摘要
目的研究中老年髋部脆性骨折患者股骨近端骨小梁类型指数(Singh指数)与血清骨代谢生化指标的相关性。方法回顾性分析2019年1月至2022年7月在江苏大学附属医院关节外科病区收治的中老年髋部脆性骨折(包括股骨颈骨折和股骨粗隆间骨折)71例患者资料,包括人口统计学资料、血清一般生化指标及甲状旁腺素(PTH)、25羟维生素D_(3)[25(OH)D_(3)]、类胰岛素生长因子1(IGF-1)3项骨代谢相关生化指标。通过X线片评估患者健侧股骨近端Singh指数,并按Singh指数分级分为轻度、中度和重度3组。Mann-Whitney U检验和Spearman相关检验分析3组患者的一般资料和血清生化指标ALB、ALP、PTH、25(OH)D_(3)、IGF-1差异。有序Logistic回归分析与股骨近端骨小梁骨质量相关的危险因素。结果单因素分析结果显示,3组患者25(OH)D_(3)、IGF-1水平有明显差异,差异具有统计学意义(P<0.05),其中Singh指数重度组25(OH)D_(3)[16.5(12.52~20.14)]显著低于轻度组[24.63(21.55~29.22)],差异具有统计学意义(P=0.006);Singh指数重度组IGF-1[64.65(48.975~87.725)]显著低于中度组[90.2(69.55~133.4)],差异具有统计学意义(P=0.025);相关性分析结果提示,Singh指数严重程度与25(OH)D_(3)、IGF-1的水平呈负相关(P<0.05)。②有序Logistic回归结果提示,IGF-1、25(OH)D_(3)可能是影响Singh指数分级的危险因素。结论中老年髋部脆性骨折患者股骨近端骨小梁类型指数与血清25(OH)D_(3)、IGF-1水平呈负相关,血清25(OH)D_(3)、IGF-1水平可能是影响中老年髋部脆性骨折患者骨质量的重要因素。
Objective To investigate the correlation between Singh index and serum bone metabolism biochemical indexes in middle-aged and elderly patients with hipfragility fracture.Methods The data of 71 middle-aged and elderly patients with hip fragility fractures(including femoral neck fractures and femoral intertrochanteric fractures)admitted to the Department of Joint Surgery,the Affiliated Hospital of Jiangsu University from January 2019 to July 2022 were retrospectively analyzed,including demographic data,serum biochemical indicators,and related biochemical indicators of bone metabolism,which included Parathyroid hormone(PTH),25-hydroxyvitamin D3(25(OH)D3),insulin-like growth factor-1(IGF-1),and Singh index of the contralateral proximal femur were evaluated by X-ray film.The patients were divided into three groups according to the Singh index measured by the upper femur anteroposition X-ray film.The differences in general data,ALB,ALP,PTH,25(OH)D3,and IGF-1 among the three groups were analyzed by Mann-Whitney U test and Sperman correlation test.Ordinal logistic regression analysis was used to analyze the risk factors related to the trabecular bone quality of proximal femur.Results The result of Single factor analysis showed that there were significant differences in 25(OH)D3 and IGF-1 among the three groups(P<0.05).The level of 25(OH)D3 in severe Singh index group(16.5(12.52-20.14))was significantly lower than that in mild Singh index group(24.63(21.55-29.22)),and the difference was statistically significant(P=0.006).IGF-1 level in severe Singh index group(64.65(48.975-87.725))was significantly lower than that in moderate Singh index group(90.2(69.55-133.4)),and the difference was statistically significant(P=0.025).Correlation analysis showed that the severity of Singh index was negatively correlated with the levels of 25(OH)D3 and IGF-1(P<0.05).②Ordered logistic regression indicated that IGF-1 and 25(OH)D3 might be risk factors affecting the classification of Singh index.Conclusion The trabecular type index of prox
作者
马安培
赵国阳
陈虹谷
殷红
MA Anpei;ZHAO Guoyang;CHEN Honggu;YIN Hong(Department of Joint Surgery,Affiliated Hospital of Jiangsu University,China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2023年第4期527-530,共4页
Chinese Journal of Osteoporosis
