多种骨代谢生化指标联合预测老年骨质疏松性髋部骨折风险的意义  

Prognostic of the risk of osteoporotic hip fracture in elderly people by combination of multiple serum biochemical bone turnover markers

作　　者：唐三元[1,2] 谭文成 杨辉[1,2] 唐天华[1,2] 梅其伟[1,2] 朱亚平[1,2] 黄馨霈 

机构地区：[1]暨南大学附属珠海医院 [2]珠海市人民医院创伤骨科,广东珠海519000 [3]澳门仁和医疗中心,澳门999078

出　　处：《中国矫形外科杂志》2015年第18期1653-1656,共4页Orthopedic Journal of China

基　　金：澳门科学技术发展基金(编号:072/2013/A);广东省社会发展科技计划项目(编号:2013B021800115);珠海市科技局计划项目(编号:2014D0401990026)

摘　　要：[目的]探讨多种骨代谢生化指标联合预测老年骨质疏松性髋部骨折风险的临床意义。[方法]老年髋部骨折患者50例,对照组同龄健康体检人员50例。骨代谢生化指标测定:采用酶联免疫法(ELLSA法)测定血清BGP、IGF-1、SHBG、CTX和DPD值。对上述结果应用SPSS 13.0统计软件进行统计学分析。[结果]骨折组和对照组间血清骨代谢指标水平差异显著,有统计学意义,P<0.05。CTX和DPD与老年骨质疏松性髋部骨折的相关性更高[OR 8.176(2.719,76.058),7.230(1.798,33.851)]。五者单独预测骨折风险的敏感度均较低,而联合预测骨折风险的敏感度为99.2%。[结论]骨折组血清骨代谢生化指标BGP、IGF-1、SHBG、CTX和DPD水平存在异常。CTX与DPD预测老年骨质疏松性髋部骨折更为敏感。5指标相结合可以明显提高预测老年骨质疏松性髋部骨折的敏感度,可以作为预测老年骨质疏松性髋部骨折风险的敏感指标。[ Objective] The study is to investigate the prognostic effect of osteoporotic hip fracture in elderly by combination of serum biochemical bone turnover markers including BGP, IGF - 1, SHBG, CTX and DPD. [ Method ] One hundred elderly people were divided to 2 groups, 50 asteoporotie hip fracture subjects were set as fracture group, the mean age at the time of the investigation was 71.32 ：t： 4.71 years （ range, 63 - 77 years）. Another 50 healthy subjects were set as control group, the mean age at the time of, investigation was 69.54：1：5.12 years （range, 60 -75 years）. For all the subjects, serum biochemical bone turnover markers including BGP, IGF - 1, SHBG, CTX and DPD were measured by enzyme - linked immunosorbent assay （ELLSA） after specimen eolleetian before uniform. SPSS13.0 statistical software was used to analyze all experimental data. Result ] The levels of serum biochemical bone turnover markers including BGP, IGF- 1, SHBG, CTX and DPD showed sig- nificantly statistic difference between fracture group and the control group （ P 〈 0.05 ）. Among them, CTX and DPD were more correlative with osteoporotic hip fracture in elderly OR 8. 176 （2.719, 76.058）, 7. 230 （ 1. 798, 33. 851 ） ]. The sensitivity of single indicator of BGP, IGF - 1, SHBG, CTX and DPD was low, whereas the sensitivity of combination of them was high （sensitivity =99.2% ）. [ Conclusion]The levels of BGP, IGF- 1, SHBG, CTX and DPD have been found abnormal in frac- ture group compared with the control group. CTX and DPD are more sensitive in predicting the risk of osteoporotic hip fracture in elderly. Combination of multiple biochemical bone turnover markers to predict the risk is more meaningful than the single bi- ocbemical bone turnover marker in osteeporotic hip fracture in elderly.

关 键 词：老年骨质疏松性髋部骨折 骨钙素 类胰岛素生长因子 性激素结合球蛋白 I型胶原交联 羧基末端肽 脱氧吡啶啉 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]