围绝经期妇女性激素水平与骨质疏松症相关性的ROC曲线分析  

ROC curve analysis of the correlation between sex hormone levels and osteoporosis in perimenopausal women

作　　者：幸程涛 黄嘉年 光波[2] 钱锟 Xing Chengtao;Huang Jianian;Guang Bo;Qian Kun(Wulian Community Health Center,The Chinese University of Hong Kong(Shenzhen)Hospital No.2,Shenzhen,Guangdong Province,518000,China;Department of Orthopedics and Traumatology,Tongling Hospital of Traditional Chinese Medicine,Anhui University of Traditional Chinese Medicine,Tongling City,Anhui Province,244000,China;Department of Orthopedics,Pengze County People's Hospital,Jiujiang City,Jiangxi Province,332701,China)

机构地区：[1]香港中文大学(深圳)附属第二医院五联社康中心,广东深圳518000 [2]安徽中医药大学附属铜陵市中医医院骨伤科,安徽铜陵244000 [3]江西省彭泽县人民医院骨科,江西九江332701

出　　处：《青岛医药卫生》2024年第6期424-427,共4页Qingdao Medical Journal

基　　金：深圳市龙岗区医疗卫生科技计划项目(LGWJ2022-36)。

摘　　要：目的探讨围绝经期妇女性激素水平与骨质疏松症的相关性分析及预测价值研究。方法选取2023年2月至2024年8月来我院就诊的70例围绝经期骨质疏松症妇女作为研究组对象,另选取同时间段来我院体检的70例围绝经期健康妇女作为对照组对象。比较两组妇女性激素[雌二醇(E2)、促卵泡生成素(FSH)、黄体生成素(LH)]、骨代谢指标[I型前胶原N端前肽(PINP)、N端骨钙素(N-MID)、β-胶原降解产物(β-CTX)]以及骨密度(BMD)水平。分析性激素水平与骨质疏松症的相关性。绘制受试者工作特征曲线,评估性激素水平对骨质疏松症的预测效能。结果与对照组相比,研究组妇女血清E2、腰椎BMD、股骨颈BMD及髋部BMD水平降低,FSH、PINP、N-MID、β-CTX水平升高。血清E2与PINP、N-MID、β-CTX水平呈负相关(r=-0.341、-0.470、-0.538,均P<0.001),与腰椎BMD、股骨颈BMD、髋部BMD水平呈正相关(r=0.579、0.527、0.522,均P<0.001)。血清FSH与PINP、N-MID、β-CTX水平呈正相关(r=0.361、0.368、0.522,均P<0.001),与腰椎BMD、股骨颈BMD、髋部BMD水平呈负相关(r=-0.536、-0.552、-0.541,均P<0.001)。血清E2、FSH及其联合预测围绝经期妇女骨质疏松症的AUC分别为0.890、0.894、0.960,95%CI分别为0.826~0.936、0.831~0.940、0.912~0.986,灵敏度分别为84.29%、80.00%、91.43%,特异度分别为78.57%、82.86%、92.86%。结论围绝经期妇女性E2、FSH水平与骨质疏松症的发生密切相关,两者联合预测骨质疏松症的效能较高,具有较好的临床应用价值。Objective To explore the correlation analysis and predictive value of perimenopausal women's sex hormone level and osteoporosis.Methods Seventy cases of perimenopausal women with osteoporosis who came to our hospital from February 2023 to August 2024 were selected as the study group,and 70 cases of perimenopausal healthy women who came to our hospital for physical examination in the same time period were selected as the control group.Sex hormones[estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)],bone metabo lism indexes[N-terminal pro-peptide of pre-collagen type I(PINP),N-terminal osteocalcin(N-MID),andβ-collagen degradation products(β-CTX)],and bone mineral density(BMD)levels were compared between the two groups.The correlation between sex hormone levels and osteo-porosis was analyzed.Working characteristic curves of the subjects were plotted to assess the predictive efficacy of sex hormone levels for osteoporosis.Results Compared with the control group,the study group had lower levels of serum E2,lumbar spine BMD,femoral neck BMD,and hip BMD,and higher levels of FSH,PINP,N-MID,andβ-CTX.Serum E2 was negatively correlated with the levels of PINP,N-MID,andβ-CTX(r=-0.341,-0.470,and-0.538,all P<0.001),and positively correlated with the levels of lumbar BMD,femoral neck BMD,and hip BMD(r=0.579,0.527,and 0.522,all P<0.001).Serum FSH was positively correlated with the levels of PINP,N-MID,andβ-CTX(r=0.361,0.368,0.522,all P<0.001),and neg-atively correlated with the levels of lumbar BMD,femoral neck BMD,and hip BMD(r=-0.536,-0.552,and-0.541,all P<0.001).The AUCs of serum E2,FSH and their combi-nation for predicting osteoporosis in perimenopausal women were 0.890,0.894,and 0.960,with 95%CIs of 0.826~0.936,0.831~0.940,and 0.912~0.986,respectively,with sensitivities of 84.29%,80.00%,and 91.43%,and specificities of 78.57%,82.86%,and 92.86%,respective-ly.Conclusion Sexual E2 and FSH levels in perimenopausal women are closely related to the oc-currence of osteoporosis,and the combination of the tw

关 键 词：围绝经期 性激素 骨质疏松症 相关性 预测价值 

分 类 号：R580[医药卫生—内分泌]