血清E2、P1NP水平对绝经后骨质疏松性腰椎骨折风险的预测价值

The predictive value of serum E2 and P1NP levels in the risk of osteoporotic lumbar fractures in postmenopausal women

目的探究血清雌二醇(E2)、Ⅰ型原胶原氨基端肽(P1NP)水平对绝经后骨质疏松性合并腰椎骨折风险的预测价值.方法选取2015年8月至2018年8月在本院就诊的62例绝经后骨质疏松性腰椎骨折患者作为骨折组,另取同期绝经后骨质疏松无腰椎骨折患者62例作为非骨折组.采用X射线骨密度仪检测两组患者髋部及腰部骨密度(BMD),并采用电化学法发光法检测其血清E2及P1NP水平.采用Logistic回归分析探究影响绝经后骨质疏松性腰椎骨折的危险因素,利用受试者工作曲线(ROC曲线)分析血清E2及P1NP对绝经后骨质疏松性腰椎骨折风险的预测价值.结果两组患者髋部及腰部BMD差异无统计学意义(P>0.05).骨折组血清E2水平明显低于非骨折组,血清P1NP水平明显高于非骨折组(P<0.05).Logistic回归分析显示低水平E2及高水平是导致绝经后骨质疏松性腰椎骨折的独立危险因素(P<0.05).血清E2及P1NP联合诊断绝经后骨质疏松性合并腰椎骨折时受试者工作(ROC)曲线下面积(AUC)为0.836,高于两者单独检测时的AUC(0.765和0.773,P<0.05).结论血清E2、P1NP水平与绝经后骨质疏松性腰椎骨折的发生密切相关,两者联合检测用于预测绝经后骨质疏松性腰椎骨折风险具有很高的价值.

Objective To investigate the predictive value of serum estradiol(E2)and procollagen type 1 amino-terminal propeptide(P1 NP)levels in the risk of osteoporosis combined with lumbar fractures in postmenopausal women.Methods A total of 62 patients with osteoporotic lumbar fractures after menopause who were diagnosed in the hospital from August 2015 to August 2018 were enrolled as fracture group.62 patients with osteoporosis but without lumbar fractures after menopause in the same period were included as nonfracture group.The bone mineral density(BMD)at hip and lumbar of both groups were detected by X-ray bone sonometers.The serum E2 and P1 NP levels were detected by electrochemistry method and luminescence method.The logistic regression analysis was used to explore the risk factors affecting postmenopausal osteoporotic lumbar fractures,and the receiver operating curve(ROC curve)was used to analyze the predictive value of serum E2 and P1 NP on the risk of postmenopausal osteoporotic lumbar fractures.Results There was no significant difference in hip or lumbar BMD between the two groups(P>0.05).Serum E2 level in fracture group was significantly lower than that in non-fracture group,while serum P1 NP level was significantly higher than that in non-fracture group(P<0.05).The logistic regression analysis showed that low levels of E2 and high levels were independent risk factors for postmenopausal osteoporotic lumbar fractures(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of serum E2 and P1 NP for the diagnosis of osteoporosis combined with lumbar fracture after menopause was 0.836,which was higher than that of either of the two(0.765 and 0.773,P<0.05).Conclusion Serum E2 and P1 NP levels are closely related to the occurrence of osteoporotic lumbar fractures after menopause.The combined detection of the two is of high value in predicting risk of osteoporotic lumbar fractures after menopause.