Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China.
Department of Orthopedics, The 80(th) Army Hospital of Chinese People's Liberation Army, Weifang, Shandong, China.
Clinics (Sao Paulo). 2022 Apr 15;77:100034. doi: 10.1016/j.clinsp.2022.100034. eCollection 2022.
To investigate the expression level and clinical significance of Methyl-CpG binding Protein 2 (MECP2) in elderly patients with hip fractures.
This prospective observational study included 367 elderly patients with hip fractures between April 2016 and December 2018. All the patients were treated with internal fixation or joint replacement. In addition, 50 healthy elderly individuals were enrolled as healthy controls. The serum levels of MECP2 and inflammatory factors Interleukin (IL)-1β, IL-6, IL-8, and Tumor Necrosis Factor (TNF)-α was determined by enzyme-linked immunosorbent assay. Data on patients' basic characteristics and postoperative complications were collected. The Harris score was used to assess hip function at 1-month, 3-months, and 6-months after surgery. Patient quality of life was measured using the Barthel Index (BI) score 3-months after surgery. The 1-year mortality was analyzed using the Kaplan-Meier curve, and logical regression was used to analyze the risk factors for mortality.
No significant differences were observed in the basic clinical characteristics of all patients. The serum MECP2 levels were remarkably high in patients with hip fractures and negatively correlated with serum IL-1β, IL-6, and TNF-α levels. Patients with higher MECP2 predicted higher dynamic Harris scores, lower postoperative complications, lower 1-year mortality, and higher BI scores. Logical regression showed that age was the only independent risk factor for postoperative 1-year mortality in elderly patients with hip fractures.
Lower MECP2 predicted poor prognosis and higher 1-year mortality in elderly patients with hip fractures.
探讨甲基化CpG 结合蛋白 2（MECP2）在老年髋部骨折患者中的表达水平及临床意义。
本前瞻性观察性研究纳入 2016 年 4 月至 2018 年 12 月期间 367 例老年髋部骨折患者。所有患者均采用内固定或关节置换治疗。此外，还纳入 50 名健康老年人作为健康对照组。采用酶联免疫吸附试验测定 MECP2 及炎症因子白细胞介素（IL）-1β、IL-6、IL-8 和肿瘤坏死因子（TNF）-α的血清水平。收集患者的基本特征和术后并发症等数据。术后 1 个月、3 个月和 6 个月采用 Harris 评分评估髋关节功能，术后 3 个月采用 Barthel 指数（BI）评分评估患者生活质量。采用 Kaplan-Meier 曲线分析患者 1 年死亡率，采用逻辑回归分析死亡率的危险因素。
所有患者的基本临床特征无显著差异。髋部骨折患者血清 MECP2 水平显著升高，与血清 IL-1β、IL-6 和 TNF-α水平呈负相关。血清 MECP2 水平较高的患者具有更高的动态 Harris 评分、更低的术后并发症发生率、更低的 1 年死亡率和更高的 BI 评分。逻辑回归显示，年龄是老年髋部骨折患者术后 1 年死亡率的唯一独立危险因素。
MECP2 水平降低预示着老年髋部骨折患者预后不良和 1 年死亡率较高。
