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| 健康中老年人群血清骨转换标志物与FRAX骨折风险相关性分析 |
| Analysis of correlation between serum bone turnover markers and FRAX in healthy middle-aged and elderly population |
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| DOI：10.3969/j.issn.1006-7108.2024.02.009 |
| 中文关键词: 骨转换标志物 总1型前胶原氨基端肽 骨折风险评估工具 |
| 英文关键词:BTMs Fracture tP1NP FRAX |
| 基金项目:江苏省卫生健康委员会科研项目（M2022119）；骨质疏松和骨矿盐疾病中青年医生优才培养计划项目（G-X-2019-1107）；江苏大学大学生创新训练计划项目（202210299014Z） |
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| 中文摘要: |
| 目的 研究健康中老年人群血清骨转换标志物（bone turnover markers，BTMs）与FRAX（fracture risk assessment tool）的相关性，探讨血清骨转化标志物在骨折风险预测中的价值。方法 回顾性收集121例50岁以上健康中老年人群的年龄、性别、体质量指数（body mass index, BMI）、骨密度和血清骨转换标志物数据，计算出FRAX 10年骨折概率。以FRAX主要骨质疏松性骨折概率（FRAX-M）≥20 %或FRAX髋部骨折概率(FRAX-H）≥3 %人群为FRAX高骨折风险组，其他为FRAX低中骨折风险组，比较两组人群各临床指标差异；对FRAX 10年骨折概率和血清骨转换标志物进行相关分析并以FRAX 10年骨折概率为因变量进行多元线性回归分析。结果 单因素分析显示，FRAX高骨折风险组受试者血清骨钙素（osteocalcin, OC）和总1型原胶原N端前肽(total type 1 procollagen N peptide,tP1NP)水平高于FRAX低中骨折风险组（P＜0.05）。在相关性分析中，OC、tP1NP与FRAX-M呈正相关，相关系数r分别是0.385 (P＜0.001)和0.378 (P＜0.001)；OC、tP1NP与FRAX-H呈正相关，相关系数r分别是0.308 (P=0.001)和0.287 (P=0.001)。在多元线性回归分析中，tP1NP均留在回归方程内，β分别为0.258（P＜0.001）和0.306（P=0.001）。并且分层分析显示在加入tP1NP后，回归模型预测骨折风险的能力显著增加。结论 tP1NP可能是脆性骨折风险的重要因素，建议在临床骨折风险预测中考虑血清骨转换标志物tP1NP的价值。 |
| 英文摘要: |
| Objective To study the correlation between serum bone turnover markers and FRAX fracture risk score in healthy middle-aged and elderly people, and to explore the value of serum bone turnover markers in fracture risk prediction. Methods The data of age, sex, body mass index (BMI), bone mineral density, and serum bone turnover indexes in 121 healthy middle-aged and elderly people over 50 years old were collected retrospectively, and the FRAX fracture probability was calculated. Patients with FRAX major osteoporotic fracture probability (FRAX-M)≥20% or FRAX hip fracture probability (FRAX-H)≥3% were classified as high fracture risk group, and patients with FRAX low-medium fracture risk group were classified as low fracture risk group. The correlation between FRAX fracture probability and serum bone turnover markers was analyzed, and multiple-linear-regression analysis was carried out with FRAX fracture probability as dependent variables. Result Univariate analysis showed that serum levels of osteocalcin (OC) and total type 1 procollagen N-terminal peptide (tP1NP) were higher in the FRAX high-risk group than in the FRAX low-medium risk group (P < 0.05). In the correlation analysis, OC and tP1NP were positively correlated with the probability of major osteoporotic fracture in FRAX (r = 0.385，0.378, P＜0.001), while OC and tP1NP were positively correlated with the probability of hip fracture in FRAX (r = 0.308，0.287, P＜0.001). In the multiple linear regression analysis with the probability of FRAX major osteoporotic fracture and hip fracture as dependent variables, tP1NP remained in the regression equation, and the β=0.258 (P＜0.001)，0.306 (P=0.001), respectively. Moreover, hierarchical analyses showed a significant increase in the ability of the regression model to predict fracture risk after the addition of tP1NP. Conclusion The total type 1 procollagen N-terminal peptide (tP1NP) may be an important factor in the risk of brittle fracture. It is suggested that the value of serum bone turnover marker tP1NP should be considered in clinical fracture risk prediction. |
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