绝经期骨质疏松症患者血清骨代谢、矿物代谢指标水平及临床诊断价值

Levels and clinical diagnostic value of serum bone metabolism and mineral metabolism indexes of women with menopausal osteoporosis

目的:探讨绝经期骨质疏松症(PMOP)女性血清骨钙素(OC)、I型胶原羧基端肽B特殊序列(β-CTX)、血钙(Ca)、血磷(P)、血25羟维生素D(25(OH)D)水平及临床意义。方法:选取2020年5月-2020年12月在本院绝经期女性257例,根据骨密度分为骨质疏松组(68例,T值≤-2.5)、骨量低下组(124例,-2.5<T值<-1)、正常对照组(65例,T值≥-1)。收集研究对象临床资料并检测其血清Ca、P、OC、β-CTX及25(OH)D水平;采用受试者工作特征曲线(ROC)分析各指标对绝经期女性骨质疏松症的诊断价值。结果:骨质疏松组、骨量低下组、正常对照组血P水平无差异(P>0.05);与正常对照组相比、骨量低下组、血Ca水平骨质疏松组依次下降,骨质疏松组OC、β-CTX水平上升、25(OH)D水平下降,骨量低下组仅OC、β-CTX水平上升(均P<0.05)。ROC曲线分析显示,血Ca、OC、β-CTX及25(OH)D诊断绝经期女性骨质疏松症的AUC分别为0.746、0.774、0.658、0.787,4项指标联合诊断的AUC(0.902)最高。结论:血清Ca、OC、β-CTX及25(OH)D水平变化可能与PMOP的发生有关,联合监测上述指标对诊断PMOP有较高临床价值。

Objective:To explore the levels and clinical significance of serum osteocalcin,βisomer of C-terminal telopeptide of type I collagen(β-CTX),calcium(Ca),phosphorus(P),and 25-hydroxyvitamin D(25(OH)D)of women with menopausal osteoporosis.Methods:A total of 257 women with menopausal osteoporosis or low bone mass confirmed by bone densitometer were enrolled between May and December 2020.According to different bone density,these women were divided into group A(68 cases with osteoporosis,T≤-2.5)and group B(124 cases with low bone mass,-2.5<T<-1).65 normal women(T≥-1)were selected in group C.The clinical data of the women in the three groups were collected.The levels of serum Ca,P,OC,β-CTX,and 25(OH)D of the women in the three groups were detected.The diagnostic value of all indexes for osteoporosis of women with menopausal osteoporosis was analyzed by receiver operating characteristic(ROC)curve.Results:There was no significant difference in the blood P level of the women among group A,group B,and group C(P>0.05).The serum Ca level of the women in group C,group B,and group A had decreased gradually(P<0.05).The OC andβ-CTX levels of the women in group A were significantly higher than those of the women in group C,but the 25(OH)D level of the women in group A was significantly lower.The OC andβ-CTX levels of the women in group B were significantly higher than those of the women in group C(all P<0.05).ROC curve analysis showed that the AUC of the level of serum Ca,OC,β-CTX,and 25(OH)D for diagnosing osteoporosis of menopausal women were 0.746,0.774,0.658,and 0.787,respectively,and the AUC of the combined of the levels of serum Ca,OC,β-CTX,and 25(OH)D for diagnosing osteoporosis of menopausal women was 0.902,which was the highest.Conclusion:The levels changes of serum Ca,OC,β-CTX,and 25(OH)D of women may be related to their occurrence of menopausal osteoporosis.The combined levels of serum Ca,OC,β-CTX,and 25(OH)D for diagnosing menopausal osteoporosis has high clinical value.