血清BALP、BGP、β-CTx联合FRAX预测绝经后骨质疏松症患者髋部骨折风险的价值  

Value of serum BALP,BGP,β-CTx combined with FRAX in predicting the risk of hip fracture in patients with postmenopausal osteoporosis

作　　者：石晓琦 王东岩[1] SHI Xiaoqi;WANG Dongyan(Department of Osteoporosis,Lianyungang First People′s Hospital,Lianyungang,Jiangsu 222000,China)

机构地区：[1]江苏省连云港市第一人民医院骨质疏松科,江苏连云港222000

出　　处：《检验医学与临床》2024年第10期1478-1483,共6页Laboratory Medicine and Clinic

摘　　要：目的探讨血清骨碱性磷酸酶(BALP)、骨钙素(BGP)、β-Ⅰ型胶原羧基端肽(β-CTx)联合骨折风险评估工具(FRAX)预测绝经后骨质疏松症髋部骨折风险的价值。方法选取2020年1月至2022年12月该院收治的绝经后骨质疏松症患者132例纳入骨质疏松组,另选择同期在该院诊断为骨量下降的123例和骨量正常的120例绝经后女性分别纳入骨量下降组和对照组。比较各组血清BALP、BGP、β-CTx水平及FRAX检测的髋部骨折风险。对绝经后骨质疏松症患者进行4~36个月的随访,根据骨质疏松症患者髋部是否骨折将其分为骨折组和未骨折组。采用多因素Logistic回归分析绝经后骨质疏松症患者髋部骨折的影响因素,绘制受试者工作特征(ROC)曲线分析血清BALP、BGP、β-CTx与FRAX单独及联合对绝经后骨质疏松症患者髋部骨折的预测价值。结果骨质疏松组血清BALP、BGP、β-CTx水平和FRAX检测的髋部骨折风险均高于骨量下降组和对照组,差异有统计学意义(P<0.05),骨量下降组血清BALP、BGP、β-CTx水平和FRAX检测的髋部骨折风险均高于对照组,差异有统计学意义(P<0.05)。132例绝经后骨质疏松症患者随访过程中,共有44例发生髋部骨折,发生率为33.33%。骨折组BALP、BGP、β-CTx水平和FRAX检测的髋部骨折风险均高于未骨折组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,父母有髋部骨折史,有脆性骨折史、长期糖皮质激素治疗史、类风湿关节炎史,无规律补钙、缺乏阳光照射及血清BALP、BGP、β-CTx水平升高均是绝经后骨质疏松症患者髋部骨折的危险因素(P<0.05),骨密度(BMD)升高、体育锻炼则是绝经后骨质疏松症患者髋部骨折的保护因素(P<0.05)。ROC曲线分析结果显示,血清BALP、BGP、β-CTx联合FRAX预测绝经后骨质疏松症患者髋部骨折的灵敏度、曲线下面积(AUC)分别为95.45%、0.954,均高于单独预测(P<0.05)。结论血清BALP、Objective To investigate the value of serum bone alkaline phosphatase(BALP),osteocalcin(BGP),β-Ⅰtype collagen carboxy terminal peptide(β-CTx)combined with fracture risk assessment tool(FRAX)in predicting hip fracture risk of postmenopausal osteoporosis.Methods A total of 132 patients with postmenopausal osteoporosis admitted to Lianyungang First People′s Hospital from January 2020 to December 2022 were selected as the osteoporosis group.In addition,123 postmenopausal women with bone loss and 120 postmenopausal women with normal bone mass diagnosed in this hospital during the same period were selected as the bone loss group and the control group respectively.The levels of serum BALP,BGP,β-CTx and hip fracture probability detected by FRAX were compared among the three groups.The patients with postmenopausal osteoporosis were followed up for 4 to 36 months and divided into fracture group and non-fracture group according to whether they had hip fracture.Multivariate logistic regression analysis was used to analyze the influencing factors of hip fracture in postmenopausal osteoporosis patients,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum BALP,BGP,β-CTx and FRAX along and in combination for hip fracture in postmenopausal osteoporosis patients.Results The levels of serum BALP,BGP,β-CTx and hip fracture probability detected by FRAX in the osteoporosis group were higher than those in the osteopenia group and the control group,the differences were statistically significant(P<0.05).The levels of serum BALP,BGP,β-CTx and hip fracture probability detected by FRAX in the osteopenia group were higher than those in the control group,the differences were statistically significant(P<0.05).During the follow-up of 132 patients with postmenopausal osteoporosis,44 cases had hip fractures,with an incidence rate of 33.33%.The levels of BALP,BGP,β-CTx and hip fracture probability detected by FRAX in the fracture group were significantly higher than those in the non-frac

关 键 词：骨碱性磷酸酶 β-Ⅰ型胶原羧基端肽 骨钙素 骨折风险评估工具 绝经 骨质疏松症 髋部骨折 

分 类 号：R446.1[医药卫生—诊断学] R683.2[医药卫生—临床医学]