摘要
目的 研究血尿酸(blood uric acid,BUA)水平与绝经后骨质疏松患者骨密度、骨转换指标的关系。方法 选取2018年5月至2021年5月于解放军总医院第三医学中心治疗的130例绝经后骨质疏松患者为研究对象,50例体检健康的绝经后女性作为对照组。所有研究对象均接受腰椎1~4、股骨颈和全髋的骨密度测定,并检测血清β-Ⅰ型胶原羧基端交联肽(serum β type 1 collagen carboxyl terminal cross-linked peptide,β-CTX)、Ⅰ型前胶原氨基端前肽(type I procollagen N-terminal propeptide,PINP)、骨钙素(bone gla protein,BGP)、骨特异性碱性磷酸酶(bone specific alkaline phosphatase,BALP)、BUA、血清雌二醇(estradiol,E2)及25-羟基维生素D [25 hydroxy-vitamin D,25-(OH)D]等骨转换指标水平。比较两组各生化指标水平,并观察两组骨密度及骨转换指标。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析BUA水平预测绝经后骨质疏松的价值,并采用Pearson相关分析BUA水平与绝经后骨质疏松患者骨密度、骨转换指标的关系。结果 骨质疏松组BUA、E2水平均显著低于对照组(P<0.05);两组25-(OH)D水平比较,差异无统计学意义(P>0.05)。骨质疏松组腰椎1~4、股骨颈、全髋骨密度均显著低于对照组(P<0.05)。骨质疏松组BALP、PINP水平显著低于对照组(P<0.05),β-CTX、BGP水平显著高于对照组(P<0.05)。经ROC分析证实BUA可用于绝经后骨质疏松的预测,曲线下面积为0.803,标准误为0.045,95%CI:0.714~0.892,最佳截断值为124.67μmol/L,敏感度为72.31%,特异度为70.70%,P<0.05。Pearson相关性分析结果显示,BUA与腰椎1~4、股骨颈、全髋骨密度呈正相关(P <0.05),与BALP、PINP水平呈正相关(P <0.05),与β-CTX、BGP呈负相关(P<0.05)。结论 BUA水平与绝经后骨质疏松患者骨密度呈正相关,监测BUA水平有助于判断绝经后骨质疏松风险。
Objective To study the relationship between blood uric acid(BUA)level and bone mineral density and bone turnover in postmenopausal osteoporosis patients.Methods 130 patients with postmenopausal osteoporosis treated in the Third Medical Center of Chinese PLA General Hospital from May 2018 to May 2021 were included as the research object,and 50 healthy postmenopausal women who underwent physical examination in the same hospital in the same period were selected as the control group.All subjects underwent bone mineral density measurement of lumbar vertebrae 1-4,femoral neck and total hip,and bone turnover index[serum type 1 collagen carboxyl terminal cross-linked peptide(β-CTX),type I procollagen N-terminal propeptide(PINP),bone gla protein(BGP),bone specific alkaline phosphatase(BALP)]was detected,BUA,serum estradiol(E2)and 25 hydroxy-vitamin D(25-(OH)D).The biochemical indexes of the two groups were compared,and the bone mineral density and bone turnover indexes of the two groups were observed.Receiver operating characteristic curve(ROC curve)was used to analyze the value of BUA level in predicting postmenopausal osteoporosis,and Pearson correlation was used to analyze the relationship between BUA level and bone mineral density and bone turnover in patients with postmenopausal osteoporosis.Results The levels of BUA and E2 in osteoporosis group were significantly lower than those in control group(P<0.05);There was no significant difference in the level of 25-(OH)d between the two groups(P>0.05).The BMD of lumbar vertebrae 1-4,femoral neck and total hip in osteoporosis group were significantly lower than those in control group(P<0.05).The levels of BALP and PINP in osteoporosis group were significantly lower than those in control group(P<0.05),β-The levels ofβ-CTX and BGP in the control group were significantly higher than those in the control group(P<0.05).ROC curve analysis confirmed that BUA could be used to predict postmenopausal osteoporosis.The area under the curve was 0.803,the standard error was 0.045,95%C
作者
王意
王文杰
安军
吴静
Wang Yi;Wang Wenjie;An Jun;Wu Jing(Department of Endocrine,the Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China;Department of Nephrology,Qingdao Eighth People's Hospital,Qingdao 266000,Shandong,China;Department of Geriatric Medicine,the Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China)
出处
《中国医学前沿杂志（电子版）》
CSCD
2023年第4期33-37,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
血尿酸
骨质疏松
骨密度
骨转换
相关性
Blood uric acid
Osteoporosis
Bone mineral density
Bone turnover
Relevance
