血清中FGF-23和MCP-1水平与儿童糖皮质激素性骨质疏松病的相关性分析  

Correlation analysis of serum FGF-23 and MCP-1 levels with the incidence of glucocorticoid osteoporosis in children

作　　者：侍海棠[1] 杨婷婷[1] 李月[2] 王平[2] 殷其改[1] Shi Haitang;Yang Tingting;Li Yue;Wang Ping;Yin Qigai(Department of Neonatology,the First People’s Hospital of Lianyungang,Lianyungang 222000,China;Department of Pediatric Internal Medicine,the First People’s Hospital of Lianyungang,Lianyungang 222000,China)

机构地区：[1]连云港市第一人民医院新生儿科,连云港222000 [2]连云港市第一人民医院儿内科,连云港222000

出　　处：《中华内分泌外科杂志》2023年第5期578-581,共4页Chinese Journal of Endocrine Surgery

基　　金：江苏省自然科学基金(BK20191211)。

摘　　要：目的探讨成纤维细胞生长因子23(fibroblast growth factor-23,FGF-23)和单核细胞趋化蛋白1(monocyte chemoattractant protein-1,MCP-1)水平与儿童糖皮质激素性骨质疏松(glucocorticoids-induced osteoporosis,GIOP)病的相关性。方法选择2018年5月至2022年5月连云港市第一人民医院收治的80例GIOP儿童患者作为研究对象,同期收集62例接受糖皮质激素治疗但骨量正常的患儿作为对照。收集一般资料并进行骨密度检测和骨代谢检测,包括I型胶原羧基末端肽(type 1 collagen carboxy-terminal peptide,CTX-1)、I型胶原氨基前端肽(type I procollagen amino-terminal peptide,PINP)和骨钙素(osteocalcin,OC)。检测两组血清中的MCP-1和FGF-23水平,采用Logistic回归模型分析进行单因素和多因素分析,探讨影响GIOP的危险因素。结果两组患者一般资料差异无统计学意义(均P>0.05)。GIOP患儿血清中FGF-23(264.81±24.61)和MCP-1(194.16±15.76)明显高于对照组(207.97±9.91;179.00±18.34)(t=17.13,P<0.001;t=5.29,P<0.001);与对照组(0.88±1.08;23.98±2.45;8.36±3.71;4.56±2.21)比较,患病组骨密度(0.44±0.29)、PINP(16.29±3.97)和OC(6.74±3.22)水平降低,CTX-1水平(6.62±1.11)增强(t=3.58,P<0.05;t=13.40,P<0.05;t=2.78,P<0.05;t=7.25,P<0.05)。多因素Logistic回归模型显示FGF-23(OR=1.161,95%CI:1.080~1.341,P<0.05)、MCP-1(OR=1.179,95%CI:1.044~1.448,P<0.05)、CTX-1(OR=3.018,95%CI:1.526~10.510,P<0.05),是影响儿童GIOP的独立临床危险因素(均P<0.05)。PINP(OR=0.453,95%CI:0.169~0.740,P<0.05)是影响儿童GIOP的保护因素。结论FGF-23和MCP-1是影响儿童GIOP发病的独立危险因素。Objective To investigate the correlation between levels of fibroblast growth factor-23(FGF-23)and monocyte chemoattractant protein-1(MCP-1)and glucocorticoids-induced osteoporosis(GIOP)in children.Methods From May.2018 to May.2022,80 children with glucocorticoid osteoporosis admitted to our hospital were selected as the study subjects,and the control group was 62 children who received glucocorticoid therapy but had normal bone mass.General data were collected and bone density and bone metabolism were measured,including type 1 collagen carboxy-terminal peptide(CTX-1),type 1 procollagen amino-terminal peptide(PINP),and osteocalcin(OC).The levels of MCP-1and FGF-23 in the serum of the two groups were detected,and univariate and multivariate analysis was performed using prism software to analyze the risk factors affecting GIOP.Results There was no significant difference in general data between the two groups(both P>0.05).The levels of FGF-23(264.81±24.61)and MCP-1(194.16±15.76)in serum of GIOP children were significantly higher than those in the control group(207.97±9.91;179.00±18.34)(t=17.13,P<0.001;t=5.29,P<0.001);Compared with those of the control group(0.88±1.08;23.98±2.45;8.36±3.71;4.56±2.21),bone mineral density(0.44±0.29),PINP(16.29±3.97)and OC(6.74±3.22)levels were decreased,and CTX-1 level was increased(6.62±1.11)(t=3.58,P<0.05;t=13.40,P<0.05;t=2.78,P<0.05;t=7.25,P<0.05)of the study group.Multivariate Logistic regression model showed that FGF-23(OR=1.161,95%CI:1.080-1.341,P<0.05),MCP-1(OR=1.179,95%CI:1.044-1.448,P<0.05)and CTX-1(OR=3.018,95%CI:1.526-10.510,P<0.05)were independent clinical risk factors for GIOP in children(all P<0.05).PINP(OR=0.453,95%CI:0.169-0.740,P<0.05)was a protective factor affecting GIOP in children.Conclusion FGF-23 and MCP-1 were independent risk factors for GIOP in children.

关 键 词：糖皮质激素性骨质疏松 单核细胞趋化蛋白 成纤维细胞生长因子 

分 类 号：R725.8[医药卫生—儿科]