Department of Emergency Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Orthopaedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
J Osteopath Med. 2023 Oct 27;124(3):121-125. doi: 10.1515/jom-2023-0174. eCollection 2024 Mar 1.
As a common disease in the elderly, osteoporosis clearly increases the risk of fractures, leading to higher mortality, but the current markers to estimate the risk of fractures are limited. MicroRNA-21 (miR-21) may play an important role in osteoporosis, but the link of this biomarker with fractures was undetermined.
We aimed to investigate the association between miR-21 levels and the presence of fragility fractures.
A total of 200 patients were recruited and miR-21 was collected from baseline serum. The correlation between miR-21 and the fracture risk assessment tool (FRAX) score was analyzed. The incidence of fragility fractures was presented by Kaplan-Meier analysis, and Cox regression analysis was utilized to evaluate risk factors. The diagnostic value of miR-21 was conducted by the area under curve (AUC).
The FRAX score was significantly associated with miR-21 level (p<0.001). According to the 50th percentile of miR-21 content in the overall distribution, the cumulative incidence of fragility fractures was significantly higher in patients with higher miR-21 levels than those with lower levels (75.4, 95 % CI: 69.0-81.8 vs. 59.2, 95 % CI: 42.1-76.3, p<0.001). The results of the Cox regression analysis showed that the miR-21 level was an independent risk factor linked to the incidence of fracture (p=0.005). The optimal cut-off value of the miR-21 was 6.08, and the AUC for predicting fracture was 0.718 (95 % CI, 0.645-0.790).
This study showed that miR-21 has optimal diagnostic performance in the discrimination of fragility fracture, and the circulating miR-21 level in predicting the risk of fragility fracture may have a certain value.
骨质疏松症是老年人的常见病，明显增加了骨折风险，导致死亡率更高，但目前用于评估骨折风险的标志物有限。微小 RNA-21（miR-21）可能在骨质疏松症中发挥重要作用，但该生物标志物与骨折的关联尚未确定。
本研究旨在探讨 miR-21 水平与脆性骨折之间的关系。
共招募了 200 名患者，并采集基线血清中的 miR-21。分析 miR-21 与骨折风险评估工具（FRAX）评分的相关性。采用 Kaplan-Meier 分析呈现脆性骨折的发生率，并用 Cox 回归分析评估风险因素。通过曲线下面积（AUC）评估 miR-21 的诊断价值。
FRAX 评分与 miR-21 水平显著相关（p<0.001）。根据总体分布中 miR-21 含量的第 50 百分位数，miR-21 水平较高的患者脆性骨折的累积发生率明显高于水平较低的患者（75.4%，95%CI：69.0-81.8%比 59.2%，95%CI：42.1-76.3%，p<0.001）。Cox 回归分析结果表明，miR-21 水平是与骨折发生率相关的独立危险因素（p=0.005）。miR-21 的最佳截断值为 6.08，预测骨折的 AUC 为 0.718（95%CI：0.645-0.790）。
本研究表明，miR-21 在区分脆性骨折方面具有最佳的诊断性能，循环 miR-21 水平在预测脆性骨折风险方面可能具有一定价值。
