摘要
目的探讨骨代谢相关指标与围绝经期骨质疏松病人发生骨质疏松相关性骨折的关系。方法选取2015年10月至2018年5月濮阳市第三人民医院收治的44例围绝经期骨质疏松且发生骨折的病人作为病例组、80例围绝经期骨质疏松但是未发生骨折的病人作为对照组;调查对比两组的一般资料、血清Ⅰ型前胶原氨基端前肽(N-terminal propeptide of type procolla‐gen,P1NP)、Ⅰ型胶原羧基端肽β特殊序列(Special sequence ofβ-carboxyl terminal peptide of typeⅠcollagen,β-CTX)、骨钙素N端中分子(Osteocalcin N-terminus molecule,N-MID)、25-羟基维生素D[25-hydroxyvitamin D,25-(OH)VitD]的水平;采用logistic多因素分析上述指标与围绝经期骨质疏松且发生骨折的关系。结果病例组和对照组的年龄、体质量指数(BMI)、骨折病史、是否参与体育锻炼、每天的日照时间、吸烟、饮酒、高血压、血脂异常均差异无统计学意义(P>0.05);病例组的骨密度为(0.48±0.07)g/cm^(2),明显低于对照组的(0.56±0.08)g/cm^(2)(P<0.001),病例组的糖尿病合并率为25%,高于对照组的5%(P<0.05);病例组病人血清P1NP、β-CTX的水平分别为(64.81±10.44)μg/L、(0.68±0.07)μg/L,明显高于对照组的(52.07±8.95)μg/L、(0.60±0.08)μg/L(P<0.001),病例组25-(OH)VitD水平为(21.84±2.40)μg/L,明显低于对照组的(25.40±3.12)μg/L(P<0.001);经logistic回归分析,血清P1NP、β-CTX的水平升高、25-(OH)VitD水平降低、骨密度降低、合并糖尿病是围绝经期骨质疏松发生骨折的独立危险因素(P<0.05)。结论血清P1NP、β-CTX的水平升高、25-(OH)VitD水平降低会增大围绝经期骨质疏松发生骨折的风险。
Objective To explore the relationship between bone metabolism indexes and osteoporosis-related fractures in peri-menopausal osteoporosis patients.Methods Forty-four patients with perimenopausal osteoporosis, who had fractures and were treated in Puyang Third People’s Hospital from October 2015 to May 2018, were selected as the case group, and 80 patients with perimenopausal osteoporosis but no fractures were selected as the control group. A comparison was made between the two groups of the general data,and the levels of serum type Ⅰ N-terminal propeptide of type procollagen(P1NP), special sequence of β-carboxyl terminal peptide of type Ⅰ collagen(β-CTX), osteocalcin N-terminal molecule(N-MID), and 25-hydroxyvitamin D [25-(OH)Vit D]. Logistic multivariate analysis was used to analyze the relationship between those indicators and peri-menopausal osteoporosis complicated with fracture.Results There were no significant differences in age, body mass index(BMI), fracture history, participation in physical exercise or not,daily sunshine duration, smoking, alcohol consumption, hypertension, and dyslipidemia between the case group and the control group(P>0.05). The bone mineral density value in the case group [(0.48±0.07) g/cm2] was significantly lower than that in the control group[(0.56±0.08) g/cm2](P<0.001), and the complication rate of diabetes in the case group(25%) was higher than that in the control group(5%, P<0.05). The serum P1NP and β-CTX levels in the case group [(64.81±10.44)μg/L,(0.68±0.07)μg/L] were significantly higher than those in the control group [(52.07±8.95)μg/L,(0.60±0.08)μg/L](P<0.001), and 25-(OH) Vit D level [(21.84±2.40)μg/L] in the case group was significantly lower than that of the control group [(25.40±3.12)μg/L](P<0.001). Logistic regression analysis results showed that elevated serum P1NP, β-CTX levels, decreased 25-(OH)Vit D level, decreased bone mineral density, and diabetes mellitus complicated with perimenopausal osteoporosis were independent risk factors for fra
作者
王彦英
王淑
王丽萍
李冰
宋莎莎
WANG Yanying;WANG Shu;WANG Liping;LI Bing;SONG Shasha(Department of Obstetrics and Gynecology,Puyang Third People's Hospital,Puyang,Henan 457000,China)
出处
《安徽医药》
CAS
2021年第9期1749-1752,共4页
Anhui Medical and Pharmaceutical Journal
关键词
骨质疏松性骨折
围绝经期
骨化二醇
胶原
骨钙素
Ⅰ型胶原羧基端肽β特殊序列
Osteoporotic fractures
Peri-menopausal
Calcifediol
Procollagen
Osteocalcin
Special sequence ofβ-carboxyl terminal peptide of typeⅠcollagen
