866@163.comAbstract:The clinical application of biochemical indicators of bone metabolism provides molecular biological basis for thediagnosis,differential diagnosis,prediction of fracture risk and evaluation of therapeutic effect of antiosteoporosis treatment ofosteoporosis,and has important significance in the epidemiological study of osteoporosis,pathogenesis,and development andresearch of osteoporosis drugs.Because of the high specificity and sensitivity of bone metabolism biochemical indicators,itsapplication is increasingly widespread.This paper has searched a large number of Chinese and foreign literatures,compiled andreviewed the Expert Consensus on Clinical Application of Bone Metabolism Biochemical Indicators (2023 Revision),and discussedthe classification of bone metabolism biochemical indicators,the method ology and biological significance of bone metabolismbiochemical indicators,and the detection and variation of bone metabolism indicators.Key words:bone metabolism biochemical markers:calcium and phosphorus metabolism indicator:parathyroid hormone;calcitonin;vitamin D3:25 -hydroxy vitamin D3:1,25-dihydroxy vitamin D3:calcium;phosphorus;bone formation markers;alkaline phosphatase:bone specific alkaline phosphatase;osteocalcin;bone glaprotein;type I procollagen carboxyl-terminalpeptide:type I procollagen aminoerminal peptid;osteoprotegerin;bone resorption markers:tartra-resistant acid phosphatase;typeI collagen carboxyterminal peptide:type I collagen aminoterminal peptide:urinary pyridinoline:urinary deoxypyridinoline:hormone:cytokine;growth hormone:estrogen:testosterone:interleukin-;interleukin-6;transforming growth factor beta:tumornecrosis factor:experimental analysis variation骨代谢生化指标分别来源于骨、软骨、软组织、通过检测血、尿中骨代谢生化指标水平，可以了皮肤、肝、肾、小肠、血液及内分泌腺体等，是由成骨解骨组织新陈代谢的情况，用于评价骨代谢状态、骨细胞或破骨细胞分泌的酶和激素，以及骨基质的胶质疏松诊断分型、预测骨折风险、代谢性骨病的鉴别原蛋白代谢产物或非胶原蛋白▣。诊断日。骨代谢生化指标作为监测手段，评估骨质疏松治疗的反应。◆通信作者：张萌萌，Eail:mnm5866@163.om目前临床上的检测方法包括：酶联免疫吸附测