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良性阵发性位置性眩晕患者骨代谢指标及耳石蛋白 90 的研究

Study on the Bone Metabolism Indices and Otoconin-90 in Benign Paroxysmal Positional Vertigo.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University.

Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China.

出版信息

Otol Neurotol. 2021 Jul 1;42(6):e744-e749. doi: 10.1097/MAO.0000000000003087.

Abstract

OBJECTIVE

To investigate the correlation between benign paroxysmal positional vertigo (BPPV) and abnormal bone metabolism and to evaluate the value of otoconial protein otoconin-90 in the pathogenesis research and clinical treatment of BPPV.

STUDY DESIGN

Prospective pilot clinical trial (Level of Evidence: 2b).

SETTING

Outpatient otolaryngologic department.

PATIENTS

Twenty seven patients with a diagnosis of BPPV referred to the otolaryngologic department and 25 controls with no history of dizziness from 2018.4 to 2018.9 were reviewed.

INTERVENTIONS

No.

MAIN OUTCOME MEASURES

Dual-energy x-ray absorptiometry scanning (DEXA), bone mineral density (BMD) measurement, and assessment of serum levels of otoconin-90 and bone metabolism indices (osteocalcin, OC; 25-OH Vitamin D; total procollagen type 1 N-peptide, TP1NP; β-C-terminal telopeptide of type 1 collagen, β-CTX).

RESULTS

  1. The average serum level of otoconin-90 in the BPPV group was significantly higher than that in the control group (p < 0.05), whereas both the BMD T scores and serum 25-OH Vitamin D levels of the BPPV group were significantly lower than those of the control group (p < 0.05). 2) There was a strong positive correlation between serum otoconin-90 and age (r = 0.44, p < 0.05) and a moderate negative correlation between otoconin-90 and the bone metabolism indices OC (r = -0.33, p > 0.05), 25-OH Vitamin D (r = -0.35, p > 0.05), and TP1NP (r = -0.30, p > 0.05). 3) Logistic regression analysis showed that serum otoconin-90 level was an independent risk factor for BPPV (odd ratio = 0.998, 95% confidence interval 0.997-0.999, p < 0.01).

CONCLUSION

A correlation between BPPV and abnormal bone metabolism was found. Moreover, otoconin-90 could serve as a research tool for BPPV.

摘要

目的

探讨良性阵发性位置性眩晕(BPPV)与骨代谢异常的相关性,并评估耳石蛋白 otoconin-90 在 BPPV 发病机制研究和临床治疗中的价值。

研究设计

前瞻性试点临床试验(证据水平 2b)。

设置

耳鼻喉科门诊。

患者

2018.4 至 2018.9 期间,共纳入 27 例 BPPV 患者和 25 例无头晕病史的对照者。

干预措施

无。

主要观察指标

双能 X 线吸收法(DEXA)扫描、骨密度(BMD)测量、血清 otoconin-90 水平及骨代谢指标(骨钙素,OC;25-羟维生素 D;I 型前胶原 N 端肽,TP1NP;I 型胶原 β 端肽,β-CTX)评估。

结果

1)BPPV 组血清 otoconin-90 水平明显高于对照组(p<0.05),BPPV 组 BMD T 评分及血清 25-羟维生素 D 水平明显低于对照组(p<0.05)。2)血清 otoconin-90 与年龄呈强正相关(r=0.44,p<0.05),与 OC(r=-0.33,p>0.05)、25-羟维生素 D(r=-0.35,p>0.05)、TP1NP(r=-0.30,p>0.05)呈中度负相关。3)Logistic 回归分析显示,血清 otoconin-90 水平是 BPPV 的独立危险因素(比值比=0.998,95%置信区间 0.997~0.999,p<0.01)。

结论

BPPV 与骨代谢异常相关,otoconin-90 可能成为 BPPV 的研究工具。

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