血清鸢尾素浓度低与中国老年女性髋部骨折风险增加相关。

Low serum concentrations of Irisin are associated with increased risk of hip fracture in Chinese older women.

机构信息

Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China; Department of Orthopaedics, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong, China.

Department of Endocrinology, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong, China.

出版信息

Joint Bone Spine. 2018 May;85(3):353-358. doi: 10.1016/j.jbspin.2017.03.011. Epub 2017 Apr 11.

DOI:10.1016/j.jbspin.2017.03.011

PMID:28408276

Abstract

OBJECTIVE

Irisin derived from muscle in response to exercise may be the molecular entity responsible for muscle wasting-osteoporosis connectivity in the elderly. The objective of the study was to determine whether serum Irisin (sIrisin) provides information on hip fracture prediction which were independent of bone mineral density (BMD) and the fracture risk assessment tool (FRAX) algorithm.

METHODS

This study enrolled 160 older women (ages, 70-90y) with minimal trauma hip fractures (MTHFs) and 160 age-matched women without fracture serving as controls. Clinical features, BMD and bone turnover markers including sIrisin levels were measured after fracture within 2 days as baseline.

RESULTS

sIrisin levels were significantly lower (361.5±140.0ng/mL vs 478.5±159.6ng/mL, P<0.001) in cases than controls. After multivariate analysis, sIrisin remained as an independent variable of BMD, which explained 17.8% of femoral neck BMD and 22.5% of lumbar spine BMD, respectively. The odds ratio (OR) of MTHFs comparing the lowest (<320.1ng/mL) to highest (>524.5ng/mL) quartiles was 1.95 (95% CI 1.23-3.79, P<0.05) for sIrisin. Adjustment for age, body mass index, time since menopause and exercise ≥30min/day yielded similar results, and BMD of femoral neck also did not change these associations. Taking FRAX score into account attenuated the association somewhat: OR of hip fracture was 1.81 (95% CI 1.26-3.49, P<0.05) in first versus fourth quartile of sIrisin. There was a negative gradient of risk by decreasing quartile in sIrisin.

CONCLUSIONS

Low concentrations of sIrisin in older women were independently associated with increased risk of hip fractures when adjusted for BMD or FRAX score.

摘要

目的

肌肉对运动的反应产生的鸢尾素可能是导致老年人肌肉减少症-骨质疏松症相关性的分子实体。本研究的目的是确定血清鸢尾素（sIrisin）是否提供了与骨密度（BMD）和骨折风险评估工具（FRAX）算法无关的髋部骨折预测信息。

方法

本研究纳入了 160 名年龄在 70-90 岁之间、因轻微创伤导致髋部骨折（MTHFs）的老年女性患者（病例组）和 160 名年龄匹配、无骨折的女性作为对照组。在骨折后 2 天内测量了病例组的临床特征、BMD 和骨转换标志物，包括 sIrisin 水平。

结果

病例组的 sIrisin 水平显著低于对照组（361.5±140.0ng/mL 比 478.5±159.6ng/mL，P<0.001）。多变量分析后，sIrisin 仍然是 BMD 的独立变量，分别解释了股骨颈 BMD 的 17.8%和腰椎 BMD 的 22.5%。sIrisin 最低（<320.1ng/mL）和最高（>524.5ng/mL）四分位数组之间 MTHFs 的比值比（OR）为 1.95（95%CI 1.23-3.79，P<0.05）。调整年龄、体重指数、绝经时间和每天运动≥30min 后，结果相似，股骨颈 BMD 也没有改变这些关联。考虑到 FRAX 评分，该关联略有减弱：sIrisin 第一四分位组与第四四分位组的髋部骨折 OR 为 1.81（95%CI 1.26-3.49，P<0.05）。sIrisin 四分位数降低与风险呈负相关。