骨密度及骨代谢指标与骨质疏松性骨折相关性研究

The Correlation between Bone Mineral Density and Bone Metabolism Markers and oOsteoporotic Fracture

目的对骨质疏松患者中存在骨质疏松性骨折与无骨折的骨密度和骨代谢指标进行对比分析,并寻找相关性。方法搜集2014年11月至2017年6月于泉州市正骨医院诊断为胸腰椎及髋部骨质疏松性骨折患者136例及84例骨质疏松但无骨折患者,分为骨折组与对照组。对比分析所有患者的年龄、性别、骨密度值及骨代谢指标,并使用二元Logistic回归对各个指标是否为骨质疏松性骨折危险因素进行分析。结果骨折组的腰椎、股骨颈及全髋BMD均低于对照组,差异具有统计学意义(P<0.05)。骨折组的骨代谢指标中TP1NP高于对照组,骨钙素低于对照组,差异具有统计学意义(P<0.05)。Logistic回归分析显示,腰椎BMD、股骨颈BMD、TP1NP及骨钙素是骨质疏松性骨折的危险因素(P<0.05)。ROC曲线显示,联合模型预测骨质疏松性骨折的效能高于各单一指标。结论腰椎与股骨颈BMD、TP1NP及骨钙素是骨质疏松性骨折的危险因素,联合上述指标对骨质疏松性骨折具有一定预测能力。

Objective To compare the bone mineral density and bone metabolism markers between osteoporotic fracture and nonfracture in patients with osteoporosis,and look for the correlation.Methods From November 2014 to June 2017,136 patients with osteoporotic fractures and 84 patients with osteoporosis without fracture were collected who were hospitalized in Quanzhou Orthopedic-Traumatological Hospital.They were divided into fracture group and control group.The age,gender,bone mineral density and bone metabolism markers of all patients were compared.The correlation between the above indicators and osteoporotic fracture was analyzed.using binary Logistic regression.Results The BMD of lumbar spine,femoral neck and total hip in fracture group were lower than those in control group(P<0.05).TP1NP in the fracture group was higher,while osteocalcin was lower than those in the control group(P<0.05).Logistic regression analysis showed that lumbar spine BMD,femoral neck BMD,TP1NP and osteocalcin were risk factors for osteoporotic fractures(P<0.05).The ROC curve showed that the combined model was more effective in predicting osteoporotic fractures than each single index.Conclusion The BMD of lumbar spine and femoral neck,TP1NP and osteocalcin were the risk factors of osteoporotic fracture,which could predict osteoporotic fracture to a certain extent.Combined with the above indexes,it has a certain predictive ability for osteoporotic fracture.