血清25(OH)D3、IGF-1联合骨密度对绝经后妇女骨质疏松发生的预测价值  

Predictive value of serum 25(OH)D3 and IGF-1 combined with bone mineral density in postmenopausal women with osteoporosis

作　　者：李艳[1] 刘亮[2] 张芸 黄瑞[1] 邵旭 Li Yan;Liu Liang;Zhang Yun;Huang Rui;Shao Xu(Gynaecology Department,Shanxi Children's Hospital,Shanxi Maternal and Child Health Hospital,Taiyuan 030013,China;Orthopedics Department,Shanxi Medical University Second Hospital,Taiyuan 030001,China)

机构地区：[1]山西省儿童医院、山西省妇幼保健院妇科,太原030013 [2]山西医科大学第二医院骨科,太原030001

出　　处：《中华内分泌外科杂志(中英文)》2025年第1期90-95,共6页Chinese Journal of Endocrine Surgery

基　　金：山西省科技厅基金资助项目(2022031305)。

摘　　要：目的:探讨血清25羟维生素D3[25(OH)D3]、胰岛素样生长因子-1(IGF-1)联合骨密度(BMD)对绝经后妇女骨质疏松症(OP)发生的预测价值。方法:选择2020年1月至2023年12月山西省儿童医院收治的87例绝经后妇女为研究对象,并分为OP组和非OP组,其中OP组40例,非OP组47例。比较两组临床特征、血清25(OH)D3、IGF-1及BMD的差异,并分析血清25(OH)D3、IGF-1与BMD(包括L 1~4 BMD、股骨颈BMD、全髋BMD)的相关性分析,采用多因素Logistic回归模型、受试者工作特征曲线(ROC)分析绝经后妇女OP发生的影响因素及血清25(OH)D3、IGF-1联合BMD对绝经后妇女OP发生的预测价值。结果:与非OP组相比,OP组年龄、身体质量指数(BMI)、绝经时间及血清钙、血清磷、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平无显著差异(t=1.42、1.03、1.71、0.93、0.76、0.43、0.04,P=0.161、0.306、0.092、0.354、0.452、0.670、0.966),合并糖尿病比例显著增高(χ^(2)=4.37,P=0.037)。与非OP组相比,OP组血清25(OH)D3、IGF-1水平及L 1~4 BMD、股骨颈BMD、全髋BMD值显著降低(t=5.37、4.83、8.31、2.01、3.11,P<0.001、P<0.001、P<0.001、P=0.048、P=0.003)。相关性分析显示,血清25(OH)D3、IGF-1与L 1~4 BMD、股骨颈BMD、全髋BMD存在显著正相关性(r=0.37、0.42、0.29、0.33、0.28、0.29,P<0.001、P<0.001、P=0.024、P=0.015、P=0.032、P=0.021);多因素Logistic分析显示,血清25(OH)D3、IGF-1、L 1~4 BMD是绝经后妇女OP发生的独立影响因素(P=0.007、0.019、0.001)。ROC曲线显示,血清25(OH)D3、IGF-1、L 1~4 BMD及三者联合预测绝经后妇女OP发生的曲线下面积(AUC)值分别为0.764、0.752、0.957、0.985。结论:血清25(OH)D3、IGF-1及L 1~4 BMD均可作为绝经后妇女OP发生的预测指标,且三者联合的预测价值更高。Objective:To investigate the predictive value of serum 25 hydroxyvitamin D3[25(OH)D3],insulin-like growth factor 1(IGF-1)and bone mineral density(BMD)in the occurrence of osteoporosis(OP)in postmenopausal women.Methods:A total of 87 postmenopausal women admitted to Shanxi Children’s Hospital from Jan.2020 to Dec.2023 were chosen and separated into OP group(n=40)and non-OP group(n=47).The differences of clinical features,serum 25(OH)D3,IGF-1 and BMD were compared,and the correlation analysis between serum 25(OH)D3,IGF-1 and BMD(including L 1-4 BMD,femoral neck BMD and total hip BMD)was analyzed.Multivariate Logistic regression model and receiver operating characteristic(ROC)curve were used to analyze the influencing factors of OP occurrence in postmenopausal women and the predictive value of serum 25(OH)D3 and IGF-1 combined with BMD for OP occurrence.Results:Compared with non-OP group,there were no significant differences in age,body mass index(BMI),menopause time,serum calcium,serum phosphorus,alanine aminotransferase(ALT),or aspartate aminotransferase(AST)levels in OP group(t=1.42,1.03,1.71,0.93,0.76,0.43,0.04;P=0.161,0.306,0.092,0.354,0.452,0.670,0.966),but the proportion of diabetes mellitus significantly increased(χ^(2)=4.37,P=0.037).Compared with non-OP group,the levels of serum 25(OH)D3 and IGF-1 and the values of L1-4 BMD,femoral neck BMD and total hip BMD in OP group significantly decreased(t=5.37,4.83,8.31,2.01,3.11;P<0.001,P<0.001,P<0.001,P=0.048,P=0.003).Correlation analysis showed that serum 25(OH)D3 and IGF-1 were significantly positively correlated with L 1-4 BMD,femoral neck BMD and total hip BMD(r=0.37,0.42,0.29,0.33,0.28,0.29;P<0.001,P<0.001,P=0.024,P=0.015,P=0.032,P=0.021).Multivariate Logistic analysis showed that serum 25(OH)D3,IGF-1 and L 1-4 BMD were independent influencing factors for OP occurrence in postmenopausal women(P=0.007,0.019,0.001)ROC curve showed that the area under the curve(AUC)values of serum 25(OH)D3,IGF-1,L 1-4 BMD and their combination in the prediction of the occurren

关 键 词：25羟维生素D3 胰岛素样生长因子-1 骨密度 绝经后妇女 骨质疏松 

分 类 号：R58[医药卫生—内分泌]