循环 microRNA-21 水平升高可作为预测脆性骨折风险的潜在指标。

Increased circulating microRNA-21 level as a potential indicator for predicting a higher risk of incident fragility fractures.

机构信息

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.

出版信息

J Osteopath Med. 2023 Oct 27;124(3):121-125. doi: 10.1515/jom-2023-0174. eCollection 2024 Mar 1.

DOI:10.1515/jom-2023-0174

PMID:37883102

Abstract

CONTEXT

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.

OBJECTIVES

We aimed to investigate the association between miR-21 levels and the presence of fragility fractures.

METHODS

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).

RESULTS

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).

CONCLUSIONS

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.

摘要

背景

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。

目的

本研究旨在探讨 miR-21 水平与脆性骨折之间的关系。

方法

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。

结果

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）。