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骨代谢生化指标在预测骨质疏松性腰椎骨折中的价值

Value of Biochemical Indexes of Bone Metabolism in Predicting Osteoporotic Lumbar Fractures.

作者信息

Feng Fen, Zhou CiLa, Huang Ping, Zhu QiaoLin, Wang Gang, Zhou Bin

机构信息

School of Pharmacy, Shaoyang University, Shaoyang 422000, China.

Department of Endocrinology, The Central Hospital of Shaoyang, Shaoyang 422000, China.

出版信息

Appl Bionics Biomech. 2022 Jun 23;2022:7348884. doi: 10.1155/2022/7348884. eCollection 2022.

Abstract

OBJECTIVE

To investigate the value of bone metabolism indexes such as type I procollagen N-terminal propeptide (P1NP), 25-hydroxyvitamin D (25(OH)D), osteocalcin (OSTEOC), and parathyroid hormone (PTH) in predicting osteoporotic lumbar fractures.

METHODS

120 female patients with osteoporosis treated in our hospital were selected as research objects. There were 76 cases in the fracture group and 44 cases in the nonfracture group. The relationship between the levels of P1NP, 25(OH)D, OSTEOC, and PTH and the incidence of osteoporotic lumbar fractures were detected and compared between the two groups. The predictive value of biochemical indexes of bone metabolism in patients with osteoporosis was analyzed by ROC curve.

RESULTS

The levels of P1NP and PTH in the fracture group were significantly higher than those in the nonfracture group, while 25(OH)D and OSTEOC levels were lower than those in the nonfracture group. Moreover, the levels of P1NP, 25(OH)D, OSTEOC, and PTH are important factors affecting the pathogenesis of osteoporosis. The area under the curve (AUC) of fracture in patients with osteoporosis predicted by the combination of P1NP, 25(OH)D, OSTEOC, and PTH levels was 0.886, which was greater than the AUC predicted by each index (0.796, 0.753, 0.670, and 0.824). The best sensitivity and specificity of comprehensive prediction of each index were 78.95% and 79.10%, respectively.

CONCLUSION

The abnormal changes of P1NP, 25(OH)D, OSTEOC, and PTH in female patients with osteoporotic lumbar fracture are closely related to the occurrence of the disease. The combination of these indicators has relatively significant application value in predicting the occurrence of fracture, which is helpful to formulate and guide relevant preventive measures for female patients with osteoporotic lumbar fracture and improve the prognosis.

摘要

目的

探讨Ⅰ型前胶原N端前肽(P1NP)、25-羟基维生素D(25(OH)D)、骨钙素(OSTEOC)及甲状旁腺激素(PTH)等骨代谢指标在预测骨质疏松性腰椎骨折中的价值。

方法

选取我院收治的120例女性骨质疏松患者作为研究对象。骨折组76例,非骨折组44例。检测并比较两组患者P1NP、25(OH)D、OSTEOC及PTH水平与骨质疏松性腰椎骨折发生率的关系。采用ROC曲线分析骨代谢生化指标对骨质疏松患者的预测价值。

结果

骨折组P1NP及PTH水平显著高于非骨折组,而25(OH)D及OSTEOC水平低于非骨折组。此外,P1NP、25(OH)D、OSTEOC及PTH水平是影响骨质疏松发病机制的重要因素。P1NP、25(OH)D、OSTEOC及PTH水平联合预测骨质疏松患者骨折的曲线下面积(AUC)为0.886,大于各指标单独预测的AUC(0.796、0.753、0.670及0.824)。各指标综合预测的最佳灵敏度和特异度分别为78.95%和79.10%。

结论

骨质疏松性腰椎骨折女性患者P1NP、25(OH)D、OSTEOC及PTH的异常变化与疾病发生密切相关。这些指标联合应用在预测骨折发生方面具有相对显著的应用价值,有助于制定和指导骨质疏松性腰椎骨折女性患者的相关预防措施,改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/080b/9246630/0190c7af80c7/ABB2022-7348884.001.jpg

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