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| 中老年骨量异常人群血清骨代谢生化指标与FRAX骨折风险相关性分析 |
| Relationship between serum biochemical indexes of bone metabolism and FRAX fracture risk in middle-aged and elder people with abnormal bone mass |
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| DOI：10.3969/j.issn.1006-7108.2020.09.007 |
| 中文关键词: 骨量减少 骨质疏松 骨折风险 25-羟基维生素D3 骨代谢生化指标 |
| 英文关键词:osteopenia osteoporosis fracture risk 25 hydroxyvitamin D3 biochemical index of bone metabolism |
| 基金项目:国际课题“IOF对骨量减少人群骨折风险评估（FRAX）前瞻性研究”(IOFCJO-D001)；骨质疏松和骨矿盐疾病中青年医生优才培养计划暨白求恩?石药骨质疏松科研基金项目 (G-X-2019-1107) |
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| 中文摘要: |
| 目的 研究中老年骨量减少或骨质疏松人群的血清骨代谢生化指标，探讨血清骨代谢生化标志物对受试者骨折风险的影响。方法 研究84例中老年骨量减少或骨质疏松受试者资料，记录相关人口统计学数据，检测受试者骨密度和血清骨代谢生化指标，使用骨折风险评估工具 (FRAX)计算个体10年骨折发生的概率。根据FRAX计算结果，将受试者分为骨质疏松骨折高风险组和低风险组，t检验比较二组年龄、性别、体质量指数、骨质疏松比例、股骨颈、髋部和腰椎的骨密度以及血清骨代谢生化指标的差异；Pearson或Spearman相关分析了解各临床指标与FRAX骨折概率的相关性；Logistic回归分析影响FRAX骨折风险的因素。结果 骨折高风险组的年龄、骨质疏松患者比例明显高于低风险组，股骨颈和髋部骨密度以及血清25-羟基维生素D3 [25-Hydroxyvitamin D3, 25(OH)D3]水平明显低于低风险组，差异有统计学意义 (P＜0.05)，其中高风险组和低风险组25(OH)D3水平的中位数和（最小值~最大值）分别为20.61(12.19~43.24)和29.97 (11.91~72.70)；年龄与两个骨折概率均呈正相关 (P＜0.05)，股骨颈和髋部骨密度以及血清25(OH)D3水平与两个骨折概率均呈负相关 (P＜0.05)，其中25(OH)D3水平与两个骨折概率的相关系数r值均为?0.51；Logistic回归分析显示，股骨颈骨密度和血清25(OH)D3是FRAX骨折风险的重要相关因素。结论 血清25(OH)D3可能是预测中老年骨量减少或骨质疏松人群脆性骨折风险较敏感的骨代谢标志物。 |
| 英文摘要: |
| Objective To explore the effects of serum biochemical markers of bone metabolism on fracture risk in middle-aged and older people with abnormal bone mass by analyzing the relationship between serum biochemical indexes of bone metabolism and FRAX fracture risk value. Methods Bone mineral density (BMD) and serum biochemical indicators of bone metabolism were detected, and the probability of fracture in 10 years were calculated using FRAX tool in 84 middle-aged and elder subjects with osteopenia or osteoporosis. All the subjects were divided into high-risk group and low-risk group according to FRAX calculation results. Student t-test was used to compare the differences of age, gender, body mass index, proportion of osteoporosis subjects, BMD of the femoral neck, hip or lumbar spine, and biochemical indexes of serum bone metabolism between the two groups. Pearson or Spearman correlation analysis was used to understand the correlation between clinical indexes and FRAX fracture probability. Logistic regression was used to evaluate factors influencing FRAX fracture risk. Results The age and the proportion of osteoporosis patients in the high-risk group were significantly higher than those in the low-risk group. BMD of the femoral neck or hip and the serum level of 25 hydroxyvitamin D3 in the high-risk group were significantly lower than those in the low-risk group (P＜0.05). The median, maximum, and minimum values of 25 (OH) D3 in high-risk group and low-risk group were 20.61 (12.19-43.24) and 29.97 (11.91-72.70), respectively. Age was positively correlated with the probability of two fractures. BMD of the femoral neck or hip and the serum level of 25 (OH) D3 were negatively correlated with the probability of two fractures (P＜0.05). The correlation coefficient r value between the level of 25 (OH) D3 and the probability of two fractures was ?0.51. Logistic regression analysis showed that BMD of the femoral neck and serum 25 (OH) D3 were important factors related to FRAX fracture risk. Conclusion Serum 25 (OH) D3 may be a sensitive marker of bone metabolism for predicting the risk of osteoporotic fracture in middle-aged and elder people with osteopenia or osteoporosis. |
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