血清FOXO3、Irisin对激素性骨质疏松患者骨折的预测价值  

Predictive value of serum FOXO3 and Irisin for fractures in patients with hormone-induced osteoporosis

作　　者：崔晓亮 敦志华 张辰 刘涛 CUI Xiaoliang;DUN Zhihua;ZHANG Chen;LIU Tao(The First Department of Orthopedics,the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Dingzhou,Hebei 073000,China;Department of Endocrinology,the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Dingzhou,Hebei 073000,China;The Second Department of Orthopedics,the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Dingzhou,Hebei 073000,China)

机构地区：[1]河北中医药大学第二附属医院骨伤一科,河北定州073000 [2]河北中医药大学第二附属医院内分泌科,河北定州073000 [3]河北中医药大学第二附属医院骨伤二科,河北定州073000

出　　处：《检验医学与临床》2025年第7期880-884,共5页Laboratory Medicine and Clinic

基　　金：河北省中医药管理局2022年度中医药类科研计划课题(2022406)。

摘　　要：目的探讨血清叉头框蛋白O3(FOXO3)、鸢尾素(Irisin)对激素性骨质疏松患者骨折的预测价值。方法选取2023年1月至2024年3月该院收治的153例激素性骨质疏松症患者为研究组,另纳入同期169例体检健康者为对照组。采用酶联免疫吸附试验(ELISA)检测血清FOXO3、Irisin水平。采用多因素Logistic回归分析骨质疏松患者骨折的影响因素。采用受试者工作特征(ROC)曲线分析血清FOXO3、Irisin水平对骨质疏松患者骨折的预测价值。结果与对照组比较,研究组髋关节骨密度、腰椎骨密度、股骨颈骨密度、大转子骨密度降低,血清FOXO3水平升高,血钙、维生素D、碱性磷酸酶、Irisin水平均降低,差异均有统计学意义(P<0.05)。与非骨折组比较,骨折组血清FOXO3水平升高,髋关节骨密度、股骨颈骨密度、大转子骨密度及血钙、维生素D、碱性磷酸酶、Irisin水平降低,差异均有统计学意义(P<0.05)。髋关节骨密度、股骨颈骨密度、大转子骨密度及血钙、维生素D、碱性磷酸酶、血清Irisin水平升高均为激素性骨质疏松患者骨折的保护因素(P<0.05),FOXO3水平升高为激素性骨质疏松患者骨折的危险因素(P<0.05)。血清FOXO3、Irisin联合预测激素性骨质疏松患者骨折的曲线下面积(AUC)为0.904,明显大于FOXO3、Irisin单独预测的AUC曲线下面积(Z=2.215,P=0.027;Z=2.191,P=0.028)。结论激素性骨质疏松骨折患者血清FOXO3水平升高,Irisin水平降低,FOXO3、Irisin水平与骨密度相关,二者联合对激素性骨质疏松患者发生骨折具有较高的预测价值。Objective To explore the predictive value of serum forkhead box protein O3(FOXO3)and irisin for fractures in patients with hormone-induced osteoporosis.Methods A total of 153 patients with hormone-induced osteoporosis admitted to the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine from January 2023 to March 2024 were selected as the study group,and 169 healthy individuals who underwent physical examinations during the same period were included as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of serum FOXO3 and Irisin.Adopting multivariate Logistic regression analysis to investigate the influencing factors of fractures in patients with osteoporosis.Using receiver operating characteristic(ROC)curve to analyze the predictive value of serum FOXO3 and Irisin levels for fractures in patients with osteoporosis.Results Compared with the control group,the study group showed a decrease in hip joint bone density,lumbar spine bone density,femoral neck bone density and greater trochanter bone density,an increase in serum FOXO3 level,and a decrease in blood calcium,vitamin D,alkaline phosphatase and irisin levels,with statistically significant differences(P<0.05).Compared with the non fracture group,the fracture group showed an increase in serum FOXO3 level and a decrease in hip joint bone density,femoral neck bone density,greater trochanter bone density,blood calcium,vitamin D,alkaline phosphatase and Irisin levels,with statistically significant differences(P<0.05).Elevated hip joint bone density,femoral neck bone density,greater trochanter bone density,blood calcium,vitamin D,alkaline phosphatase and serum Irisin levels were all protective factors for fractures in hormone-induced osteoporosis patients(P<0.05),while elevated FOXO3 level was risk factors for fractures in hormone-induced osteoporosis patients(P<0.05).The combined prediction of serum FOXO3 and Irisin for the area under the curve(AUC)of fractures in patients with hormone-induced osteoporosis

关 键 词：激素性骨质疏松 骨折 叉头框蛋白O3 鸢尾素 预测 

分 类 号：R683[医药卫生—骨科学] R589.5[医药卫生—外科学]