血清SOST、DKK-1水平与分化型甲状腺癌术后骨质疏松患者骨代谢指标的相关性研究  

Correlation between serum SOST, DKK-1 levels and bone metabolism indexes in patients with osteoporosis after differentiated thyroid cancer surgery

作　　者：刘冲[1] 商中华[1] 原晋阳 田仲明 刘亮[3] Liu Chong;Shang Zhonghua;Yuan Jinyang;Tian Zhongming;Liu Liang(Department of General Surgery,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Gland Surgery,Taiyuan Central Hospital,Taiyuan 030009,China;Department of Orthopedics,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院普通外科,太原030001 [2]太原市中心医院腺体外科,太原030009 [3]山西医科大学第二医院骨科,太原030001

出　　处：《中华内分泌外科杂志》2023年第2期194-197,共4页Chinese Journal of Endocrine Surgery

基　　金：山西省应用基础计划项目(201901D211496)。

摘　　要：目的探讨血清硬骨素(recombinant sclerostin,SOST)、dickkopf相关蛋白1(dickkopf-like protein 1,DKK-1)水平与分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后发生骨质疏松患者骨代谢指标的相关性。方法收集山西医科大学第二医院110例DTC术后诊断为骨质疏松的患者作为观察组,另收集110例DTC术后未诊断出骨质疏松的患者作为对照组。对比两组患者一般资料、骨密度、硬骨素(recombinant sclerostin,SOST)、DKK-1水平与骨代谢指标Ⅰ型前胶原氨基端原肽(N-terminal propeptide of type I procollagen,PINP)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)、β-异构C-端肽(beta-isomerized C-telopeptide,β-CTX)、25-羟基维生素D3[25-hydroxyvitamin D3,25-(OH)D3]水平。分析血清SOST、DKK-1水平与骨代谢指标的相关性,探讨影响骨质疏松形成的危险因素。结果观察组患者骨密度T值(-3.27±0.92)显著低于对照组(-1.23±0.27,t=22.32,P<0.001)。观察组血清SOST(15.84±1.34,t=32.53,P<0.001)、DKK-1(5.96±1.40,t=4.82,P<0.001)水平显著高于对照组(SOST:10.24±1.21,DKK-1:5.05±1.40)。观察组血清PINP(40.95±9.84,t=7.59,P<0.001)、BALP(23.14±5.26,t=5.06,P<0.001)、β-CTX(1.07±0.54,t=4.96,P<0.001)水平显著高于对照组(31.48±8.64,19.64±4.99,0.78±0.29),25-(OH)D3水平(13.68±4.49)显著低于对照组(18.31±5.72,t=6.68,P<0.001)。血清SOST与PINP(r=0.33,P=0.001)、BALP(r=0.23,P=0.016)、β-CTX(r=0.19,P=0.046)呈显著正相关,与25-(OH)D3相关性不显著(r=-0.09,P=0.349)。血清DKK-1与PINP(r=0.19,P=0.044)、BALP(r=0.26,P=0.007)、β-CTX(r=0.21,P=0.028)呈显著正相关,与25-(OH)D3相关性不显著(r=-0.16,P=0.088)。血清SOST、DKK-1水平是影响骨质疏松形成的独立危险因素(均P<0.05)。结论血清SOST、DKK-1水平是影响骨质疏松形成的独立危险因素,其与DTC术后骨质疏松患者骨代谢指标PINP、BALP、β-CTX呈显著正相关。Objective To investigate the correlation between serum recombinant sclerostin(SOST)and dickkopf-related protein 1(DKK-1)levels and bone metabolism indexes in patients with osteoporosis after differentiated thyroid cancer surgery.Methods A total of 110 patients diagnosed with osteoporosis after differentiated thyroid cancer surgery were recruited as the study group,and another 110 patients without osteoporosis diagnosed after differentiated thyroid cancer surgery were recruited as the control group.The general data,bone mineral density,serum SOST,DKK-1 levels and bone metabolism indicators N-terminal propeptide of type I procollagen(PINP),bone alkaline phosphatase(BALP),beta-isomerized C-telopeptide(β-CTX),25-hydroxyvitamin D3[25-(OH)D3]levels were compared between the two groups.The correlation between serum SOST,DKK-1 levels and bone metabolism indexes was analyzed,and the risk factors affecting the formation of osteoporosis were explored.Results The T value of bone mineral density in the study group(-3.27±0.92)was significantly lower than that in the control group(-1.23±0.27,t=22.32,P<0.001).The serum SOST(15.84±1.34,t=32.53,P<0.001)and DKK-1(5.96±1.40,t=4.82,P<0.001)levels in the study group were significantly higher than those in the control group(SOST:10.24±1.21,DKK-1:5.05±1.40).The serum PINP(40.95±9.84,t=7.59,P<0.001),BALP(23.14±5.26,t=5.06,P<0.001)andβ-CTX(1.07±0.54,t=4.96,P<0.001)in the study group were significantly higher than those in the control group(31.48±8.64,19.64±4.99,0.78±0.29),and the 25-(OH)D3 level(13.68±4.49)was significantly lower than that of the control group(18.31±5.72,t=6.68,P<0.001).Serum SOST was positively correlated with PINP(r=0.33,P=0.001),BALP(r=0.23,P=0.016)andβ-CTX(r=0.19,P=0.046),but not with 25-(OH)D3(r=-0.09,P=0.349).Serum DKK-1 was positively correlated with PINP(r=0.19,P=0.044),BALP(r=0.26,P=0.007)andβ-CTX(r=0.21,P=0.028),but not with 25-(OH)D3(r=-0.16,P=0.088).Serum SOST and DKK-1 levels were independent risk factors for osteoporosis(all P<0.05).Conclus

关 键 词：分化型甲状腺癌 骨质疏松 硬骨素 dickkopf相关蛋白1 骨代谢指标 

分 类 号：R736.1[医药卫生—肿瘤] R580[医药卫生—临床医学]