血清PON3、25羟维生素D3、FGF-23在早产儿中的表达及其对代谢性骨病的预测价值

Expression of serum PON3,25 hydroxyvitamin D3 and FGF-23 in preterm infants and the predictive value for metabolic osteopathy

目的:探讨血清对氧磷酶3(PON3)、25羟维生素D3[25(OH)D3]、成纤维细胞生长因子23(FGF-23)在早产儿中的表达及其对代谢性骨病的预测价值。方法:选取2014年12月至2016年12月于河北省沧州市人民医院新生儿科住院治疗的患病早产儿200例作为实验组,选取同期于本院分娩的正常早产儿200例作为对照组。两组均于出生后1 d、7 d、14 d、30 d测定血清PON3、25(OH)D3、FGF-23水平,分析上述指标在患病早产儿、正常早产儿中的表达差异。根据患病早产儿代谢性骨病发生情况,将其分成代谢性骨病组、非代谢性骨病组,比较两组出生后1 d的血清PON3、25(OH)D3、FGF-23水平,绘制受试者工作特征曲线(ROC)分析各指标对代谢性骨病的预测价值。结果:两组出生后30 d的血清25(OH)D3、FGF-23显著高于出生后1 d,且血清PON3显著低于出生后1 d(P<0.05)。实验组血清25(OH)D3、FGF-23水平均显著低于对照组(P<0.05)。两组胎龄≤30周的早产儿血清25(OH)D3含量显著低于胎龄>30周的早产儿(P<0.05)。在400例早产儿中,有52(13.00%)例发生代谢性骨病,348(87.00%)例无代谢性骨病。代谢性骨病组血清25(OH)D3、FGF-23水平显著低于非代谢性骨病组(P<0.05)。血清25(OH)D3、FGF-23水平预测代谢性骨病的曲线下面积分别为0.632、0.679。结论:与正常早产儿相比,患病早产儿的血清25(OH)D3、FGF-23水平显著下降,且胎龄越小,血清25(OH)D3、FGF-23水平越低,随着出生时间延长,二者逐渐增高;与非代谢性骨病患儿相比,代谢性骨病者的血清25(OH)D3、FGF-23水平明显下降,且二者对代谢性骨病具有预测价值。

Objective:To explore the expression of serum paraoxonase 3(PON3),25 hydroxyvitamin D3[25(OH)D3]and fibroblast growth factor(FGF)-23 in preterm infants and the predictive value for metabolic osteopathy.Methods:200 cases of sick premature infants in our hospital from December 2014 to December 2016 were selected as an experimental group,and 200 cases of normal premature infants delivered in our hospital during the same period were selected as a control group.The levels of PON3,25(OH)D3 and FGF-23 in serum were measured on the 1st,7th,14th and 30th day after birth,and the differences in the expressions of PON3,25(OH)D3 and FGF-23 in sick premature infants and normal premature infants were analyzed.The premature infants were divided into metabolic osteopathy group and non-metabolic osteopathy group.The levels of PON3,25(OH)D3 and FGF-23 in serum on day 1 after birth were compared.Predictive value of metabolic osteopathy was analyze by ROC curve.Results:The serum 25(OH)D3 and FGF-23 levels on day 30 after birth were higher than those on the first day after birth in both groups,while the serum PON3 level was significantly lower(P<0.05).Serum levels of 25(OH)D3 and FGF-23 were significantly lower in the experimental group than those in the control group(P<0.05).The serum 25(OH)D3 level in infants with gestational age≤30 weeks was significantly lower compared with those with gestational age>30 weeks(P<0.05).Among 400 premature infants,52 cases(13.00%)had metabolic osteopathy,and 348 cases(87.00%)had no metabolic osteopathy.The serum levels of 25(OH)D3 and FGF-23 in metabolic osteopathy group were significantly lower than those in non-metabolic osteopathy group(P<0.05).The area under the ROC curve of 25(OH)D3 and FGF-23 in predicting metabolic osteopathy was 0.632 and 0.679,respectively.Conclusion:Compared with normal preterm infants,the serum levels of 25(OH)D3 and FGF-23 in sick preterm infants decreased significantly;the lower the gestational age,the lower the serum levels of 25(OH)D3 and FGF-23,and with the prolongation of birth time,both of them increased gradually.Compared with non-metabolic osteopathy children,the levels of serum 25(OH)D3 and FGF-23 in metabolic osteopathy children decreased significantly,and both of them were valuable in predicting metabolic osteopathy.