摘要
目的 探讨血清C1q肿瘤坏死因子相关蛋白3(CTRP3)和Dickkopf相关蛋白1(DKK-1)水平与绝经后骨质疏松(PMOP)患者发生骨折的关系。方法 选取2020年6月-2022年12月武警江西总队医院PMOP患者126例(PMOP组)和健康体检者(无骨质疏松、自然绝经1年以上)118名(正常对照组)。根据PMOP患者是否发生骨折分为骨折组(41例)和无骨折组(85例)。收集所有研究对象一般资料和实验室生化项目检测结果,同时检测血清CTRP3、DKK-1水平和腰椎(L_(1)-L_(4))的骨密度。采用Spearman相关分析评估血清CTRP3和DKK-1水平与PMOP患者发生骨折的相关性。采用多因素Logistic回归分析评估PMOP患者发生骨折的影响因素。采用受试者工作特征(ROC)曲线评估血清CTRP3、DKK-1水平和骨密度判断PMOP患者发生骨折的效能。结果 与正常对照组比较,PMOP组25-羟基维生素D[25-(OH)D]、CTRP3水平和骨密度显著降低(P<0.001),DKK-1水平显著升高(P<0.001),其他指标2个组之间差异均无统计学意义(P>0.05)。与无骨折组比较,骨折组骨密度和血清CTRP3水平显著降低(P<0.001),DKK-1水平显著升高(P<0.001)。血清CTRP3水平与PMOP患者发生骨折呈负相关(r=-0.574,P<0.05),血清DKK-1水平与PMOP患者发生骨折呈正相关(r=0.658,P<0.05)。DKK-1升高、CTRP3降低、骨密度降低均是PMOP患者发生骨折的危险因素[比值比(OR)值分别为2.249、0.529、0.424],95%可信区间(CI)分别为1.199~4.219、0.299~0.936、0.188~0.958,P<0.05。血清CTRP3、DKK-1、骨密度单项检测和联合预测判断PMOP患者发生骨折的曲线下面积(AUC)分别为0.871、0.904、0.806和0.974。结论 PMOP患者血清CTRP3水平显著降低,DKK-1显著升高。2项指标与骨密度联合检测对判断PMOP患者发生骨折有较高的效能,有助于临床对PMOP患者中的骨折高风险人群及时干预。
Objective To determine the levels of C1q tumor necrosis factor related protein 3(CTRP3)and Dickkopf related protein 1(DKK-1)in serum,and to investigate their predictive values for the occurrence of fractures in postmenopausal osteoporosis(PMOP)patients.Methods From June 2020 to December 2022,126 PMOP patients from Jiangxi Armed Police Corps Hospital were enrolled as PMOP group.They were classified into fracture group(41 cases)and non-fracture group(85 cases),and another 118 volunteers who underwent physical examination(females without osteoporosis and with a natural menopause of more than 1 year)were enrolled as control group.The levels of serum CTRP3,DKK-1 and lumbar spine(L_(1)~L_(4))bone mineral density(BMD)were determined and compared.Spearman analysis was used to analyze the correlation between serum levels of CTRP3 and DKK-1 and the occurrence of fractures in PMOP patients.Multivariate Logistic regression was used to analyze the influencing factors of fractures in PMOP patients.Receiver operating characteristic(ROC)curve was used to analyze the clinical values of serum CTRP3,DKK-1 levels and BMD in predicting fracture occurrence in PMOP patients.Results Compared with control group,the levels of 25-hydroxyvitamin D[25-(OH)D],CTRP3 and BMD in PMOP group were decreased(P<0.001),and the level of DKK-1 was increased(P<0.001),and there was no statistical significance in the other indicators between the 2 groups(P>0.05).Compared with non-fracture group,BMD and serum CTRP3 level in fracture group were decreased(P<0.001),and DKK-1 level was increased(P<0.001).Serum CTRP3 level was negatively correlated with fracture in PMOP patients(r=-0.574,P<0.05),and serum DKK-1 level was positively correlated with fracture in PMOP patients(r=0.658,P<0.05).Increased DKK-1,decreased serum CTRP3 and decreased BMD were risk factors for fracture in PMOP patients[odds ratios(OR)were 2.249,0.529,0.424,95%confidence intervals(CI)were 1.199-4.219,0.299-0.936,0.188-0.958,respectively].The areas under curves(AUC)of serum CTRP3,DKK-1 and
作者
黄茜
申琴
胡秋云
孙静
万平印
HUANG Qian;SHEN Qin;HU Qiuyun;SUN Jing;WAN Pingyin(Department of Rehabilitation Medicine and Physiotherapy,Jiangxi Armed Police Corps Hospital,Nanchang 330001,Jiangxi,China;Department of Orthopedics,Jiangxi Armed Police Corps Hospital,Nanchang 330001,Jiangxi,China)
出处
《检验医学》
CAS
2024年第10期950-955,共6页
Laboratory Medicine
基金
江西省教育厅科学技术研究项目(GJJ213302)。
