老年胸腰段骨质疏松性椎体压缩骨折患者维生素D受体基因多态性与其骨密度及半定量分型的相关性分析

Correlation analysis between vitamin D receptor gene polymorphism and bonemineral density and semi-quantitative typing in elderly patients with thoracolumbar osteoporotic vertebral compression fractures

目的探讨老年胸腰段骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者维生素D受体(vitamin D receptor,VDR)基因多态性与其骨密度及半定量分型的相关性。方法选取2016年3月至2019年3月我院94例老年OVCF患者作为观察组,另选取同期来我院进行健康体检的老年健康者94名作为对照组。比较两组及不同基因型患者一般资料,分析维生素D受体基因型与老年OVCF的关系,并探讨不同基因型患者半定量分型及骨密度。结果两组性别、VDR基因型相比,差异有统计学意义(P<0.05);VDR-BB基因型为老年OVCF发生的保护因素,VDR-Bb、bb基因型为老年OVCF发生的危险因素(P<0.05);不同VDR基因型患者性别、年龄、骨折节段、病变节段、血磷、钙浓度相比,差异无统计学意义(P>0.05);VDR-Bb基因型与bb基因型骨折半定量分型例数及椎体数分布相比,差异有统计学意义(P<0.05),VDR-Bb基因型老年OVCF患者I型例数及椎体数明显低于VDR-bb基因型患者(P<0.05),且VDR基因型与骨折半定量分型具有显著相关性(P<0.05);不同VDR基因型患者胸椎、腰椎骨密度相比,差异无统计学意义(P>0.05),且VDR基因型与胸椎、腰椎骨密度无显著相关性(P>0.05)。结论VDR-Bb、bb基因型可增加老年OVCF发生风险,并与半定量分型存在一定关联性,早期检测VDR基因多态性,对评估OVCF压缩程度具有一定预测价值。

Objective To investigate the correlation between vitamin D receptor(VDR)gene polymorphism and bone mineral density and semi-quantitative typing in elderly patients with thoracolumbar osteoporotic vertebral compression fracture(OVCF).Me thods From March 2016 to March 2019,94 elderly OVCF patients in our hospital were selected as the observation group,and94 elderly healthy people who came to our hospital for a physical examination during the same period were selected as the control group.The general data of the two groups and patients with different genotypes were compared.The relationship between the vitamin D receptor genotype and elderly OVCF was analyzed.The semiquantitative typing and bone mineral density of patients with different genotypes were discussed.Re sults The differences of sex and VDR genotypes between the two groups were statistically significant(P<0.05).VDR-BB genotype was a protective factor for the occurrence of OVCF in the elderly,and VDR-Bb and bb genotype were the risk factors for the occurrence of OVCF in the elderly(P<0.05).There was no significant difference in gender,age,fracture segment,lesion segment,blood phosphorus,and calcium concentration in patients with different VDR genotypes(P>0.05).There was a statistically significant difference in the number of cases between VDR-Bb genotype and bb genotype fractures and the distribution of vertebral body number(P<0.05).The number of type I cases and vertebral bodies in elderly OVCF patients with VDR-BB genotype were significantly lower than those with VDR-BB genotype(P<0.05).VDR genotype was significantly correlated with semi-quantitative fracture typing(P<0.05).There was no significant difference in thoracic and lumbar vertebrae bone mineral density among patients with different VDR genotypes(P>0.05),and there was no significant correlation between VDR genotype and thoracic vertebra and lumbar vertebra bone mineral density(P>0.05).Conclusion The VDR-Bb and bb genotypes increase the risk of OVCF in the elderly,and there is a certain correlation with semi-quantitative typing.Early detection of VDR gene polymorphisms has certain predictive value for assessing the degree of OVCF compression.