ROC曲线法分析血清OPG、RANKL及雌二醇对运动性骨疲劳的早期筛查价值  

Value of Early Screening of Exercise-induced Bone Fatigue Based on Serum Concentrations of RANKL,OPG and E_2 by ROC Curves

作　　者：兰晓霞[1] 王新兴[2] 赵宏[3] 杨震[4] 高宏生[5] 赵化冰 LAN Xiaoxia;WANG Xinxing;ZHAO Hong;YANG Zhen;GAO Hongsheng;ZHAO Huabing(Department of Army Epidemiology and Statistics,Logistics College of Chinese People's Armed Police Force,Tianjin 300162,China)

机构地区：[1]武警后勤学院部队流行病学与统计学教研室,天津300309 [2]军事医学科学院卫生学环境医学研究所 [3]天津出入境检验检疫局动植食检测中心 [4]武警后勤学院科研部组织计划处 [5]武警后勤学院部队卫生学教研室 [6]天津市职业与环境危害防制重点实验室

出　　处：《解放军预防医学杂志》2018年第1期30-33,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：武警后勤学院重大项目(No.wjz2007-4);武警医学院博士启动基金(No.WBS200805)

摘　　要：目的分析血清骨保护素(osteoprotegerin,OPG)、核因子κB活化因子配体(receptor-activator of nuclear factor kappa B ligand,RANKL)及雌二醇(estradiol,E_2)对运动性骨疲劳的早期筛查价值。方法健康雌性大鼠随机分为对照组和实验组,8周训练结束后处死大鼠,采用酶联免疫法检测血清RANKL、OPG和E_2水平,采用IBM 21.0 SPSS绘制受试者工作特征曲线曲线(receiver operating characteristic curve,ROC曲线),计算它们的ROC曲线下面积(area under the curve,AUC)、灵敏度和特异度,根据约登指数确定其诊断界值并评价筛查价值。结果血清RANKL、OPG、OPG/RANKL比值及E_2的AUC均大于0.9。选定的血清RANKL、OPG、OPG/RANKL比值和E_2的诊断界值分别为96.245 ng/ml、2.383 ng/ml、0.028和105.293 pg/ml,其灵敏度和特异度分别为90.21%和45.22%、96.19%和51.07%、94.42%和56.69%、93.36%和40.71%。血清RANKL、OPG、OPG/RANKL比值和E_2均早于金标准出现阳性诊断结果。结论动态检测血清RANKL、OPG及E_2水平,有望实现运动性骨疲劳的早期预警。Objective To investigate the value of early sceening of exercise-induced bone fatigue based on serum concentrations of RANKL,OPG and E2.Methods Healthy female SD rats were randomly divided into the control group and the training group.After 8 weeks of trainning,the rats were sacrificed.The levels of serum OPG,RANKL and E2 were detected using ELISA method.ROC curves were drawn by IBM 21.0 SPSS.The diagnostic cut-off values were determined by the Youden index,and the AUC sensitivity and specificity of the above serum indexes were calculated to appraise their value for early diagnosis of exerciseinduced bone fatigue.Results The AUCs of serum RANKL,OPG and E2 were all more than 0.9.The cut-off values of serum RANKL,OPG,OPG/RANKL and E2 determined by the Youden index were 96.245 ng/ml、2.383 ng/ml、0.028 and 105.293 pg/ml respectively,and their sensitivity and specificity were 90.21%and 45.22%、96.19%and 51.07%、94.42%and 56.69%,93.36%and 40.71%respectively.The positive results based on serum indicators were showed earlier than those based on the gold standard.Conclusion Dynamic detection of serum concentrations of RANKL,OPG,OPG/RANKL and E2 can facilitate early warning of exercise-induced bone fatigue.

关 键 词：受试者工作曲线 运动性骨疲劳 早期诊断 骨保护蛋白 核因子-κβ受体活化因子配体 雌二醇 

分 类 号：R821[医药卫生—临床医学]