血清CCL3和CCL4水平与老年男性骨质疏松症的关系及其预测效能评价  

The relationship between serum levels of CCL3 and CCL4 and the osteoporosis in elderly men and an evaluation on their predictive efficacy

作　　者：朱烈烈 夏健宁 邵湘芝 吴登宠[1] ZHU Lie-lie;XIA Jian-ning;SHAO Xiang-zhi;WU Deng-chong(Department of Rehabilitation,Wenzhou Hospital of Traditional Chinese Medicine,Zhejiang 325000,China)

机构地区：[1]温州市中医院康复科,浙江325000

出　　处：《中国卫生检验杂志》2023年第10期1226-1230,1263,共6页Chinese Journal of Health Laboratory Technology

基　　金：温州市科协服务科技创新项目(jczc153);温州市基础性科研计划项目(Y20220064)。

摘　　要：目的 探讨血清CCL3和CCL4水平与老年男性骨质疏松的关系并进一步评价其预测效能。方法 收集2022年1月—8月本单位康复科收治的286例老年男性患者临床相关资料,分为骨质疏松组和非骨质疏松组,比较2组一般人口学资料、糖代谢、脂代谢及骨代谢等指标之间的差异。采用Spearman偏相关分析血清CCL3和CCL4与代谢指标之间的相关性,同时采用logistic回归分析血清CCL3和CCL4与骨质疏松的关系并应用ROC曲线评估血清CCL3、CCL4以及联合检测两者对骨质疏松症的预测效能。结果 与非骨质疏松组比较,骨质疏松组年龄更小、高BMI值的人数构成比更高、白蛋白校正钙水平更低、Album水平更低、CCL3水平更高、CCL4水平更高以及平均BMD更低,差异均有统计学意义(P<0.05)。校正年龄和BMI后,Spearman偏相关分析显示CCL3、CCL4水平仍与平均BMD成负相关关系(r=-0.446、r=-0.632,P<0.05)。多因素logistic回归分析发现,经过校正,CCL3及CCL4均是骨质疏松发生的危险因素(P<0.01),Album是骨质疏松发生的保护因素(P<0.05)。通过ROC分析发现,CCL3、CCL4和Album的AUC分别为0.767、0.749和0.620,其中CCL3的预测灵敏度更高(85.86%),而CCL4的预测特异度更高(80.21%)。CCL3和CCL4联合检测的AUC为0.817。CCL3、CCL4和Album三者联合检测的AUC达到0.874,灵敏度为90.91%,特异度为73.26%。结论 血清CCL3、CCL4水平与老年男性骨质疏松的发生密切相关,血清CCL3和CCL4是敏感且有效的骨质疏松症预测指标。联合检测血清CCL3和CCL4能够提高骨质疏松症预测的效能。此外,联合检测CCL3、CCL4和Album能获得更佳的预测效果。Objective This paper aims to investigate the relationship between the serum levels of CCL3 and CCL4 and the osteoporosis in elderly men and further evaluate their predictive efficacy.Methods A total of 286 elderly male patients admitted to the rehabilitation department of our hospital from January to August,2022 were divided into osteoporosis group and non-osteoporosis group,so as to compare the differences on general demographic data,glucose metabolism,lipid metabolism and bone metabolism.Spearman partial correlation was used to analyze the correlation between the serum levels of CCL3,serum CCL4 and the metabolic indicators.Logistic regression was used to analyze the relationship between serum levels of CCL3 and CCL4 and the osteoporosis,and ROC was applied to evaluate the predictive efficacy of single serum CCL3 or CCL4 test and their combined test for osteoporosis.Results Compared with the non-osteoporosis group,the osteoporosis group showed younger age,a higher proportion of high BMI values,lower albumin-corrected calcium,lower Album,higher CCL3,higher CCL4,and lower mean BMD,and the differences were statistically significant(P<0.05).After adjusting age and BMI,Spearman partial correlation analysis showed that the serum levels of CCL3 and CCL4 were still negatively correlated with the mean BMD(r=-0.446,r=-0.632,P<0.05).Multivariate logistic regression analysis showed that both CCL3 and CCL4 were risk factors for osteoporosis(P<0.01).Album was an protective factor for the occurrence of osteoporosis(P<0.05).According to ROC analysis,the AUC of CCL3,CCL4 and Album was 0.767,0.749 and 0.620,respectively,with the higher sensitivity for CCL3(85.86%) and the much higher specificity for CCL4(80.21%).The AUC of combined test of CCL3 and CCL4 was 0.817.The combination test of CCL3,CCL4 and Album achieved an AUC of 0.874,with a sensitivity of 90.91% and a specificity of 73.26%.Conclusion The serum levels of CCL3 and CCL4 are closely related to the occurrence of osteoporosis in elderly men,and both CCL3 and CCL4 are effe

关 键 词：趋化因子细胞因子配体3 CC基序配体4 骨质疏松 男性 预测 

分 类 号：R58[医药卫生—内分泌]