血清白介素-1β、铁蛋白与衰弱状态并发骨质疏松症的关系  

The relationship between serum interleukin-1β,ferritin and frailty complicated by osteoporosis

作　　者：戴靖榕 李燕[2] 李婕 黄红[2] 肖斐 李丽萍 易丹 何四华 黄芳 DAI Jingrong;LI Yan;LI Jie;HUANG Hong;XIAO Fei;LI Liping;YI Dan;HE Sihua;HUANG Fang(Department of General Medicine,The Affiliated Changsha Hospital of Xiangya School of Medicine,Central South University(The First Hospital of Changsha),Changsha 410005,China;Yunnan Clinical Medical Research Center for Geriatric Diseases(Department of Geriatry,Yunnan First People's Hospital),Kunming 650032,China;Chaoyang Street Community Health Service Center in Furong District,Changsha 410000,China)

机构地区：[1]中南大学湘雅医学院附属长沙医院(长沙市第一医院)全科医学科,湖南长沙410000 [2]云南省老年疾病临床医学研究中心(云南省第一人民医院老年医学科),云南昆明650032 [3]长沙市芙蓉区朝阳街道社区卫生服务中心,湖南长沙410000

出　　处：《中国骨质疏松杂志》2025年第4期484-489,506,共7页Chinese Journal of Osteoporosis

基　　金：国家重大科技专项计划(202102AA310069);国家重点研发计划(2018YFC2002103);云南省董碧蓉专家工作站项目(202105AF150032);湖南省卫生健康健康委科研计划(YXGP2021-02-01);云南省医疗卫生单位内设研究机构科研项目(2017NS221)。

摘　　要：目的研究老年患者中血清白介素(IL)-1β、铁蛋白(SF)与衰弱状态并发骨质疏松症(osteoporosis,OP)的关系。方法收集2021年5月至2023年8月云南省某医院老年医学科389例老年患者为研究对象,并根据FRIED评估量表分为无衰弱组、衰弱前期组和衰弱期组,其中衰弱前期及衰弱期患者259例,并根据是否合并OP将衰弱状态患者分为非OP组和OP组,收集患者基本资料及外周血指标,并采用自主研发的“老年综合评估系统软件平台”对住院患者进行评估。最后通过二元Logistic回归分析衰弱合并OP的独立影响因素,同时分析IL-1、SF与腰椎骨密度(BMD)、左股骨颈及左髋关节BMD的关系。结果259例衰弱患者中,OP组78例(30.1%),非OP组181例(69.9%)。多因素Logistic回归分析结果显示,年龄[OR=1.079,95%CI(1.028,1.132),P=0.002]、IL-1β[OR=1.065,95%CI(1.007,1.126),P=0.029]、SF[OR=1.004,95%CI(1.001,1.006),P=0.002]、便秘[OR=2.766,95%CI(1.310,5.841),P=0.008]、尿失禁[OR=3.302,95%CI(1.286,8.476),P=0.013]是衰弱并发OP的独立危险因素;Spearman相关性分析结果显示,在衰弱患者中,血清IL-1、SF与腰椎BMD(L1-L4)、左股骨颈及左髋关节BMD均呈负相关。结论IL-1β、SF与衰弱状态并发OP的关系密切,通过降低IL-1β、SF水平有望成为干预衰弱并发OP的潜在途径。Objective This study investigated the associations between serum interleukin-1β(IL-1β),ferritin(SF),and frailty complicated by osteoporosis(OP)in elderly patients.Methods A total of 389 inpatients with valid data from the Department of Geriatric Medicine of Yunnan First People’s Hospital from May 2021 to August 2023 were selected as the study objects,and divided into non-frailty group,pre-frailty group and frailty group according to the FRIED assessment scale,including 259 patients with pre-frailty and frailty stage.Patients with frailty state were divided into non-OP group and OP group according to whether OP was combined.Basic data and peripheral blood indicators of patients were collected,and the“comprehensive geriatric assessment system software platform”developed by ourselves was used for comprehensive geriatric assessment of patients.Finally,the independent influencing factors of frailty combined with OP were analyzed by binary Logistic regression,and the relationships between IL-1,SF and BMD of lumbar spine(L1-L4),left femoral neck and left hip joint were also analyzed.Results Among the 259 patients with frailty,there were 78 cases(30.1%)in the OP group and 181 cases(69.9%)in the non OP group.Binary Logistic regression analysis showed:age[OR=1.079,95%CI(1.028,1.132),P=0.002];IL-1β[OR=1.065,95%CI(1.007,1.126),P=0.029],SF[OR=1.004,95%CI(1.001,1.006),P=0.002],constipation[OR=2.766,95%CI(1.310,5.841),P=0.008],urinary incontinence[OR=3.302,95%CI(1.286,8.476),P=0.013]were independent risk factors for frailty complicated with OP.Spearman correlation analysis showed that serum IL-1 and SF were negatively correlated with BMD of lumbar spine(L1-L4),left femoral neck and left hip joint in patients with frailty.Conclusion IL-1βand SF are closely related to OP in frailty.Reduction of IL-1βand SF may be potential approach for intervention in frailty complicated by OP.

关 键 词：白介素-1Β 铁蛋白 衰弱 骨质疏松症 老年综合评估 

分 类 号：R592[医药卫生—老年医学] R589.5[医药卫生—内科学]