血清25羟维生素D、甲状旁腺激素、总Ⅰ型胶原氨基端延长肽/β-胶联降解产物水平与老年骨质疏松症患者胸腰椎压缩性骨折关系及检测意义

Relationship between serum 25-OH-VD,PTH,t-PINP/β-CTX and osteoporotive vertebral compression fractures in elderly patients osteoporosis and their detection significance

目的:探讨老年骨质疏松症患者血清25羟维生素D(25-OH-VD)、甲状旁腺激素(PTH)、总Ⅰ型胶原氨基端延长肽(t-PINP)/β-胶联降解产物(β-CTX)水平与胸腰椎压缩性骨折的关系及意义。方法:选取确诊的老年骨质疏松性胸腰椎压缩性骨折(OVCF)患者36例为OVCF组,选取同期确诊老年骨质疏松症但未骨折患者72例为对照组。比较两组血清25-OH-VD、PTH、t-PINP、β-CTX、耐酒石酸酸性磷酸酶5b(TRAP5b)、t-PINP/β-CTX水平及骨密度。分析血清骨转换标志物与骨密度的相关性,老年骨质疏松症患者OVCF发生的影响因素,以及血清骨转换标志物对老年OVCF的诊断价值。结果:OVCF组患者血清25-OH-VD、β-CTX水平低于对照组,PTH、t-PINP、TRAP5b、t-PINP/β-CTX水平高于对照组(均P<0.05)。OVCF组患者腰椎骨密度和全髋骨密度低于对照组(均P<0.05)。Pearson相关性分析显示,腰椎骨密度和全髋骨密度与血清25-OH-VD、β-CTX呈正相关,与PTH、t-PINP、TRAP5b、t-PINP/β-CTX呈负相关(均P<0.05)。多因素Logistic回归分析显示,血清低水平的25-OH-VD、β-CTX和高水平的PTH、t-PINP、t-PINP/β-CTX是老年骨质疏松症患者OVCF发生的影响因素(均P<0.05)。血清25-OH-VD、PTH、t-PINP、β-CTX、t-PINP/β-CTX对诊断老年OVCF有一定价值(均P<0.05)。结论:血清25-OH-VD降低、PTH水平和t-PINP/β-CTX水平升高与老年骨质疏松患者发生OVCF具有相关性,对老年骨质疏松症患者OVCF的发生均有一定的诊断价值。

Objective:To explore the relationship between serum 25-hydroxyvitamin D(25-OH-VD),parathyroid hormone(PTH),ratio of total typeⅠcollagen amino terminal extender peptide(t-PINP)/β-gel linked degradation products(β-CTX)and osteoporotive vertebral compression fractures(OVCF)in elderly osteoporosis patients and their detection significance.Methods:A total of 36 elderly patients with OVCF were enrolled as OVCF group,and 72 elderly osteoporosis patients without fracture during same period were enrolled as control group.The general data,levels of serum 25-OH-VD,PTH,t-PINP,β-CTX,TRAP5b,t-PINP/β-CTX and bone mineral density(BMD)were compared between the two groups.The correlation between serum bone turnover markers and BMD,and the influencing factors of OVCF in elderly patients with osteoporosis,and the diagnostic value of serum bone turnover markers for OVCF in elderly patients were analyzed.Results:The levels of serum 25-OH-VD andβ-CTX in OVCF group were lower than those in control group,while levels of PTH,t-PINP,TRAP5b and t-PINP/β-CTX were higher than those in control group(all P<0.05).The lumbar BMD and total hip BMD in OVCF group were lower than those in control group(all P<0.05).Pearson correlation analysis showed that lumbar BMD and total hip BMD were positively correlated with serum 25-OH-VD andβ-CTX,while negatively correlated with PTH,t-PINP,TRAP5b,t-PINP/β-CTX(all P<0.05).Multivariate Logistic regression analysis showed that low levels of serum 25-OH-VD andβ-CTX,and high levels of PTH,t-PINP and t-PINP/β-CTX were influencing factors for OVCF in elderly patients with osteoporosis(all P<0.05).Serum 25-OH-VD,PTH,t-PINP,β-CTX and t-PINP/β-CTX had certain value in the diagnosis of OVCF in the elderly(all P<0.05).Conclusion:The decrease of serum 25-OH-VD,the increase of serum PTH and t-PINP/β-CTX are correlated with the occurrence of OVCF in elderly patients with osteoporosis,and they all have certain diagnostic value for the occurrence of OVCF in elderly patients with osteoporosis.