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50 岁及以上因手术干预住院的骨质疏松性骨折患者中甘油三酯-葡萄糖指数与骨转换标志物的相关性:一项回顾性横断面研究。

The association between the triglyceride-glucose index and bone turnover markers in osteoporotic fractures patients aged 50 and above who are hospitalized for surgical intervention: a retrospective cross-sectional study.

机构信息

Department of Orthopedics, The First People's Hospital of Kunshan, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.

Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China.

出版信息

Front Endocrinol (Lausanne). 2024 Sep 18;15:1418271. doi: 10.3389/fendo.2024.1418271. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the correlation between the triglyceride-glucose (TyG) index and bone turnover markers (BTMs) in osteoporotic fractures (OPFs) patients hospitalized for surgical intervention.

METHODS

A retrospective cross-sectional study was conducted on 3558 OPFs patients hospitalized for surgical intervention between January 2017 and July 2022. The study obtained baseline values for various biomarkers and covariates, including fasting blood glucose, β-C-terminal telopeptide of type I collagen (β-CTX), procollagen type 1 N-terminal propeptide (P1NP), triglycerides, age, sex, body mass index, smoking, drinking, low-density lipoprotein, high-density lipoprotein, aspartate aminotransferase, uric acid, the score of American society of anesthesiologists, homocysteine, parathyroid hormone, apolipoprotein B, apolipoprotein A, magnesium, phosphorus and calcium. Multiple linear regression, curve fitting, threshold effects, and subgroup analyses were also applied.

RESULTS

After adjusting for covariates in the regression analysis, the results revealed a negative correlation between β-CTX and P1NP levels and the baseline TyG index. Specifically, a one-unit increase in the TyG index was associated with a reduction in β-CTX levels of -0.06 (95% CI: -0.10, -0.01; P-value = 0.012) and a reduction in P1NP levels of -4.70 (95% CI: -9.30, -0.09; P-value = 0.046). Additionally, the inflection points for the nonlinear correlation between the TyG index and β-CTX and P1NP were found to be K = 6.31 and K = 6.63, respectively.

CONCLUSION

The study demonstrated a negative, non-linear relationship among the TyG index, β-CTX and P1NP in OPFs patients hospitalized for surgical intervention. These findings suggest that elevated TyG index levels may adversely affect bone turnover, potentially contributing to the progression of OP.

摘要

目的

评估甘油三酯-葡萄糖(TyG)指数与接受手术干预的骨质疏松性骨折(OPF)患者骨转换标志物(BTM)之间的相关性。

方法

对 2017 年 1 月至 2022 年 7 月间因手术干预住院的 3558 例 OPF 患者进行回顾性横断面研究。研究获得了各种生物标志物和协变量的基线值,包括空腹血糖、I 型胶原β-C 末端肽(β-CTX)、I 型前胶原 N 端前肽(P1NP)、甘油三酯、年龄、性别、体重指数、吸烟、饮酒、低密度脂蛋白、高密度脂蛋白、天冬氨酸转氨酶、尿酸、美国麻醉医师协会评分、同型半胱氨酸、甲状旁腺激素、载脂蛋白 B、载脂蛋白 A、镁、磷和钙。还应用了多元线性回归、曲线拟合、阈值效应和亚组分析。

结果

在回归分析中调整协变量后,结果显示β-CTX 和 P1NP 水平与基线 TyG 指数呈负相关。具体而言,TyG 指数增加一个单位,β-CTX 水平降低-0.06(95%CI:-0.10,-0.01;P 值=0.012),P1NP 水平降低-4.70(95%CI:-9.30,-0.09;P 值=0.046)。此外,还发现 TyG 指数与β-CTX 和 P1NP 之间非线性关系的拐点分别为 K=6.31 和 K=6.63。

结论

该研究表明,接受手术干预的 OPF 患者中 TyG 指数、β-CTX 和 P1NP 之间存在负性、非线性关系。这些发现提示升高的 TyG 指数水平可能对骨转换产生不利影响,从而促进 OP 的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be4c/11445018/fde0a312e9a6/fendo-15-1418271-g001.jpg

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