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脆性髋部骨折患者的骨转换表型:骨折联络服务人群中的经验。

The Phenotype of Bone Turnover in Patients with Fragility Hip Fracture: Experience in a Fracture Liaison Service Population.

机构信息

Department of Medicine, Surgery and Neuroscience, Section of Internal Medicine, University of Siena, 53100 Siena, Italy.

Department of Medicine, Surgery and Neurosciences, Section of Orthopedics and Traumatology, University of Siena, 53100 Siena, Italy.

出版信息

Int J Environ Res Public Health. 2022 Jun 15;19(12):7362. doi: 10.3390/ijerph19127362.

Abstract

Background: Hip fragility fractures are becoming one of the main health care problems in countries with an aging population. This study aimed to evaluate the clinical characteristics and the usefulness of bone turnover markers in patients with a hip fracture. Methods: In a cohort of 363 patients (84.1 ± 9.2 years) with hip fractures we measured 25-hydroxyvitamin D (25OHD), bone alkaline phosphatase, type I collagen β carboxy telopeptide (βCTX), and parathyroid hormone (PTH). We recorded patients’ Charlson Comorbidity Index (CCI) and previous history of fragility fractures. Results: Vitamin D and PTH levels were inversely correlated (r = −024; p < 0.001). The prevalence of 25OHD deficiency was 57.8%, the PTH levels greater than 65 pg/mL was in 47.0 %, and in those who had βCTX values the upper limit was 61.8%. Moreover, 62% of patients with a fragility hip fracture had a history of a previous fracture. The 25OHD serum levels were inversely associated with CCI and a previous fragility fracture. On the contrary, PTH and βCTX serum levels showed a positive significant correlation with CCI and previous fragility fractures. Conclusion: This study confirmed the usefulness of a bone turnover markers assessment, along with the comorbidities and history of previous fragility fractures in order to better identify the risk of hip fracture.

摘要

背景

髋部脆性骨折正成为老龄化国家主要的医疗保健问题之一。本研究旨在评估髋部骨折患者的临床特征及骨转换标志物的应用价值。

方法

我们对 363 例髋部骨折患者(84.1±9.2 岁)进行了 25-羟维生素 D(25OHD)、骨碱性磷酸酶、I 型胶原 β 羧基端肽(βCTX)和甲状旁腺激素(PTH)检测。记录了患者的 Charlson 合并症指数(CCI)和脆性骨折史。

结果

维生素 D 和 PTH 水平呈负相关(r=-0.24;p<0.001)。25OHD 缺乏的患病率为 57.8%,PTH 水平>65 pg/mL 的占 47.0%,βCTX 值超过上限的占 61.8%。此外,62%的髋部脆性骨折患者有既往骨折史。血清 25OHD 水平与 CCI 和既往脆性骨折呈负相关。相反,PTH 和 βCTX 血清水平与 CCI 和既往脆性骨折呈正相关。

结论

本研究证实了骨转换标志物评估、共病及既往脆性骨折史在识别髋部骨折风险方面的应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4c2/9223564/4d7c18a55d09/ijerph-19-07362-g001.jpg

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