老年骨质疏松患者SDC4、TNC表达水平与骨代谢标志物、骨折的关系  

Relationship Between SDC4 and TNC Expression Levels and Bone Metabolic Markers and Fractures in Elderly Osteoporotic Patients

作　　者：向奎 XIANG Kui(Department of Orthopedics,Anyang No.3 People's Hospital,Anyang Henan 455000,China)

机构地区：[1]安阳市第三人民医院骨科,河南安阳455000

出　　处：《临床研究》2025年第1期79-83,共5页Clinical Research

摘　　要：目的探究老年骨质疏松性患者血清多配体蛋白聚糖-4(SDC4)、肌腱蛋白C(TNC)表达水平与骨代谢标志物、骨折的关系。方法选取2021年3月至2023年3月于安阳市第三人民医院就诊的80例老年骨质疏松性患者为研究对象作为观察组,另选同一个时间段本院实施健康体检的72例老年人为此次试验的正常对照组,依据所纳入的老年骨质疏松患者有无骨折分为骨折组(n=32)和非骨折组(n=48)。收集全部研究对象的一般资料,检测血清SDC4、TNC表达水平与I型前胶原氨基端原肽(PINP)、I型胶原C末端肽(CTX)、骨钙素(BGP)等骨代谢标志物水平,采用Pearson分析血清SDC4、TNC表达水平与骨代谢标志物的相关性,采用Logistic回归分析血清SDC4、TNC表达水平与骨折之间的关系。结果观察组的SDC4、TNC、CTX水平均高于对照组,差异有统计学意义(P<0.05),而PINP、BGP水平明显低于对照组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,血清SDC4、TNC表达水平与PINP、BGP呈负相关(P<0.05),血清SDC4、TNC表达水平与CTX呈正相关(P<0.05)。骨折组的血清SDC4、TNC表达水平明显高于非骨折组,差异有统计学意义(P<0.05)。多因素Logistic回归结果显示,血清SDC4(OR:1.475;95%CI:1.179~1.845)、TNC(OR:1.544;95%CI:1.143~2.086)表达水平均是老年骨质疏松性患者发生骨折的危险因素(P<0.05),血清SDC4、TNC表达水平越高的老年骨质疏松性患者骨折的发生风险越大。由受试者工作曲线(ROC)曲线分析可得,血清SDC4、TNC表达水平预测老年骨质疏松性患者发生骨折的曲线下面积(AUC)分别为0.856、0.830,灵敏度分别为84.42%、78.18%,特异度分别为79.23%、75.06%;两个指标联合预测的AUC为0.959,灵敏度为96.90%,特异度为85.45%。结论老年骨质疏松病人血清里面的SDC4、TNC表达水平均升高,其在老年骨质疏松病人骨折预测方面存在一定的价值。Objective To explore the relationship between serum syndecan-4(SDC4)and tenascin-C(TNC)expression levels with bone metabolic markers and fractures in elderly osteoporotic patients.Methods Eighty elderly patients with osteoporosis who visited Anyang No.3 People's Hospital from March 2021 to March 2023 were selected as the observation group.Additionally,72 elderly individuals who underwent health check-ups during the same period were selected as the normal control group.Based on the presence or absence of fractures,the osteoporosis patients were further divided into a fracture group(n=32)and a non-fracture group(n=48).General data of all participants were collected,and serum levels of SDC4,TNC,Procollagen I N-Terminal Propeptide(PINP),C-terminal telopeptide of type I collagen(CTX),and Osteocalcin Bone Gama-Gla Protein(BGP)were measured.Pearson correlation analysis was used to evaluate the correlation between serum SDC4 and TNC expression levels and bone metabolic markers.Logistic regression analysis was performed to examine the relationship between serum SDC4 and TNC levels and fractures.Results The levels of SDC4,TNC,and CTX in the observation group were significantly higher than those in the control group(P<0.05),while the levels of PINP and BGP were significantly lower(P<0.05).Pearson correlation analysis indicated that serum SDC4 and TNC expression levels were negatively correlated with PINP and BGP(P<0.05),and positively correlated with CTX(P<0.05).The serum SDC4 and TNC levels in the fracture group were significantly higher than those in the non-fracture group(P<0.05).Multivariate logistic regression analysis showed that serum SDC4(OR:1.475;95%CI:1.179~1.845)and TNC(OR:1.544;95%CI:1.143~2.086)levels were risk factors for fractures in elderly osteoporotic patients(P<0.05).Higher serum levels of SDC4 and TNC were associated with an increased risk of fractures.Receiver operating characteristic(ROC)curve analysis revealed that the area under the curve(AUC)for predicting fractures in elderly osteoporotic patients

关 键 词：老年骨质疏松 SDC4 TNC 骨代谢标志物 骨折 

分 类 号：R687.3[医药卫生—骨科学]