Zhang Bi, Xiao Jie, Xin Zengfeng, Zhou Luyi, Li Xiaotian, Liao Xin, Huang Jiaqi
Department of Orthopedics, Jiande First People's Hospital, No. 599, Yanzhou Avenue, Xin'anjiang Street, Jiande City, Hangzhou, Zhejiang Province, 311600, China.
BMC Musculoskelet Disord. 2025 Sep 1;26(1):834. doi: 10.1186/s12891-025-09091-z.
Pentraxin 3 (PTX3) is an acute-phase protein of the pentraxin family, primarily secreted by immune cells and endothelial cells. This study analyzed its correlation with the severity of postmenopausal osteoporosis (PMOP) and its prognostic value.
Postmenopausal women (n = 405) were retrospectively selected and arranged into normal bone mineral density (BMD), osteopenia, and PMOP groups. Baseline data and follow-up records were analyzed. Serum PTX3 were quantified, and its correlations with Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) score, BMD, and bone turnover markers (BTMs) were analyzed. The independent risk factors for fractures in PMOP patients were screened. The prediction of PTX3 for fractures was evaluated, and its effects, together with BMD, on fracture risk were assessed.
PMOP patients showed reduced BMD and serum 25-hydroxyvitamin D levels and increased BTM and PTX3 levels. Serum PTX3 showed positive correlations with ODI, VAS scores, and BTM levels, but negative correlations with BMD. PMOP patients experiencing fractures exhibited markedly higher PTX3 levels than non-fracture patients. Multivariate analysis identified PTX3 as an independent risk factors for fractures in PMOP patients, while elevated BMD (lumbar spine, femur neck, and hip joint) as protective factors. PTX3 demonstrated superior predictive accuracy for fracture risk in PMOP patients (area-under-the-curve [AUC]: 0.874) over β-CTX (AUC = 0.689), PINP (AUC = 0.811), OC (AUC = 0.831), lumbar spine BMD (AUC = 0.791), femoral neck BMD (AUC = 0.793), and hip joint BMD (AUC = 0.799), with no statistically significant differences (all p > 0.05). Low BMD and high PTX3 levels elevated fracture risk in PMOP patients.
Serum PTX3 levels are correlated with BMD, BTMs, and symptom severity, and can assist in predicting fractures in PMOP patients.
五聚体3（PTX3）是五聚体家族的一种急性期蛋白，主要由免疫细胞和内皮细胞分泌。本研究分析其与绝经后骨质疏松症（PMOP）严重程度的相关性及其预后价值。
回顾性选取绝经后女性（n = 405），分为正常骨密度（BMD）组、骨量减少组和PMOP组。分析基线数据和随访记录。对血清PTX3进行定量，并分析其与Oswestry功能障碍指数（ODI）、视觉模拟评分（VAS）、BMD和骨转换标志物（BTM）的相关性。筛选PMOP患者骨折的独立危险因素。评估PTX3对骨折的预测作用，并评估其与BMD对骨折风险的影响。
PMOP患者的BMD和血清25-羟基维生素D水平降低，BTM和PTX3水平升高。血清PTX3与ODI、VAS评分和BTM水平呈正相关，与BMD呈负相关。发生骨折的PMOP患者的PTX3水平明显高于未骨折患者。多因素分析确定PTX3是PMOP患者骨折的独立危险因素，而BMD升高（腰椎、股骨颈和髋关节）是保护因素。PTX3对PMOP患者骨折风险的预测准确性优于β-CTX（曲线下面积[AUC]：0.689）、PINP（AUC = 0.811）、OC（AUC = 0.831）、腰椎BMD（AUC = 0.791）、股骨颈BMD（AUC = 0.793）和髋关节BMD（AUC = 0.799），差异均无统计学意义（均p > 0.05）。低BMD和高PTX3水平会增加PMOP患者的骨折风险。
血清PTX3水平与BMD、BTM及症状严重程度相关，可辅助预测PMOP患者的骨折情况。
