预测老年人骨质疏松性骨折风险的骨代谢因素。
Bone metabolism factors in predicting the risk of osteoporosis fracture in the elderly.
机构信息
Department of Orthopedic, Changde Hospital, Xiangya School of Medicine, Central South University (The First People'S Hospital Of Changde City), No.818, Renmin Road, Wuling District, Changde City, Hunan Province, 415000, PR China.
出版信息
BMC Musculoskelet Disord. 2024 Jun 5;25(1):442. doi: 10.1186/s12891-024-07560-5.
OBJECTIVE
Osteoporosis (OS) is a systemic bone disease characterized by low bone mass and bone microstructure damage. This study.
METHODS
According to the T value, 88 elderly fracture patients were grouped as the control group (without OS, 43 cases) and observation group (with T value <-2.5, which could be diagnosed as OS, 45 cases). The content of boney containing protein (BGP), total type 1 collagen amino terminal extender peptide (TPINP), β-Crosslaps (β-CTX), parathyroid hormone (PTH) and insulin-like growth factors-1 (IGF-1) was compared. Multivariate logistic regression was adopted to analyze the correlation between biochemical indexes and the occurrence of senile OS fracture and the related risk factors. The diagnostic value in the elderly was analyzed by receiver operating characteristic (ROC) curve.
RESULTS
The levels of BGP, TPINP, β-CTX, PTH and IGF-1 were elevated, and the level of IGF-1 was decreased in the observation group compared with the control group (P < 0.05). The elevated content of BGP, TPINP, β-CTX and PTH, and the decreased expression of IGF-1 were influencing factors for OS fractures in the elderly (P < 0.05). The sensitivity and specificity to predict the occurrence of OS fractures in the elderly were 91.70% and 90.50%, respectively. The AUC of combined detection was 0.976 (95% CI: 0.952-1.000), which was memorably higher than single indicator detection (P < 0.05). Among 45 patients, 32 cases had good prognosis and 13 had poor prognosis. In comparison with the good prognosis group, the content of BGP, TPINP, β-CTX and PTH were sensibly higher, the level of IGF-1 was prominently lower, and the proportion of fracture history was much higher in poor prognosis group (P < 0.05). Fracture history, BGP, TPINP, β-CTX, PTH and IGF-1 were independent risk factors for poor prognosis of elderly OS fractures (P < 0.05).
CONCLUSION
Bone metabolism factors were associated with poor prognosis of OS in the elderly. The combined detection had higher diagnostic value in calculating the risk of OS fracture in the elderly than single indicator detection.
目的
骨质疏松症（OS）是一种以骨量低和骨微结构损伤为特征的全身性骨病。本研究。
方法
根据 T 值，将 88 例老年骨折患者分为对照组（无 OS，43 例）和观察组（T 值<-2.5，可诊断为 OS，45 例）。比较骨钙素（BGP）、总型 1 胶原氨基端延伸肽（TPINP）、β-胶原交联（β-CTX）、甲状旁腺激素（PTH）和胰岛素样生长因子-1（IGF-1）的含量。采用多因素 logistic 回归分析生化指标与老年 OS 骨折发生的相关性及相关危险因素。通过接收者操作特征（ROC）曲线分析其在老年人中的诊断价值。
结果
观察组 BGP、TPINP、β-CTX、PTH 和 IGF-1 水平升高，IGF-1 水平降低与对照组比较（P<0.05）。BGP、TPINP、β-CTX 和 PTH 含量升高，IGF-1 表达降低是影响老年 OS 骨折的因素（P<0.05）。联合检测对老年 OS 骨折发生的灵敏度和特异性分别为 91.70%和 90.50%，联合检测的 AUC 为 0.976（95%CI：0.952-1.000），明显高于单项指标检测（P<0.05）。在 45 例患者中，32 例预后良好，13 例预后不良。与预后良好组相比，预后不良组 BGP、TPINP、β-CTX 和 PTH 含量明显升高，IGF-1 水平明显降低，骨折史比例明显升高（P<0.05）。骨折史、BGP、TPINP、β-CTX、PTH 和 IGF-1 是老年 OS 骨折不良预后的独立危险因素（P<0.05）。
结论
骨代谢因素与老年 OS 预后不良有关。与单项指标检测相比，联合检测对计算老年 OS 骨折风险具有更高的诊断价值。
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