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绝经后女性骨代谢指标与骨质疏松性胸腰椎椎体骨折的相关性

Correlation Between Bone Metabolism Indices and Osteoporotic Thoracolumbar Vertebrae Fracture in Postmenopausal Women.

作者信息

Jing Pengrui, Kong Fanqi, Meng Bin, Yang Shaofeng

机构信息

Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.

出版信息

Int J Gen Med. 2024 Dec 13;17:6165-6170. doi: 10.2147/IJGM.S499528. eCollection 2024.

Abstract

BACKGROUND

This study aims to explore the correlation between bone metabolism indices and osteoporotic thoracolumbar vertebrae fracture (OTVF) in postmenopausal women.

METHODS

A total of 447 female patients with postmenopause and underwent OTVF in our hospital were selected as group A. Three hundred eighty-seven out-patients without fractures were selected as group B. Bone metabolism index including the serum levels of total Serum procollagen type N-terminal propeptide (tPINP), the age-related type I cross linked C-telopeptide (β-CTX) and 25-hydroxyvitamin D (25-OHD) were collected and compared. The relation between bone metabolism indices and OTVF was analyzed.

RESULTS

The mean tPINP in group A was 61.72 ± 28.43, which was notably higher than group B (P < 0.01). Meanwhile, greater β-CTX were higher founded in group A than group B (0.778 ± 0.316 vs 0.669 ± 0.303 μg/l). However, the 25-OHD in group A was significantly lower than that in group B (P < 0.05). Multivariate logistic regression analysis revealed that the serum level of tPINP (OR: 0.008, P = 0.011), the serum level of β-CTX (OR: 0.805, P = 0.002) and the serum level of 25-OHD (OR: -0.029, P = 0.003) were independently correlated with postmenopausal OTVF.

CONCLUSION

Bone metabolic markers play an important role in predicting OTVF. As a reflection of bone mass and bone strength, BMD is inadequate in predicting OTVF. High expression of bone metabolism indicators β-CTX, tPINP and relatively low expression of 25-OHD suggest an increased risk of OTVF. Early detection of postmenopausal bone metabolism abnormalities can be used for early intervention to reduce the incidence of OTVF.

摘要

背景

本研究旨在探讨绝经后女性骨代谢指标与骨质疏松性胸腰椎骨折(OTVF)之间的相关性。

方法

选取我院447例绝经后发生OTVF的女性患者作为A组。选取387例无骨折的门诊患者作为B组。收集并比较骨代谢指标,包括血清总I型前胶原N端前肽(tPINP)、年龄相关I型交联C端肽(β-CTX)和25-羟维生素D(25-OHD)的水平。分析骨代谢指标与OTVF之间的关系。

结果

A组tPINP的平均值为61.72±28.43,显著高于B组(P<0.01)。同时,A组的β-CTX水平高于B组(0.778±0.316 vs 0.669±0.303μg/l)。然而,A组的25-OHD水平显著低于B组(P<0.05)。多因素逻辑回归分析显示,血清tPINP水平(OR:,0.008,P = 0.011)、血清β-CTX水平(OR:0.805,P = 0.002)和血清25-OHD水平(OR:-0.029,P = 0.003)与绝经后OTVF独立相关。

结论

骨代谢标志物在预测OTVF中起重要作用。作为骨量和骨强度的反映,骨密度在预测OTVF方面并不充分。骨代谢指标β-CTX、tPINP的高表达以及25-OHD的相对低表达提示OTVF风险增加。早期发现绝经后骨代谢异常可用于早期干预,以降低OTVF的发生率。

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