联合检测维生素D、CRP和TNF-α对老年男性骨质疏松症具有较高的预测价值。

Combined detection of vitamin D, CRP and TNF-α has high predictive value for osteoporosis in elderly men.

作者信息

Dong Ziyu, Li Min, Zhang Yonghai, Liu Hui, Cui Yuhan

机构信息

Inspection Technology School, Xinyang Vocational and Technical College No. 48, 24th Street, Yangshan New District, Xinyang 464000, Henan, China.

Medical School, Xinyang Vocational and Technical College No. 48, 24th Street, Yangshan New District, Xinyang 464000, Henan, China.

出版信息

Am J Transl Res. 2023 Aug 15;15(8):5536-5542. eCollection 2023.

PMID:37692933

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10492047/

Abstract

OBJECTIVE

To observe the predictive value of 25-hydroxyvitamin D3 (25(OH)D3), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) levels for osteoporosis in elderly men.

METHODS

A retrospective analysis was conducted in 122 elderly male patients that were tested in The Affiliated Hospital of Xinyang Vocational and Technical College between January 2020 and May 2022. The patients were divided into an osteoporosis group (OG, n = 77) and a control group (CG, n = 45) according to the results of bone mineral density. The formula N = Z^2*(P*(1-P))/E^2 was used to calculate the required sample size (N) for a given confidence interval (Z), total error (E), and proportion (P) of the target population. The proportion (P) is often assumed to be 0.5 and not randomly distributed across the population. The levels of cross-linked C-terminal telopeptide of type I collagen (CTX-I), procollagen type I N-terminal propeptide (PINP), intact parathyroid hormone (iPTH), osteocalcin (OC), and serum levels of 25(OH)D3, CRP, and TNF-α were measured and compared between the two groups. Pearson correlation was used to analyze the relationship between the parameters. The predictive value of 25(OH)D3, CRP and TNF-α for osteoporosis was also analyzed using receiver operating characteristic (ROC) curves. Logistic multivariate analysis was performed to analyze the risk factors for osteoporosis in elderly men.

RESULTS

Compared with the CG, the OG exhibited evidently lower serum 25(OH)D3, but significantly higher CRP and TNF-α (P < 0.05). Pearson correlation demonstrated that the bone mineral density was negatively correlated with CTX-I, PINP, serum CRP and TNF-α, whereas it was positively correlated with OC and 25(OH)D3 in elderly men. The areas under the ROC curve (AUCs) of serum 25(OH)D3, CRP and TNF-α were identified as 0.931, 0.878 and 0.846, respectively, and the AUC of the combined detection of the three was 0.991. Furthermore, age, CTX-I, PINP, OC, 25(OH)D3, as well as serum CRP and TNF-α were identified as risk factors for osteoporosis among elderly men.

CONCLUSION

Serum 25(OH)D3, CRP, and TNF-α are associated with osteoporosis in elderly men, and can serve as predictors for osteoporosis.

摘要

目的

观察25-羟基维生素D3（25(OH)D3）、C反应蛋白（CRP）及肿瘤坏死因子-α（TNF-α）水平对老年男性骨质疏松症的预测价值。

方法

对2020年1月至2022年5月在信阳职业技术学院附属医院接受检查的122例老年男性患者进行回顾性分析。根据骨密度结果将患者分为骨质疏松组（OG，n = 77）和对照组（CG，n = 45）。使用公式N = Z^2*(P*(1 - P))/E^2计算给定置信区间（Z）、总误差（E）和目标人群比例（P）所需的样本量（N）。比例（P）通常假定为0.5，且在人群中不是随机分布的。测量并比较两组患者的I型胶原交联C末端肽（CTX-I）、I型前胶原N末端前肽（PINP）、完整甲状旁腺激素（iPTH）、骨钙素（OC）水平以及25(OH)D3、CRP和TNF-α的血清水平。采用Pearson相关性分析参数之间的关系。还使用受试者工作特征（ROC）曲线分析25(OH)D3、CRP和TNF-α对骨质疏松症的预测价值。进行Logistic多因素分析以分析老年男性骨质疏松症的危险因素。

结果

与CG组相比，OG组血清25(OH)D3明显降低，但CRP和TNF-α显著升高（P < 0.05）。Pearson相关性分析表明，老年男性的骨密度与CTX-I、PINP、血清CRP和TNF-α呈负相关，而与OC和25(OH)D3呈正相关。血清25(OH)D3、CRP和TNF-α的ROC曲线下面积（AUC）分别为0.931、0.878和0.846，三者联合检测的AUC为0.991。此外，年龄、CTX-I、PINP、OC、25(OH)D3以及血清CRP和TNF-α被确定为老年男性骨质疏松症的危险因素。