Objective To evaluate the significances of prostate specific antigen(PSA),alkaline phosphatase(ALP) as a marker of bone formation,tartrate-resistant acid phosphatase 5b(TRACP5b) and pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ICTP) as markers of bone resorption in diagnosis of bone metastasis of prostate cancer. Methods Totally 57 elderly patients aged 61-90 years with prostate cancer were divided into groups with bone metastasis(n=27)and without bone metastasis (n=30) according to radionuclide bone imaging,and into progressive(n=18) and limited metastasis groups(n=39) by EOD score.Serum concentrations of PSA,TRACP5b,ALP and ICTP were measured by electrochemiluminescence,colorimetric assay,enzyme-linked immunosorbent assays(ELISA).Sensitivities and specificities were calculated for each marker and the diagnostic values of markers were evaluated by receiver operating characteristic curve (ROC).Resuits The serum levels of PSA,TRACP5b,ALP and ICTP were significantly higher in group with bone metastasis than in group without metastasis (P＜ 0.05).In the progressive bone metastasis group,Gleason score and the concentrations of PSA,ALP,TRACP5b,ICTP were increased as compared with limited metastasis group (P＜ 0.05). In diagnosis of prostate cancer with bone metastasis,the area under ROC curve(AUC) of PSA,TRACP5b,ALP,ICTP were 0.796,0.657,0.762,0.743,respectively.The diagnostic value PSA,ALP and ICTP were comparable,followed by TRACP5b.Using the cut point values of 10.235 μg/L for PSA,4.25 U/L for TRACP5b,116.0 U/L for ALP and 7.6 U/L for ICTP,the sensitivities were 66.7％,59.3％,37％,59.3％ and the specificities were 90％,76.7％,96.7％,80％,respectively.PSA,ALP,ICTP and Gleason score were independent predictors of bone metastasis of prostate cancer,the total coincidence rate of regression model was 84.2％. Conclusions The diagnostic values of PSA,TRACP5b,ALP,ICTP are comparable,the combined and dynamic observation may facilitate early diagnosis of prostate cancer with bone metastasis.

Objective To evaluate the significances of prostate specific antigen (PSA)and alkaline phosphatase(ALP) as a marker of bone formation and tartrate-resistant acid phosphatase 5b (TRACP5b)and pyridinoline cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(ICTP)as markers of bone resorption in predicting therapeutic effect of bone metastasis of prostate cancer patients.Methods Serum levels of PSA,tALP,TRACP5b and ICTP in 57 elderly patients aged 61-90 years with prostate cancer were determined by electrochemiluminescence,colorimetric assay,enzyme linked immunosorbent assays(ELISA)respectively.The correlation between the duration of ADT and the concentrations of each marker index (ln-transformed) was analyzed by Pearson correlation analysis.All prostate cancer patients with bone metastasis were divided into group A (patients without bisphosphonates,n =13),group B (patients with stable bone metastasis and bisphosphonates,n=6) and group C (patients with severe bone metastasis and bisphosphonates,n=8).The concentration of each bone metabolic marker was compared between the three groups.Results Pearson correlation analysis showed that serum concentrations of PSA,ALP and ICTP had no significant correlations with the duration of ADT,but TRACP5b concentration (ln transformed) had a significant positive correlation with the duration of ADT (ln transformed) (R =0.421,P＜ 0.01).The concentrations of PSA,TRACP5b and tALP were increased in group C as compared with group A,but only TRACP5b concentration had a significant difference between group A and C (P＜ 0.05).The concentrations of PSA,tALP,ICTP and TRACP5b were significantly increased in group C as compared with group B (all P＜0.05).Conclusions PSA and bone resorption and formation markers can be excellent monitors of therapeutic effect-relating bone metabolism changes during castration and bisphosphonate treatment in prostate cancer patients with bone metastasis,and TRACP5b may be more sensitive.

OBJECTIVETo investigate the clinical value of serum total procollagen type 1 aminoterminal propeptide (total P1NP), cross-linked C-terminal telopeptide of type I collagen (β-CTX) and 25(OH)D3 detection in evaluating the risks of fragile hip fracture in elderly patients with osteoporosis.

METHODSSerum levels of total P1NP, β-CTX and 25(OH)D3 was measured in 68 elderly osteoporotic patients with fragile hip fracture and 68 age- and gender-matched osteoporotic controls without fragile hip fracture. In both groups, bone mineral density (BMD) was detected with dual X-ray absorptiometry.

RESULTSThe serum levels of total P1NP and β-CTX were significantly higher and 25(OH)D3 level was significantly lower in fragile hip fracture group than in the control group (P<0.05), but the two groups showed no significant difference in lumbar or total hip BMD. Bivariate correlation analysis suggested that in fragile hip fracture group, serum 25(OH)D3 level was positively, while serum total P1NP and β-CTX levels were inversely correlated with lumbar and total hip BMD (P<0.05). In control group, 25(OH)D3 was not related to lumbar or total hip BMD, and serum total P1NP and β-CTX levels were inversely correlated with total hip BMD (P<0.05) but not related to lumbar BMD.

CONCLUSIONIn osteoporotic elderly patients with close BMD levels, high serum levels of total P1NP and β-CTX and low serum levels of 25(OH)D3 might independently indicate high fragile hip fracture risk, and detection of the three markers can help identify high-risk individuals.

Aged ; Aged, 80 and over ; Biomarkers ; blood ; Bone Density ; Calcifediol ; blood ; Collagen Type I ; blood ; Female ; Hip Fractures ; blood ; diagnosis ; etiology ; Humans ; Male ; Osteoporosis ; complications ; diagnosis ; Osteoporosis, Postmenopausal ; blood ; diagnosis ; Peptides ; blood ; Procollagen ; blood

Objective:To investigate the association of osteosarcopenia with falls, risk of fracture, malnutrition among middle-aged and elderly adults.Methods:A total of 253 participants dwelling in Guangzhou community aged 40-90 years were included in this cross-sectional study from December 2017 to December 2019.Bone mineral density(BMD)was detected by dual-energy X-ray absorptiometry(DEXA). Body composition was analyzed by a bioelectrical impedance analysis.Handgrip strength and gait speed were examined.The 10-year probability of a major osteoporotic fracture and hip fracture were evaluated by online WHO fracture risk assessment tool( FRAX?). Results:According to diagnostic criteria of AWGS and EWGSOP2, the incidences of osteosarcopenia varied from 5.1% to 7.6%, 5.1% to 11.4% respectively.After the adjustment for age and gender, Logistic regression analysis showed that osteosarcopenia was correlated with falls, risk of fracture and malnutrition.Osteosarcopenia definited by AWGS criteria was strongly correlated with falls( OR=3.27-5.68, P<0.05), osteosarcopenia definited by non-severe sarcopenia criteria was strongly correlated with the risk of hip fracture( OR=1.14-1.15, P<0.05), and fat-free mass index was strongly correlated with osteosarcopenia with different definitions( OR=0.21-0.48, P<0.05). Conclusions:Osteosarcopenia is associated with higher risk of falls, fracture and malnutrition in the Guangzhou community-dwelling middle-aged and elderly adults, and fat-free mass index is an independent risk factor for osteosarcopenia.