Chen Xilong, Chen Yansheng
Department of Orthopedics, Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, Changsha, Hunan, China.
Zhuzhou TCM Orthopedics Hospital, Zhuzhou, Hunan, China.
Endocrine. 2025 Jul 18. doi: 10.1007/s12020-025-04346-0.
To investigate the correlation between postoperative serum bone metabolism levels and fracture healing in elderly patients with osteoporotic vertebral compression fractures (OVCFs).
110 OVCF patients treated in the hospital from February 2023 to January 2024 were enrolled in this study. The patients were divided into the Normal healing and Delayed healing groups based on postoperative fracture healing. The general information of the two groups was first compared, and then serum levels of procollagen type I N-terminal propeptide (P1NP), osteoprotegerin (OPG), osteocalcin (BGP), and alkaline phosphatase (ALP) were measured in the patients. The correlation between postoperative bone metabolism levels and bone mineral density (BMD) and postoperative Oswestry disability index (ODI) were analyzed using Spearman's correlation test. Independent risk factors affecting postoperative fracture healing time were analyzed using multifactorial logistic regression. The value of serum bone metabolism indexes in assessing delayed postoperative fracture healing was analyzed using the receiver operating characteristic (ROC) curves.
In the Delayed healing group, the age, proportion of comorbid diabetes mellitus, postoperative ODI, and fracture healing time were significantly higher than those in the Normal healing group. Conversely, the postoperative calcium-phosphorus product, 25-hydroxyvitamin D [25(OH)D] level, and postoperative BMD T-value were lower than those in the Normal healing group (P < 0.05). Serum P1NP, OPG, BGP, and ALP levels were higher in the Normal healing group than in the Delayed healing group (P < 0.05). Spearman's correlation test demonstrated that serum P1NP, OPG, BGP, and ALP levels were all positively correlated with BMD T-value and negatively correlated with ODI in elderly OVCF patients (all P < 0.05). Low serum P1NP level, low serum OPG level, low serum BGP level, and low serum ALP level were independent risk factors affecting fracture healing in elderly OVCF patients (P < 0.05). The results of ROC analysis showed that the area under the curves (AUCs) of serum P1NP, OPG, BGP, and ALP in assessing delayed postoperative fracture healing in elderly OVCF patients were 0.888, 0.890, 0.894, and 0.856, respectively.
Delayed postoperative fracture healing in elderly OVCF patients might be affected by serum P1NP, OPG, BGP, and ALP levels, and serum bone metabolism levels can be an auxiliary judgment indicator of delayed postoperative fracture healing.
探讨老年骨质疏松性椎体压缩骨折（OVCFs）患者术后血清骨代谢水平与骨折愈合的相关性。
选取2023年2月至2024年1月在我院接受治疗的110例OVCF患者纳入本研究。根据术后骨折愈合情况将患者分为正常愈合组和延迟愈合组。首先比较两组的一般资料，然后检测患者血清I型前胶原N端前肽（P1NP）、骨保护素（OPG）、骨钙素（BGP）和碱性磷酸酶（ALP）水平。采用Spearman相关性检验分析术后骨代谢水平与骨密度（BMD）及术后Oswestry功能障碍指数（ODI）的相关性。采用多因素logistic回归分析影响术后骨折愈合时间的独立危险因素。采用受试者工作特征（ROC）曲线分析血清骨代谢指标评估术后骨折延迟愈合的价值。
延迟愈合组患者的年龄、合并糖尿病比例、术后ODI及骨折愈合时间均显著高于正常愈合组。相反，术后钙磷乘积、25-羟维生素D[25(OH)D]水平及术后BMD T值均低于正常愈合组（P<0.05）。正常愈合组血清P1NP、OPG、BGP和ALP水平高于延迟愈合组（P<0.05）。Spearman相关性检验表明，老年OVCF患者血清P1NP、OPG、BGP和ALP水平均与BMD T值呈正相关，与ODI呈负相关（均P<0.05）。血清P1NP水平低、血清OPG水平低、血清BGP水平低和血清ALP水平低是影响老年OVCF患者骨折愈合的独立危险因素（P<0.05）。ROC分析结果显示，血清P1NP、OPG、BGP和ALP评估老年OVCF患者术后骨折延迟愈合的曲线下面积（AUC）分别为0.888、0.890、0.894和0.856。
老年OVCF患者术后骨折延迟愈合可能受血清P1NP、OPG、BGP和ALP水平影响，血清骨代谢水平可作为术后骨折延迟愈合的辅助判断指标。
