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中国老年髋部骨折患者的血清生物标志物与髋部骨密度

Serum biomarkers and bone mineral density of the hip in Chinese elderly patients with hip fractures.

作者信息

Liu Luhui, Chen Shuang, Huang Qiang

机构信息

Department of Orthopedic Surgery, The People's Hospital of Sixian County, Anhui Province, China.

Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.

出版信息

Medicine (Baltimore). 2025 Jun 20;104(25):e42954. doi: 10.1097/MD.0000000000042954.

Abstract

This study aims to analyze the serum biomarkers and bone mineral density (BMD) of the hip in patients with hip fractures, and to explore the risk factors for different types of hip fractures in Chinese elderly patients. In this retrospective case-control study, 235 patients aged >60 and suffered from their first hip fracture were included. The patients were divided into 2 groups: the femoral neck fracture group (n = 99, mean age 80.6 ± 7.76 yr) and the intertrochanteric fracture group (n = 136, mean age 83.5 ± 6.82 yr). Serum biomarkers and BMD parameters (femoral neck, trochanter, intertrochanteric region, total hip, and Ward triangle) of the contralateral hip were collected and compared.The intertrochanteric fracture group had significantly lower red blood cell count, hemoglobin, albumin, total cholesterol, and serum calcium levels than the femoral neck fracture group (P < .001), but had higher blood urea nitrogen levels (P = .01). In both male and female patients, the intertrochanteric fracture group had significantly lower BMD in the greater trochanter and total hip regions compared to the femoral neck fracture group (P < .05). Logistic regression analysis showed that advanced age, lower hemoglobin, and lower total cholesterol levels were significant risk factors for intertrochanteric fractures (odds ratio [OR] = 1.06, P = .016; OR = 3.65, P < .001; OR = 3.20, P = .017), while higher greater trochanter BMD was a protective factor (OR = 0.36, P < .001).Different risk factors are associated with femoral neck and intertrochanteric fractures. Some of the serum biomarkers and hip BMD parameters are closely related to the types of fractures.

摘要

本研究旨在分析髋部骨折患者的血清生物标志物及髋部骨密度(BMD),并探讨中国老年患者不同类型髋部骨折的危险因素。在这项回顾性病例对照研究中,纳入了235例年龄>60岁且首次发生髋部骨折的患者。患者被分为两组:股骨颈骨折组(n = 99,平均年龄80.6±7.76岁)和转子间骨折组(n = 136,平均年龄83.5±6.82岁)。收集并比较了对侧髋部的血清生物标志物和BMD参数(股骨颈、大转子、转子间区域、全髋和Ward三角区)。转子间骨折组的红细胞计数、血红蛋白、白蛋白、总胆固醇和血清钙水平显著低于股骨颈骨折组(P <.001),但血尿素氮水平较高(P = 0.01)。在男性和女性患者中,与股骨颈骨折组相比,转子间骨折组大转子和全髋区域的BMD均显著降低(P <.05)。Logistic回归分析显示,高龄、较低的血红蛋白和较低的总胆固醇水平是转子间骨折的显著危险因素(比值比[OR]=1.06,P = 0.016;OR = 3.65,P <.001;OR = 3.20,P = 0.017),而较高的大转子BMD是保护因素(OR = 0.36,P <.001)。不同的危险因素与股骨颈骨折和转子间骨折相关。一些血清生物标志物和髋部BMD参数与骨折类型密切相关。

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