摘要
目的探讨血清CXC趋化因子配体(CXC chemokine ligand,CXCL)1、CXCL8及CXCL12在老年绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)患者中的表达及其联合骨折风险评估工具(fracture risk assessment tool,FRAX)预测骨折发生的价值。方法选取2021年1月至2023年12月中国人民解放军联勤保障部队第九八〇医院收治的老年女性PMOP患者128例,年龄60~86岁,平均(69.20±6.28)岁;另选取50例老年女性体检正常者(对照组)作为对照,年龄60~82岁,平均(67.40±5.93)岁。128例老年PMOP患者分为骨折组56例和未骨折组72例,根据FRAX评分检查分为骨折高风险组77例和骨折低风险组51例。比较各组血清CXCL1、CXCL8及CXCL12水平。多因素Logistic回归分析影响老年PMOP患者发生骨折的危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CXCL1、CXCL8及CXCL12联合FRAX评分对老年PMOP患者骨折发生的价值。采用Pearson相关分析血清CXCL1、CXCL8、CXCL12水平与FRAX评分的相关性。结果骨折组和未骨折组血清CXCL1、CXCL8及CXCL12水平均明显高于对照组(P<0.001),且骨折组血清CXCL1、CXCL8及CXCL12水平均明显高于未骨折组(P<0.001)。骨折高风险组血清CXCL1、CXCL8及CXCL12水平均明显高于低风险组(P<0.001)。多因素Logistic回归分析显示,血清CXCL1、CXCL8及CXCL12水平升高是影响老年PMOP患者发生骨折的危险因素。ROC曲线显示,CXCL1、CXCL8及CXCL12联合FRAX评分预测老年PMOP患者发生骨折的AUC最大(0.96,95%CI:0.90~0.99),其准确度为94.15%。相关分析显示,老年PMOP患者血清CXCL1、CXCL8及CXCL12水平与FRAX评分均呈正相关(P<0.001)。结论血清CXCL1、CXCL8及CXCL12水平升高是影响老年PMOP患者发生骨折的危险因素,其与FRAX评分密切相关,CXCL1、CXCL8及CXCL12联合FRAX评分预测老年PMOP患者发生骨折的准确度较高。
Objective To investigate the expression of serum CXC chemokine ligand(CXCL)1,CXCL8 and CXCL12 in elderly postmenopausal osteoporosis(PMOP)patients and the value of combined fracture risk assessment tool(FRAX)in predicting fracture occurrence.Methods A retrospective study was conducted on 128 elderly female patients with PMOP admitted to the Bethune International Peace Hospital,the 980th Hospital of Joint Logistics Support Force,Chinese People’s Liberation Army,from January 2021 to December 2023.The mean age of the patients was(69.20±6.28)years,ranging from 60 to 86 years.A control group of 50 elderly women with normal physical examination results,aged 60 to 82 years[mean age:(67.40±5.93)years],was also included.The PMOP patients were further categorized into fracture(56 cases)and non-fracture(72 cases)groups,and based on FRAX scores,into high-risk(77 cases)and low-risk(51 cases)groups.Serum levels of CXCL1,CXCL8,and CXCL12 were compared among the groups.Multivariate logistic regression analysis was employed to identify risk factors for fracture in elderly PMOP patients,and a ROC curve was constructed to assess the predictive value of combining CXCL1,CXCL8,CXCL12,and FRAX score for fracture occurrence.Pearson correlation analysis was used to examine the relationship between serum CXCL1,CXCL8,CXCL12 levels,and FRAX scores.Results The serum concentrations of CXCL1,CXCL8,and CXCL12 were significantly elevated in both the fracture and non-fracture PMOP groups compared to the control group(P<0.001).Notably,the levels of these chemokines were significantly higher in the fracture group than in the non-fracture group(P<0.001).Within the PMOP cohort,patients in the high-risk fracture group had significantly higher serum levels of CXCL1,CXCL8,and CXCL12 than those in the low-risk group(P<0.001).Multivariate logistic regression analysis revealed that elevated serum levels of CXCL1,CXCL8,and CXCL12 were independent risk factors for fracture in elderly PMOP patients.The ROC curve analysis demonstrated that the combination
作者
李军涛
郝玉青
刘斌
王永辉
Li Juntao;Hao Yuqing;Liu Bin;Wang Yonghui(Department of Clinical Laboratory,Bethune International Peace Hospital,the 980th Hospital of Joint Logistics Support Force,Chinese People’s Liberation Army,Shijiazhuang 050071,China;Department of Orthopaedics,Bethune International Peace Hospital,the 980th Hospital of Joint Logistics Support Force,Chinese People’s Liberation Army,Shijiazhuang 050071,China;Department of First Outpatient,Bethune International Peace Hospital,the 980th Hospital of Joint Logistics Support Force,Chinese People’s Liberation Army,Shijiazhuang 050071,China)
出处
《实用骨科杂志》
2024年第9期798-803,共6页
Journal of Practical Orthopaedics
