血清MIP-1β、TRACP-5b和FGF-23检测对绝经后骨质疏松患者发生骨折的预测价值  

Predictive value of serum MIP-1β,TRACP-5b and FGF-23 detection to fracture occurrence in patients with postmenopausal osteoporosis

作　　者：王强珍 WANG Qiangzhen(Department of Gynecology,Affiliated Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China)

机构地区：[1]复旦大学附属妇产科医院妇科,上海200090

出　　处：《检验医学与临床》2023年第1期36-40,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨血清巨噬细胞炎症蛋白-1β(MIP-1β)、抗酒石酸酸性磷酸酶5b(TRACP-5b)和成纤维细胞生长因子23(FGF-23)检测对绝经后骨质疏松患者发生骨折的预测价值。方法选择2019年1月至2021年12月该院收治的绝经后骨质疏松患者121例纳入骨质疏松组,根据患者是否发生骨折分为骨折组(54例)和非骨折组(67例)。选择同期在该院诊断为骨量下降和骨量正常的绝经后女性分别纳入骨量下降组(82例)和对照组(65例)。比较各组血清MIP-1β、TRACP-5b和FGF-23水平,对骨质疏松患者发生骨折的影响因素进行单因素和多因素分析,评价血清MIP-1β、TRACP-5b和FGF-23检测对绝经后骨质疏松患者发生骨折的预测价值,以及分析血清MIP-1β、TRACP-5b和FGF-23水平与骨折严重程度的关系。结果骨质疏松组血清MIP-1β、TRACP-5b和FGF-23水平明显高于骨量下降组和对照组(P<0.01),骨量下降组血清MIP-1β、TRACP-5b和FGF-23水平明显高于对照组(P<0.01)。骨折组的血清MIP-1β、TRACP-5b、FGF-23水平明显高于非骨折组(P<0.01)。多因素分析发现,血清MIP-1β>719.72 pg/mL、TRACP-5b>6.97 U/L和FGF-23>247.32 pg/mL是绝经后骨质疏松患者发生骨折的危险因素(P<0.01)。血清MIP-1β、TRACP-5b和FGF-23水平在预测骨质疏松患者发生骨折方面具有较高的效能(P<0.01),3项指标联合检测灵敏度为90.7%,特异度为89.4%,曲线下面积(AUC)为0.946,AUC明显高于MIP-1β(Z=3.412,P<0.01)、TRACP-5b(Z=3.811,P<0.01)和FGF-23(Z=3.983,P<0.01)单项指标检测,而单项指标之间的AUC比较差异无统计学意义(P>0.05)。结论血清MIP-1β、TRACP-5b和FGF-23参与了绝经后骨质疏松的发生、发展过程,其水平检测对预测绝经后骨质疏松患者发生骨折具有较高的价值。Objective To investigate the predictive value of serum macrophage inflammatory protein-1β(MIP-1β),tartrate-resistant acid phosphatase 5b(TRACP-5b)and fibroblast growth factor 23(FGF-23)detection to fracture occurrence in the patients with postmenopausal osteoporosis.Methods A total of 121 patients with postmenopausal osteoporosis treated in this hospital from January 2019 to December 2021 were selected as the osteoporosis group and divided into the fracture group(54 cases)and non-fracture group(67cases)according to whether developing fracture.The postmenopausal women diagnosed as the bone mass decrease and bone mass normal were selected and included into the bone mass decrease group(82 cases)and control group(65 cases)during the same period.The levels of serum MIP-1β,TRACP-5b and FGF-23 were compared among the various groups.The univariate and multivariate analysis were performed on the influencing factors of fracture occurrence in the patients with postmenopausal osteoporosis.The predictive value of detecting serum MIP-1β,TRACP-5b and FGF-23 levels on fracture occurrence for the patients with postmenopausal osteoporosis was evaluated.The relationship between serum MIP-1β,TRACP-5b and FGF-23 levels with the fracture severity was analyzed.Results The levels of serum MIP-1β,TRACP-5b and FGF-23 in the osteoporosis group were significantly higher than those in the bone mass decrease group and control group(P<0.01),and those in the bone mass decrease group were also significantly higher than those in the control group(P<0.01).The levels of serum MIP-1β,TRACP-5b and FGF-23 in the fracture group were significantly higher than those in the non-fracture group(P<0.01).The multivariate analysis found that serum MIP-1β>719.72 pg/mL,TRACP-5b>6.97 U/L and FGF-23>247.32 pg/mL were the risk factors for fracture occurrence in the patients with postmenopausal osteoporosis(P<0.01).The serum MIP-1β,TRACP-5b and FGF-23 levels had high efficiency in predicting the fracture occurrence in the patients with osteoporosis(P<0.01).

关 键 词：巨噬细胞炎症蛋白-1β 抗酒石酸酸性磷酸酶5B 成纤维细胞生长因子23 骨质疏松 骨折 

分 类 号：R683[医药卫生—骨科学]