血清Apelin-13、脂肪酸结合蛋白4水平与绝经后骨质疏松症的相关性研究  

Correlations of serum Apelin-13 and fatty acid binding protein 4 levels with postmenopausal osteoporosis

作　　者：徐曼灵 朱静波 俞恺雯 陈玲[1] 樊华英[1] 范庆涛[1] 王秋萍[1] 鲁燕[1] XU Manling;ZHU Jingbo;YU Kaiwen;CHEN Ling;FAN Huaying;FAN Qingtao;WANG Qiuping;LU Yan(Department of Endocrinology,the First Hospital Affiliated to Soochow University,Suzhou,Jiangsu,215006)

机构地区：[1]苏州大学附属第一医院内分泌科,江苏苏州215006

出　　处：《实用临床医药杂志》2024年第11期73-78,83,共7页Journal of Clinical Medicine in Practice

基　　金：江苏省苏州市科技计划项目(SYS2020073);2023年度江苏省苏州市临床重点病种诊疗技术专项项目(LCZX202304)。

摘　　要：目的探讨血清Apelin-13、脂肪酸结合蛋白4(FABP4)水平与不同骨量绝经后女性代谢参数和骨代谢指标的相关性。方法选取145例绝经后女性作为研究对象,根据骨密度(BMD)检测结果分为骨量正常组49例、骨量减少(ON)组51例和骨质疏松(OP)组45例,测定并比较3组血清Apelin-13、FABP4水平和骨代谢指标、生化指标水平。采用Spearman相关分析法分析Apelin-13、FABP4等指标与BMD的相关性,采用多因素Logistic回归分析法分析OP的危险因素,绘制受试者工作特征(ROC)曲线分析血清Apelin-13对绝经后骨质疏松症(PMOP)的预测价值。结果OP组血清Apelin-13水平低于ON组、骨量正常组,差异有统计学意义(P<0.05);3组血清FABP4水平比较,差异无统计学意义(P>0.05);OP组血清甲状旁腺激素(PTH)、碱性磷酸酶(ALP)、Ⅰ型前胶原氨基端前肽(PⅠNP)、Ⅰ型胶原交联C端肽(CTXⅠ)、骨特异性碱性磷酸酶(BALP)水平高于ON组、骨量正常组,差异有统计学意义(P<0.05)。绝经后女性腰椎BMD与血清Apelin-13水平呈正相关(P<0.05),与血清FABP4水平无相关性(P>0.05);腰椎BMD与血清PTH、ALP、PⅠNP、CTXⅠ、BALP和年龄呈负相关(P<0.05),与体质量、体质量指数、T值、空腹胰岛素、胰岛素抵抗指数呈正相关(P<0.05)。多因素Logistic回归分析显示,血清Apelin-13、PTH、ALP、PⅠNP、CTXⅠ、BALP水平均为绝经后女性发生OP的独立影响因素(P<0.05)。ROC曲线结果显示,血清Apelin-13预测PMOP的最佳临界值为18.51 pg/mL,曲线下面积为0.716,敏感度为70.0%,特异度为64.4%。结论Apelin-13在PMOP患者血清中呈低表达,且其表达水平与腰椎BMD密切相关,或可作为PMOP的早期筛查指标和潜在治疗靶点。Objective To investigate the correlations of serum Apelin-13 and fatty acid binding protein 4(FABP4)levels with metabolic and bone metabolic indicators in postmenopausal women with different bone mass.Methods A total of 145 postmenopausal women were selected as subjects and divided into three groups based on bone mineral density(BMD)test results:normal bone mass group(49 cases),osteopenia(ON)group(51 cases),and osteoporosis(OP)group(45 cases).Serum Apelin-13,FABP4 levels,bone metabolic indicators,and biochemical indicators were measured and compared among the three groups.Spearman correlation analysis was used to analyze the correlations of Apelin-13,FABP4,and other indicators with BMD.Multivariate Logistic regression analysis was performed to analyze the risk factors for OP,and the receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum Apelin-13 for postmenopausal osteoporosis(PMOP).Results The serum Apelin-13 level in the OP group was lower than that in the ON group and the normal bone mass group(P<0.05).No significant difference in serum FABP4 levels was found among the three groups(P>0.05).The levels of serum parathyroid hormone(PTH),alkaline phosphatase(ALP),typeⅠprocollagen amino-terminal propeptide(PⅠNP),typeⅠcollagen cross-linked C-terminal peptide(CTXⅠ),and bone-specific alkaline phosphatase(BALP)in the OP group were higher than those in the ON group and the normal bone mass group(P<0.05).Lumbar post-menopause BMD was positively correlated with serum Apelin-13 levels(P<0.05),but had no correlation with serum FABP4 levels(P>0.05).Lumbar BMD was negatively correlated with serum PTH,ALP,PⅠNP,CTXⅠ,BALP,and age(P<0.05),but positively correlated with body weight,body mass index,T-score,fasting insulin,and insulin resistance index(P<0.05).Multivariate Logistic regression analysis showed that serum Apelin-13,PTH,ALP,PⅠNP,CTXⅠ,and BALP levels were independent factors influencing the occurrence of OP in postmenopausal women(P<0.05).ROC curve results showed

关 键 词：绝经后骨质疏松症 APELIN-13 脂肪酸结合蛋白4 Ⅰ型前胶原氨基端前肽 Ⅰ型胶原交联C端肽 骨特异性碱性磷酸酶 

分 类 号：R681[医药卫生—骨科学] R589.5[医药卫生—外科学] R446[医药卫生—临床医学]