血清Irisin、SOST、H_(2)S与膝骨关节炎合并骨质疏松症患者骨密度、骨代谢标志物的相关性及其预测价值  

Correlation and Predictive Value of Serum Irisin,SOST and H_(2)S with Bone Density and Bone Metabolism Markers in Patients with Knee Osteoarthritis Combined with Osteoporosis

作　　者：孙鹏[1] 张国华[1] 陈超斌 刘彬[1] 陈美 周一林 丁凡[1] SUN Peng;ZHANG Guo-hua;CHEN Chao-bin;LIU Bin;CHEN Mei;ZHOU Yi-lin;DING Fan(Department of Orthopaedics,Puren Hospital affiliated to Wuhan University of Science and Technology/Wuhan Puren Hospital,Wuhan,Hubei,430081,China)

机构地区：[1]武汉科技大学附属普仁医院/武汉市普仁医院骨科,湖北武汉430081

出　　处：《现代生物医学进展》2024年第10期1980-1984,共5页Progress in Modern Biomedicine

基　　金：湖北省卫生健康委员会联合基金项目(WJ2019H430);武汉市医学科研项目(WX19B07)。

摘　　要：目的:探讨血清鸢尾素(Irisin)、骨硬化蛋白(SOST)、硫化氢(H_(2)S)与膝骨关节炎(KOA)合并骨质疏松症(OP)患者骨密度、骨代谢标志物的相关性,分析Irisin、SOST、H_(2)S预测KOA合并OP的价值。方法:选取2020年4月至2023年4月我院收治的179例KOA患者,根据是否合并OP将其分为OP组(68例)和非OP组(111例)。检测血清Irisin、SOST、H_(2)S和骨代谢标志物骨钙素(OC)、骨碱性磷酸酶(BALP)、Ⅰ型原胶原N-端前肽(PINP)、抗酒石酸酸性磷酸酶异体(TRACP5b)水平,股骨颈、腰椎L1~4骨密度。Pearson分析血清Irisin、SOST、H_(2)S与股骨颈、腰椎L1~4骨密度和血清骨代谢标志物的相关性,受试者工作特征(ROC)曲线分析血清Irisin、SOST、H_(2)S对KOA合并OP的预测价值。结果:OP组血清Irisin、H_(2)S、OC、BALP、PINP水平,股骨颈、腰椎L1~4骨密度低于非OP组(P<0.05),TRACP、SOST水平高于非OP组(P<0.05)。OP组血清Irisin、H_(2)S水平与股骨颈、腰椎L1~4骨密度,血清OC、BALP、PINP水平呈正相关(P<0.05),与血清TRACP水平呈负相关(P<0.05);SOST水平与股骨颈、腰椎L1~4骨密度,血清OC、BALP、PINP水平呈负相关(P<0.05),与血清TRACP水平呈正相关(P<0.05)。Irisin、SOST、H_(2)S预测KOA合并OP的曲线下面积为0.784、0.773、0.755,联合预测KOA合并OP的曲线下面积为0.908,高于单独预测。结论:KOA合并OP患者血清Irisin、H_(2)S水平降低、SOST水平增高,低水平Irisin、H_(2)S和高水平SOST与骨密度降低、骨代谢异常有关,可用于预测KOA合并OP患者骨代谢异常状态和骨质流失风险。Objective:To investigate the correlation between serum irisin(Irisin),sclerostin(SOST),hydrogen sulfide(H_(2)S)and bone density and bone metabolism markers in patients with knee osteoarthritis(KOA)combined with osteoporosis(OP),and to analyze the predictive value of Irisin,SOST,and H_(2)S for KOA complicated with OP.Methods:179 KOA patients who were admitted to our hospital from April 2020 to April 2023 were selected,and patients were divided into OP group(68 cases)and non-OP group(111 cases)according to whether they were combine with OP.The levels of serum Irisin,SOST,H_(2)S and bone metabolism markers osteocalcin(OC)bone alkaline phosphatase(BALP),type I procollagen N-terminal propeptide(PINP),tartrate-resistant acid phosphatase allogenic(TRACP5b),bone density of femoral neck and lumbar spine L1~4 were detected.The correlation between serum Irisin,SOST,H_(2)S and bone density of femoral neck and lumbar spine L1~4 and serum bone metabolic markers were analyzed by Pearson,the predictive value of serum Irisin,SOST and H_(2)S for KOA combine with OP were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of serum Irisin,H_(2)S,OC,BALP and PINP,bone density of femoral neck and lumbar spine L1~4 in OP group were lower than those in non-OP group(P<0.05),while the levels of TRACP and SOST were higher than those in non-OP group(P<0.05).Serum Irisin and H_(2)S levels in OP group were positively correlated with bone density of femoral neck and lumbar spine L1~4,serum OC,BALP and PINP levels(P<0.05),and negatively correlated with serum TRACP level(P<0.05).SOST level was negatively correlated with bone density of femoral neck and lumbar spine L1~4,serum OC,BALP and PINP levels(P<0.05),and positively correlated with serum TRACP level(P<0.05).The area under the curve of Irisin,SOST and H_(2)S in predicting KOA combined with OP was 0.784,0.773 and 0.755respectively,the area under the curve of combined prediction of KOA combine with OP was 0.908,which was higher than that of single prediction.Conclusion:

关 键 词：膝骨关节炎 骨质疏松症 Irisin SOST H_(2)S 骨密度 骨代谢 相关性 预测价值 

分 类 号：R684.3[医药卫生—骨科学]