骨质疏松性胸腰椎或髋部骨折患者骨折初期血清骨转换指标与性别及血糖状态的相关性研究  

Correlation study between serum bone turnover markers and gender and blood glucose status in patients with early stage osteoporotic thoracolumbar and hip fracture

作　　者：曹东华[1] 刘溯[1] 汪纯[2] CAO Dong-hua;LIU Su;WANG Chun(Department of Geriatrics,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336,China;Department of Osteoporosis and Metabolic Bone Diseases,Shanghai Jiao Tong University Affiliated Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属同仁医院老年科,上海200336 [2]上海交通大学附属第六人民医院骨质疏松和骨病专科,上海200233

出　　处：《临床和实验医学杂志》2020年第6期638-641,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市自然科学基金面上支持项目(编号:11ZR1427300)。

摘　　要：目的通过检测骨折初期患者的术前骨转换指标,研究糖尿病和非糖尿病骨折患者以及不同性别和不同骨折部位骨转换指标的差异。方法采用回顾性研究方法选取2015年1月至2017年4月上海交通大学医学院附属同仁医院收治入院的骨折48 h以内的骨质疏松性胸腰椎或髋部骨折患者216例,其中胸腰椎骨折患者98例,髋部骨折118例,于入院第二天清晨对患者进行血清25羟维生素D[25(OH) D]、骨钙素(OC)、I型胶原羧基端肽β特殊序列(β-CTX)和甲状旁腺激素(PTH)]检测,按性别、骨折部位及有糖尿病和无糖尿病分组,比较组间的25 (OH) D、OC、β-CTX和PTH的差异。结果①男性患者62例,平均年龄(68.371±12.194)岁;女性患者154例,平均年龄(75.403±12.360)岁。糖尿病患者36例,平均空腹血糖水平(8.956±4.223) mmol/L;非糖尿病患者180例,平均空腹血糖(6.175±1.608) mmol/L。②OC和β-CTX在不同性别骨折患者、以及糖尿病和非糖尿病亚组之间差异具有统计学意义(P<0.05);其中男性骨折患者OC和β-CTX显著低于女性骨折患者(P<0.05);男性骨折患者合并糖尿病亚组OC和β-CTX显著低于非糖尿病亚组(P<0.05),但是不同骨折部位(髋部骨折亚组和胸腰椎骨折亚组) OC和β-CTX比较差异无统计学意义(P>0.05);女性骨折患者合并糖尿病亚组OC和β-CTX显著低于非糖尿病亚组(P<0.05),与男性一样在不同骨折部位亚组OC和β-CTX差异无统计学意义(P>0.05)。③96.3%的患者存在25(OH) D缺乏情况,女性髋部骨折亚组患者25(OH) D显著低于胸腰椎骨折亚组,差异具有统计学意义(P<0.05)。④女性患者髋部骨折亚组PTH水平显著高于胸腰椎骨折亚组,差异具有统计学意义(P<0.05);而对于男性患者而言,血清PTH水平在不同骨折部位(髋部骨折亚组和胸腰椎骨折亚组)及是否合并糖尿病(糖尿病亚组和非糖尿病亚组)差异均无统计学意义(P>0.05)。结论男性骨折患者骨转换低于女性�Objective To investigate the differences in bone turnover markers between fracture patients with or without type 2 diabetes mellitus(T2 DM),different gender and different fracture sites.Methods A total of 216 patients with osteoporotic thoracolumbar(n=98)and hip fractures(n=118)were recruited in our cohort study and retrospectively analyzed by Tongren Hospital,Shanghai Jiao Tong University School of Medicine from January 2015 to April 2017.The serum bone turnover markers and related hormone levels [25(OH)D,OC,β-CTX and PTH] were measured before operation.All participants were divided into subgroups depending on gender,the diagnosis of T2 DM and sites of fracture.The differences of 25(OH)D,OC,β-CTX and PTH between the groups were compared.Results ① There were 62 male patients with an average age of(68.371±12.194)years;154 female patients with an average age of(75.403±12.360)years.There were 36 cases of T2 DM patients with an average fasting blood glucose level of(8.956±4.223)mmol/L,180 cases of non-diabetic patients with an average fasting blood glucose level of(6.175±1.608)mmol/L.②There were significant differences in OC and β-CTX between patients with different gender and T2 DM and non-diabetic subgroups(P<0.05).Compared with female patients,the levels of serum OC and β-CTX were significantly lower in male patients(P<0.05).For male patients,the levels of serum OC and β-CTX were significantly lower in T2 DM subgroup than that in non-diabetic subgroup(P<0.05).However,there was no significant difference in OC and β-CTX between different fracture sites(hip fractures or thoracolumbar fractures)(P>0.05).For female patients,the levels of serum OC and β-CTX were significantly lower in T2 DM subgroup than that in non-diabetic subgroup(P<0.05).Same as male patients,no significant difference in OC and β-CTX were observed between different fracture sites(P>0.05).③25(OH)D deficiency occured in 96.3% of patients.For female patients,the level of serum 25(OH)D in hip fracture subgroup was significantly lower t

关 键 词：骨质疏松 胸腰椎骨折 髋部骨折 骨转换标志物 性别 糖尿病 

分 类 号：R683[医药卫生—骨科学] R580[医药卫生—外科学]