摘要
目的了解骨转换指标(bone turnover markers,BTMs)以及其他骨代谢指标水平与女性原发性骨质疏松症(primary osteoporosis,POP)患者初次脆性骨折发生的相关性。方法2005年7月至2016年12月在上海市第一人民医院骨质疏松症专病门诊初次就诊且已确诊POP、资料齐全并符合骨折史由初诊时患者自述及影像学检查显示为初次新发骨折,为主要部位脆性骨折等纳入标准的女性患者,共117例,按骨折后1年内就诊患者及未发生骨折患者分为骨折组和未骨折组,记录所有研究对象的一般资料、血清生化及BTMs、骨密度(bone mineral density,BMD)检测结果、骨折史等临床资料进行回顾性分析研究。结果与未骨折组相比,骨折组血清Ca显著下降,差异有统计学意义(P<0.05);且骨折组BMD L1-4显著降低,差异有统计学意义(P<0.05)。按年龄进行亚组分析发现:骨折组血清Ca均低于未骨折组,其中≤70岁两组差异有统计学意义(P<0.05);骨折组BMD较未骨折组均下降,>70岁组BMD L1-4差异有统计学意义(P<0.05)。Spearman相关分析显示:BMD L1-4(r=-0.188,P=0.043)、血清骨钙素(bone Gla protein,BGP)(r=-0.217,P=0.019)、血清Ca(r=-0.302,P=0.001)、血清25羟维生素D(25 hydroxyvitamin D,25OHD)(r=-0.189,P=0.041)与骨折发生呈负相关;二元Logistic回归分析表明:BMDL1-4(OR=0.042,P=0.039)、血清BGP(OR=0.948,P=0.049)、Ca(OR=0.042,P=0.039)、25OHD(OR=0.975,P=0.015)均为骨折的保护因素。结论腰椎BMD、血清BGP、Ca、25OHD与脆性骨折发生相关。
Objective To investigate whether bone turnover markers(BTMs)and other bone metabolic indicators are related to the occurrence of initial fragility fractures in women with primary osteoporosis(POP).Methods Reviewing the first visits to the Osteoporosis Specialty Clinic of Shanghai General Hospital from July 2005 to December 2016,the patients with POP completed data collection,and fracture history was self-reported by the patient during initial diagnosis and the results of imaging examination showed that it was the first new fracture.All fragility fractures were major sites fractures.A total of 117 cases were divided into fracture group and non-fracture group according to with or without fracture within recent one year.The general data,serum biochemical markers,bone mineral density(BMD),fracture history,and other clinical data were recorded for retrospective analysis.Results Compared with the non-fracture group,serum Ca level of the fracture group decreased,and the difference was statistically significant(P<0.05).Compared with the non-fracture group,BMD L1-4 of the fracture group was significantly lower and the difference was statistically significant(P<0.05).Analysis of subgroups by age found that serum Ca level in the fracture group was lower than that of the non-fracture group in all age group,and the difference between the two subgroups was statistically significant(P<0.05).BMD of the fracture group was lower than that of the non-fracture group,and the difference in 70-year-old group was statistically significant(P<0.05).Spearman correlation analysis showed:BMD L1-4(r=-0.188,P=0.043),serum levels of bone Gla protein(BGP)(r=-0.217,P=0.019),Ca(r=-0.302,P=0.001),and 25 hydroxyvitamin D(25OHD)(r=-0.189,P=0.041)were negatively correlated with fracture occurrence.Binary Logistic regression analysis showed BMD L1-4(OR=0.042,P=0.039),serum BGP(OR=0.948,P=0.049),Ca(OR=0.042,P=0.039),and 25OHD(OR=0.975,P=0.015)were protective factors for fractures.Conclusion Lumbar spine BMD,serum levels of BGP,Ca,and 25OHD are related t
作者
曾越茜
陈琳
潘凌
李思雨
朱小楠
彭永德
王育璠
游利
ZENG Yue-xi;CHEN Lin;PAN Ling;LI Si-yu;ZHU Xiao-nan;PENG Yong-de;WANG Yu-fan;YOU Li(Department of Endocrinology and Metabolism,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200080,China)
出处
《中华骨质疏松和骨矿盐疾病杂志》
CSCD
北大核心
2022年第3期232-238,共7页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
上海市卫健委老年健康与妇儿项目(2020YJZX0104)。
关键词
骨代谢指标
初次骨折
骨密度
原发性骨质疏松症
bone metabolism indicators
initial fracture
bone mineral density
primary osteoporosis
