Zhu Meng-Cheng, Xu Min-Zhe, Li Chang-Xuan, Wang Jia-Hao, Li Chong, Gong Ya-Qin, Jin Jian, Lu Ke, Hao Yan-Ming
Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China.
Kunshan Biomedical Big Data Innovation Application Laboratory, Suzhou, Jiangsu, China.
Front Med (Lausanne). 2025 Apr 10;12:1564957. doi: 10.3389/fmed.2025.1564957. eCollection 2025.
Recent studies suggest that metabolic factors, such as fasting blood glucose (FBG), may significantly affect bone health, influencing the risk and severity of osteoporotic fractures (OPFs). This study examined the association between FBG levels and bone turnover markers (BTMs) in patients hospitalized for OPFs requiring surgical intervention.
A retrospective cross-sectional analysis was conducted on 888 patients treated for OPFs at Kunshan Hospital affiliated with Jiangsu University from November 2018 to August 2023. Serum levels of FBG, procollagen type 1 N-terminal propeptide (P1NP), and β-C-terminal telopeptide of type I collagen (β-CTX) were measured, with FBG serving as an independent variable, and P1NP and β-CTX as outcome variables. Patients were stratified into tertiles based on FBG levels, and multiple regression models were adjusted for confounding variables, including age, gender, BMI, and clinical parameters. Non-linear relationships and threshold effects were analyzed.
Adjusted regression models identified a negative association between FBG and BTMs. For each 1 mmol/L increase in FBG, β-CTX levels decreased by 0.02 ng/mL (95% CI: -0.04 to -0.01; < 0.01), and P1NP levels decreased by 2.91 ng/mL (95% CI: -4.38 to -1.45; < 0.01). Non-linear relationships were observed, with an inflection point at 7.93 mmol/L for both markers. Below this threshold, higher FBG levels were associated with a steeper decline in BTMs.
FBG levels exhibit a negative non-linear association with P1NP and β-CTX in patients with OPFs. Elevated FBG levels may adversely affect BTMs, potentially contributing to the progression of osteoporosis (OP). These findings underscore the importance of glycemic control in managing bone health among patients with OPFs.
近期研究表明，诸如空腹血糖（FBG）等代谢因素可能会显著影响骨骼健康，进而影响骨质疏松性骨折（OPF）的风险和严重程度。本研究调查了因需手术干预的OPF而住院的患者中FBG水平与骨转换标志物（BTM）之间的关联。
对2018年11月至2023年8月在江苏大学附属昆山医院接受OPF治疗的888例患者进行回顾性横断面分析。测量血清FBG、I型前胶原N端前肽（P1NP）和I型胶原β羧基末端肽（β-CTX）水平，以FBG作为自变量，P1NP和β-CTX作为结果变量。根据FBG水平将患者分为三分位数，并针对包括年龄、性别、体重指数和临床参数在内的混杂变量调整多元回归模型。分析非线性关系和阈值效应。
调整后的回归模型确定FBG与BTM之间存在负相关。FBG每升高1 mmol/L，β-CTX水平降低0.02 ng/mL（95%CI：-0.04至-0.01；<0.01），PNP水平降低2.91 ng/mL（95%CI：-4.38至-1.45；<0.01）。观察到非线性关系，两种标志物的拐点均为7.93 mmol/L。低于该阈值时，较高的FBG水平与BTM的更急剧下降相关。
在OPF患者中，FBG水平与P1NP和β-CTX呈负非线性关联。FBG水平升高可能会对BTM产生不利影响，可能导致骨质疏松症（OP）进展。这些发现强调了血糖控制在OPF患者骨骼健康管理中的重要性。
