Wang Zhengming, Wang Rui, Ge Haiya, Gu Yong, Xian Sicheng, Yan Laijun, Du Guoqing, Shen Zhibi, Lv Shuaijie, Zhan Hongsheng, Li Zhengyan
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
Arch Med Sci. 2024 Mar 7;20(6):1854-1863. doi: 10.5114/aoms/184346. eCollection 2024.
Osteoporosis patients undergoing surgery often have significant bleeding, which is closely related to coagulation function. This study aimed to assess the correlation between bone turnover markers (BTMs), bone mineral density (BMD), and coagulation biomarkers.
Cases meeting the inclusion criteria were included from our center from January 2020 to December 2021. The relationships between coagulation biomarkers, BTMs, and BMD were investigated by Spearman correlation analysis and canonical correlation analysis (CCA). Consequently, age, bone mass stage, 25-hydroxyvitamin D (25-(OH)D), and BMD were included as independent variables in the logistic regression model. Furthermore, the international normalized ratio (INR), fibrinogen, platelets, and D-dimer levels were set as dependent variables in the regression analysis. Finally, multivariable regressions were conducted to adjust for differences in demographics and comorbidities among groups.
A total of 306 patients were included in the study. Significant differences were observed in prothrombin time, fibrinogen, INR, D-dimer, and platelets ( < 0.05). D-dimer exhibited the most significant positive association with age and the most pronounced negative correlation with the BMD of Ward's triangle ( = 0.322, < 0.001; = -0.298, < 0.001; respectively). 25-(OH)D and calcium were related to coagulation biomarkers. Multivariate analysis demonstrated that age was positively associated with D-dimer levels (odd ratio [OR] = 1.046, = 0.007), while the BMD of Ward's triangle was negatively related to D-dimer levels (OR = 0.004, = 0.0017).
For the Chinese population aged 50 and above, attention should be paid to alterations in coagulation biomarkers.
接受手术的骨质疏松症患者常出现明显出血,这与凝血功能密切相关。本研究旨在评估骨转换标志物(BTMs)、骨密度(BMD)和凝血生物标志物之间的相关性。
选取2020年1月至2021年12月我院中心符合纳入标准的病例。采用Spearman相关分析和典型相关分析(CCA)研究凝血生物标志物、BTMs和BMD之间的关系。因此,将年龄、骨量阶段、25-羟基维生素D(25-(OH)D)和BMD作为逻辑回归模型的自变量。此外,将国际标准化比值(INR)、纤维蛋白原、血小板和D-二聚体水平作为回归分析的因变量。最后,进行多变量回归以调整各组间人口统计学和合并症的差异。
本研究共纳入306例患者。凝血酶原时间、纤维蛋白原、INR、D-二聚体和血小板存在显著差异(<0.05)。D-二聚体与年龄呈最显著正相关,与Ward三角区骨密度呈最显著负相关(分别为=0.322,<0.001;=-0.298,<0.001)。25-(OH)D和钙与凝血生物标志物有关。多变量分析表明,年龄与D-二聚体水平呈正相关(优势比[OR]=1.046,=0.007),而Ward三角区骨密度与D-二聚体水平呈负相关(OR=0.004,=0.0017)。
对于50岁及以上的中国人群,应关注凝血生物标志物的变化。