血清PDPK1水平与绝经后髋部骨折患者早期骨密度和骨转化标志物变化的关系  

Relationship between serum PDPK1 level with changes of bone mineral density at early stage and bone turnover markers in postmenopausal women with hip fracture

作　　者：张岩[1] 吴多艺[1] 张志伟[1] 叶宝飞[1] ZHANG Yan;WU Duoyi;ZHANG Zhiwei;YE Baofei(First Department of Orthopedics,Hainan Provincial Hospital of Traditional Chinese Medicine,Haikou,Hainan 570000,China)

机构地区：[1]海南省中医院骨一科,海南海口570000

出　　处：《国际检验医学杂志》2022年第18期2264-2268,共5页International Journal of Laboratory Medicine

基　　金：海南省高等学校科学研究项目(Hnky2018-50)。

摘　　要：目的 探讨绝经后髋部骨折患者血清3’-磷酸肌醇依赖性蛋白激酶1(PDPK1)水平与早期骨密度(BMD)和骨转化标志物变化的关系。方法 2017年1月至2020年6月共纳入了261例55岁以上绝经后骨质疏松性髋部骨折患者作为骨折组,106例年龄匹配的无骨折绝经女性作为对照组。对照组于体检当天,骨折组于骨折后2、4、7、10、14、30、365 d检测血清PDPK1、Ⅰ型前胶原氨基端原肽(PINP)、Ⅰ型胶原蛋白的β-异构化羧基端肽(β-CTX)水平。结果 骨折患者血清PDPK1基线(骨折后2 d)水平明显高于对照组(P<0.05)。在整个队列中,血清PDPK1基线水平与β-CTX(r=0.403,P=0.008)和PINP(r=0.236,P=0.042)呈正相关,而与股骨颈BMD呈负相关(r=-0.529,P<0.001)。经多元线性回归分析发现,血清PDPK1基线水平是影响股骨颈BMD的独立危险因素(β=-0.390,t=-2.302,P=0.004)。骨折后7 d时血清PDPK1水平达到峰值,随后逐渐下降(F=8.351,P<0.05)。Pearson相关分析结果显示,骨折7 d时血清PDPK1水平变化百分比与β-CTX、PINP变化百分比呈正相关(r=0.396,P=0.002;r=0.180,P=0.033),且在整个研究期间,血清PDPK1水平变化百分比与β-CTX变化百分比呈正相关(r=0.293,P=0.019)。结论 在绝经后骨质疏松性髋部骨折的患者中,基线和愈合早期血清PDPK1水平较高,与骨转化标志物PINP、β-CTX变化趋势基本一致,且血清PDPK1水平是影响股骨颈BMD的独立危险因素。Objective To investigate the relationship between serum 3-phosphoinositide-dependent protein kinase 1(PDPK1) level with the changes of bone mineral density(BMD) at early age and bone turnover markers in postmenopausal women with hip fracture.Methods A total of 261 postmenopausal women patients with osteoporotic hip fractures aged ≥55 years in this hospital from January 2017 to June 2020 served as the fracture group and 106 age-matched women without fractures served as the control group.Serum PDPK1,type Ⅰ procollagen N-terminal peptide(PINP) and β-isomeric carboxy-terminal peptide of type Ⅰ collagen(β-CTX) levels were measured on 2,4,7,10,14,30,365 d after fracture in the fracture group and on the physical examination day in the control group.Results The serum PDPK1 baseline level(2 d after fracture) in the patients with fracture was significantly higher than that in the control group(P<0.05).In the whole queue, the baseline level of serum PDPK1 was positively correlated with β-CTX(r=0.403,P=0.008) and PINP(r=0.236,P=0.042),but negatively correlated with femoral neck BMD(r=-0.529,P<0.001).The multiple linear regression analysis showed that serum PDPK1 baseline level was an independent risk factor affecting femoral neck BMD(β=-0.390,t=-2.302,P=0.004).The serum PDPK1 level reached its peak on 7 d after fracture, and then decreased gradually(F=8.351,P<0.05).The Pearson correlation analysis results showed that percentage of serum PDPK1 level change on 7 d after fracture was positively correlated with the percentage of β-CTX and PINP levels change(r=0.396,P=0.002;r=0.180,P=0.033),moreover during the whole study period, the percentage of serum PDPK1 level change was positively correlated with the percentage of β-CTX change(r=0.293,P=0.019).Conclusion In postmenopausal women patients with hip fracture, serum PDPK1 level is higher at baseline and early healing stage, which is basically consistent with the change trend of bone turnover marker PINP and β-CTX,moreover serum PDPK1 level is an independent risk fac

关 键 词：绝经 骨折修复 髋部骨折 骨转化标志物 3’-磷酸肌醇依赖性蛋白激酶1 

分 类 号：R446.1[医药卫生—诊断学]