血清雌激素铁调素t-PINP/β-CTX比值联合预测老年女性骨质疏松患者骨折风险的价值  

Value of Combined Serum Estrogen,Sideromodulin,and t-PINP/β-CTX Ratio for Prediction of Fracture Risk in Elderly Women with Osteoporosis

作　　者：吴旭磊 刘坤 王承良 刘丹 张白雪 胡珊 WU Xulei;LIU Kun;WANG Chengliang(Wuhan Steel General Hospital,Hubei Wuhan 430080,China)

机构地区：[1]湖北省华润武钢总医院,湖北武汉430080

出　　处：《河北医学》2024年第12期2078-2084,共7页Hebei Medicine

基　　金：湖北省自然科学基金资助项目,(编号:2020CDB1249)。

摘　　要：目的:探讨血清雌激素(E 2)、铁调素(Hepcidin)、总Ⅰ型胶原氨基端延长肽(t-PINP)/Ⅰ型胶原羧基端肽β特殊序列(β-CTX)比值联合预测老年女性骨质疏松(OP)患者骨折风险的价值。方法:选取2021年1月至2023年6月老年女性OP患者205例,根据随访1年期间是否发生骨折分为骨折组与未骨折组,两组均于患者入院当日清晨采集静脉血标本,采用化学发光法检测血清E 2、Hepcidin、血清t-PINP、β-CTX水平,比较两组基线资料、血清E 2、Hepcidin、t-PINP/β-CTX比值水平,分析血清E 2、Hepcidin、t-PINP/β-CTX对骨折风险的预测价值。结果:随访1年,失访4例,共201例患者完成随访,其中63例发生骨折,138例未发生骨折,骨折发生率为31.34%,将发生骨折与未发生骨折的患者分别纳入骨折组与未骨折组。骨折组年龄、绝经年限、脆性骨折史、雌激素使用史高于未骨折组,髋部、腰椎、Wald三角区骨密度低于未骨折组(P<0.05);骨折组血清E 2、Hepcidin、t-PINP/β-CTX比值分别为(25.65±4.63)pg/mL、(76.16±15.82)ng/mL、(126.50±15.25),低于未骨折组(32.71±5.09)pg/mL、(102.43±18.90)ng/mL、(152.68±20.10),t-PINP、β-CTX分别为(60.72±6.57)ng/mL、(0.48±0.10)ng/mL高于未骨折组(56.49±5.03)ng/mL、(0.37±0.08)ng/mL(t=9.378、9.600、5.007、8.342、9.196,P均<0.001);血清E 2、Hepcidin、t-PINP/β-CTX比值与髋部、腰椎、Wald三角区骨密度呈正相关(r=0.622、0.641、0.658、0.609、0.617、0.634、0.710、0.729、0.746,P均<0.001);在控制年龄、绝经年限、脆性骨折史、雌激素使用史等其他因素前后,血清E 2、Hepcidin、t-PINP/β-CTX比值仍是老年女性OP患者骨折的独立影响因素(P<0.05);血清E 2、Hepcidin、t-PINP/β-CTX比值预测老年女性OP患者骨折的AUC分别为0.810、0.789、0.760,最佳截断值分别为27.77pg/mL、88.49ng/mL、142.52,敏感度分别为68.25%、76.19%、73.02%,特异度分别为76.81%、74.64%、74.64%;三者联合预测老年女性OP患者�Objective:To investigate the combined value of serum estrogen(E 2),ferriregulation(Hepcidin)and the ratio of total type I collagen amino terminal prolongating peptide(t-PINP)/Type I collagen carboxy-terminal peptideβspecial sequence(β-CTX)in predicting fracture risk in elderly women with osteoporosis(OP).Methods:A total of 205 elderly female OP patients from January 2021 to June 2023 were selected and divided into fracture group and non-fracture group according to whether they had fractures during the 1-year follow-up period.Venous blood samples were collected from both groups on the admission morning of the patient.The levels of serum E 2,Hepcidin,serum t-PINP,andβ-CTX were detected using chemiluminescence.Baseline data,serum E 2,Hepcidin,and t-PINP/β-CTX ratio levels were compared between the two groups.The predictive value of serum E 2,Hepcidin,and t-PINP/β-CTX for fracture risk was analyzed.Results:After a year of follow-up,the contact of 4 patients were lost,and a total of 201 patients completed the follow-up.Among them,63 cases had fractures and 138 cases had no fractures,with a fracture incidence at 31.34%.Patients with and without fractures were included in the fracture group and non-fracture group,respectively.The age,menopausal years,history of fragility fractures,and history of estrogen use in the fracture group were higher than those in the non-fracture group,while the bone mineral density of the hip,lumbar spine,and Wald triangle area was lower than that in the non-fracture group(P<0.05).The serum E 2,Hepcidin,and t-PINP/β-CTX ratios in the fracture group were(25.65±4.63)pg/mL,(76.16±15.82)ng/mL,and(126.50±15.25),respectively,which were lower than those in the non-fracture group(32.71±5.09)pg/mL,(102.43±18.90)ng/mL,and(152.68±20.10).The t-PINP andβ-CTX were(60.72±6.57)ng/mL and(0.48±0.10)ng/mL,respectively,which were higher than those in the non-fracture group(56.49±5.03)ng/mL and(0.37±0.08)ng/mL(t=9.378,9.600,5.007,8.342,9.196,all P<0.001).Serum E 2,Hepcidin,and t-PINP/β-CTX ratio

关 键 词：老年女性 骨质疏松 雌激素 铁调素 总Ⅰ型胶原氨基端延长肽 Ⅰ型胶原羧基端肽β特殊序列 骨折风险 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]