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| 共病视角下膝骨性关节炎患者的骨代谢标志物分析 |
| Analysis of bone metabolic markers in patients with osteoarthritis of the knee from the perspective of co-morbidity |
| 投稿时间：2025-09-05 修订日期：2025-11-26 |
| DOI： |
| 中文关键词: 共病 膝骨性关节炎 骨质疏松 2型糖尿病 骨代谢标志物 |
| 英文关键词:LI Huanhuan 1, Liu Hongling2?,Huang Kaihua3,Ling Yilu3,Jiang Peixi2,Li Dongmei2, Tan Zongcai2,Fan Yeling2 |
| 基金项目: |
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| 中文摘要: |
| 目的 观察膝骨性关节炎合病状态下的骨代谢标志物水平特征。方法 纳入98例膝骨性关节炎（KOA）、2型糖尿病（T2DM）、骨质疏松症（OP）患者，分成KOA+OP组、KOA+T2DM组以及KOA组和T2DM组，统计各组患者的骨代谢标志物指标，包括β-胶原降解产物(β-CTX)?、总?I型前胶原N端前肽(TPINP)?、25(OH）-?维生素?D[25(OH)-D]?、血清N端骨钙素（N-MID）和甲状旁腺激素(PTH)?以及年龄、性别、体重指数（BMI）、病史等基本信息，运用SPSS26.0统计软件对各组骨代谢标志物及相应比值进行差异分析。结果 KOA+OP组的β-CTX、TPINP、N-MID/β-CTX均升高，25(OH)-D降低；β-CTX/TPINP低于T2DM组（P<0.05）。KOA+T2DM组的β-CTX、TPINP、PTH以及PINP/PTH均降低；N-MID显著低于KOA+OP组、KOA组（P<0.05）；β-CTX/TPINP低于T2DM组（P<0.05）。维生素D含量缺乏和不足总人数共43人，占比43.9%，其中KOA+OP组缺乏和不足的占54.8%，KOA+T2DM组占33.3%，KOA组占42.1%，T2DM组占39.4%。四组维生素D含量占比差异无统计学意义（χ2=2.483，P＞0.05）。结论 膝骨性关节炎患者常多病共存，在合并骨质疏松和2型糖尿病时，建议利用骨代谢标志物检测进行评估和监测，进而采取具有针对性的干预措施。 |
| 英文摘要: |
| Objective To investigate the characteristics of bone metabolic markers in patients with knee osteoarthritis combined with diabetes mellitus (KOA) and type 2 diabetes mellitus (T2DM), as well as osteoporosis (OP). Methods A total of 98 patients with knee osteoarthritis (KOA), type 2 diabetes mellitus (T2DM), or osteoporosis were enrolled and divided into four groups: KOA+OP, KOA+T2DM, KOA, and T2DM. The study analyzed bone metabolic markers including β-collagen degradation product (β-CTX), total type I procollagen N-terminal propeptide (TPINP), 25(OH)-vitamin D [25(OH)-D], serum N-terminal bone calcitonin (N-MID), parathyroid hormone (PTH), along with basic information such as age, gender, body mass index (BMI), and medical history. SPSS26.0 statistical software was used to analyze differences in bone metabolic markers and corresponding ratios among the groups. Results In the KOA+OP group, β-CTX, TPINP, and N-MID/β-CTX levels were elevated, while vitamin D content decreased. The β-CTX/TPINP ratio was lower than that in the T2DM group (P<0.05). In the KOA+T2DM group, β-CTX, TPINP, PTH, and PINP/PTH levels were reduced. N-MID significantly differed from both the KOA+OP and KOA groups (P<0.05), while the β-CTX/TPINP ratio remained lower than that in the T2DM group (P<0.05). A total of 43 patients (43.9%) were diagnosed with vitamin D deficiency or insufficiency. The distribution was as follows: 54.8% in the KOA+OP group, 33.3% in the KOA+T2DM group, 42.1% in the KOA group, and 39.4% in the T2DM group.There was no statistically significant difference in the proportion of vitamin D content among the four groups(χ2=2.483, P>0.05). Conclusion Knee osteoarthritis patients often experience comorbidities. When osteoporosis and type 2 diabetes coexist, it is recommended to use bone metabolism biomarkers for assessment and monitoring, enabling targeted interventions. |
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