血尿酸/肌酐比值、OSTA对西藏地区藏族中老年人群骨质疏松预测价值研究  

Value of Blood Uric Acid/Creatinine Ratio and Osteoporosis Self-Assessment Tool for Asians for Predicting Osteoporosis in Middle-Aged,Older,and Elderly Adult Tibetan Populations in Xizang

作　　者：丁康致 王鹏 张静 张玉飞[1] 熊海 DING Kangzhi;WANG Peng;ZHANG Jing;ZHANG Yufei;XIONG Hai(School of Medicine,Tibet University,Lhasa 850000,China;West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]西藏大学医学院,拉萨850000 [2]四川大学华西公共卫生学院/四川大学华西第四医院检验科,成都610041

出　　处：《四川大学学报(医学版)》2025年第1期247-253,共7页Journal of Sichuan University(Medical Sciences)

基　　金：中央支持地方高校改革发展专项资金(No.00060585、No.00060695/051);西藏大学研究生高水平人才培养项目(No.2022-GSP-S110)资助。

摘　　要：目的探讨血尿酸/肌酐比值(serum uric acid/creatinine,SUA/Cr)、亚洲人骨质疏松自我筛查工具(osteoporosis self-assessment tool for Asians,OSTA)对西藏地区藏族中老年居民骨质疏松症(osteoporosis,OP)的预测价值。方法收集2020年6月–2023年12月在西藏地区进行体格检测的藏族中老年居民共1058人作为调查对象,采集其空腹静脉血进行实验室检查,采用双能X线吸收法测量居民桡骨骨密度(bone mineral density,BMD),根据BMD测量结果及OP诊断标准将调查对象分为OP组(n=759)和非OP组(n=299)。采用多因素logistic逐步回归分析进一步遴选与藏族中老年人群OP患病风险相关的独立预测因子。使用受试者工作特征(receiver operating characteristic,ROC)曲线评估SUA/Cr、OSTA对OP的预测价值。结果①本研究藏族中老年居民OP患病率28.3%(299人),其中女性209人(69.9%)、男性90人(30.1%),两组年龄〔OP组:62(54,69)岁vs.非OP组:56(51,62)岁〕、SUA/Cr〔OP组:6.86(5.06,10.23)vs.非OP组:5.36(4.36,6.52)〕、OSTA(OP组:-1.27±3.06 vs.非OP组:1.25±2.68)组间比较差异有统计学意义(P<0.05);②SUA/Cr〔比值比(odds ratio,OR):1.592,95%置信区间(confidence interval,CI):1.469~1.726〕是OP发生的危险因素,OSTA(OR:0.706,95%CI:0.662~0.752)是OP发生的保护因素(P<0.05);③性别分组下,SUA/Cr+OSTA联合诊断OP效能较好,男性和女性曲线下面积分别为0.807(95%CI:0.751~0.863),0.820(95%CI:0.782~0.857);年龄分组下,SUA/Cr+OSTA联合诊断OP效能最好,最佳截断值随着年龄增加而升高。④男性中年组和年轻老年组中,SUA/Cr+OSTA联合诊断优于SUA/Cr、OSTA单独检测(P<0.001),男性年老老年组SUA/Cr的曲线下面积为0.954(95%CI:0.858~1.000),灵敏度88.9%,特异度100.0%,预测效果较好;女性不同年龄段OSTA和SUA/Cr+OSTA的诊断效能随年龄增加而增加。结论SUA/Cr、OSTA对西藏地区不同性别、年龄段人群OP预测效果不同,SUA/Cr、OSTA均可用于西藏地区藏族中老年居民OP预Objective To explore the predictive value of the blood uric acid/creatinine ratio(SUA/Cr)and the Osteoporosis Self-Assessment Tool for Asians(OSTA)for osteoporosis(OP)in middle-aged,older,and elderly adult Tibetan populations in Xizang.Methods A total of 1058 middle-aged and older adult ethnic Tibetans who underwent physical examination in Xizang between June 2020 and December 2023 were selected for the study.Fasting venous blood samples were collected for laboratory analysis.The bone mineral density(BMD)of the radius of the participants was measured using dual-energy X-ray absorptiometry.Based on the BMD measurement results and OP diagnostic criteria,participants were divided into the OP group(n=759)and the non-OP group(n=299).Multivariate logistic stepwise regression analysis was used to further identify independent predictors associated with OP risk in the middle-aged and older adult Tibetan population.The predictive value of SUA/Cr and OSTA for OP was evaluated using the receiver operating characteristic(ROC)curve.Results 1)The OP prevalence among the middle-aged and older adult Tibetan populations was 28.3%(299 people),including 209 females(69.9%)and 90 males(30.1%).Significant differences between the two groups were found in terms of age(OP group:62[54,69]vs non-OP group:56[51,62]),SUA/Cr(OP group:6.86[5.06,10.23]vs non-OP group:5.36[4.36,6.52]),and OSTA(OP group:[-1.27±3.06]vs non-OP group:[1.25±2.68])(P<0.05).2)SUA/Cr(OR:1.592,95%CI:1.469-1.726)was identified as a risk factor for OP,while OSTA(OR:0.706,95%CI:0.662-0.752)was a protective factor for OP(P<0.05).3)For gender-based group analysis,the combined use of SUA/Cr and OSTA showed better diagnostic performance for OP,with AUCs of 0.807(95%CI:0.751-0.863)for males and 0.820(95%CI:0.782-0.857)for females.For age-based group analysis,the combined diagnosis of OP using SUA/Cr and OSTA provided the best performance,with the optimal cutoff value increasing with age.4)In the middle-aged group and the older adult male group,the combined use of SUA/Cr and OST

关 键 词：中老年居民 骨质疏松症 尿酸/肌酐比值 OSTA 预测价值 

分 类 号：R580[医药卫生—内分泌]