老年男性血清Gremlin-1、dp-ucMGP与骨质疏松的相关性

Correlation analysis between serum Gremlin-1,dp-ucMGP and osteoporosis in elderly men

目的探讨老年男性血清Gremlin-1、脱磷-未羧化-基质Gla蛋白(dp-ucMGP)水平与骨质疏松的相关性。方法选取2019年1月~2020年12月于我院确诊的139例老年男性骨质疏松患者为病例组,纳入同期本院142例男性健康体检者为对照组。采用酶联免疫吸附法测定两组血清Gremlin-1、dp-ucMGP水平以及相关骨代谢指标。采用ROC曲线分析血清Gremlin-1、dp-ucMGP水平诊断骨质疏松的临床价值,多因素Logistic逐步回归模型探讨骨质疏松发生的相关因素。结果两组年龄、ALB、HDLC、LDLC、TC、TG、TP、收缩压、舒张压、BMI等基础资料比较差异无统计学意义(P>0.05)。病例组血清Gremlin-1、dp-ucMGP水平明显低于对照组(P<0.05)。病例组血清Ⅰ型胶原氨基酶端延长肽(PINP)、β-胶原特殊序列(β-CTX)水平明显高于对照组,血清25-(OH)D、N-端骨钙素(N-MID)、骨钙素(OC)以及骨密度(BMD)明显低于对照组,差异均有统计学意义(P<0.05)。Gremlin-1、dp-ucMGP与PINP、β-CTX呈负相关,与25-(OH)D、N-MID、OC以及BMD呈正相关(P<0.05)。受试者工作特征曲线显示,Gremlin-1、dp-ucMGP预测老年男性骨质疏松的ROC曲线下面积分别为0.859(95%CI:0.768~0.943)、0.833(95%CI:0.748~0.924),两者诊断骨质疏松的灵敏度、特异度相近(2=1.563、1.215,P>0.05)。多因素Logistic回归分析显示,Gremlin-1、dp-ucMGP、25-(OH)D降低,β-CTX升高均为老年男性发生骨质疏松的危险因素[OR及95%CI:2.18(1.17~4.08)、4.14(1.58~10.81)、5.62(2.06~10.32)、3.06(1.54~6.08)]。结论骨质疏松症患者血清Gremlin-1、dp-ucMGP降低,且Gremlin-1、dp-ucMGP水平与骨代谢指标密切相关;Gremlin-1、dp-ucMGP降低均为老年男性出现骨质疏松的危险因素。

Objective To investigate the correlation between serum Gremlin-1,dp-ucMGP and osteoporosis in elderly men.Methods A total of 139 elderly male patients with osteoporosis diagnosed in our hospital from January 2019 to December 2020 were selected as the case group,and 142 healthy male patients in our hospital during the same period were included as the control group.Serum Levels of Gremlin-1,DP-ucMGP and bone metabolism were determined by enzyme-linked immunosorbent assay.ROC curve was used to analyze the clinical value of serum Levels of Gremlin-1 and DP-ucMGP in the diagnosis of osteoporosis.Results The ALB,HDLC,LDLC,TC,TG,TP,age,systolic blood pressure,diastolic blood pressure,BMI and other basic data was no significant difference between the control group and the case group(P>0.05).The serum levels of Gremlin-1 and dp-ucMGP in the case group were significantly lower than those in the control group(P<0.05).The serum PINP andβ-CTX levels of the case group were significantly higher than those of the control group,and the serum^(2)5-(OH)D,N-MID,OC and BMD levels were significantly lower than those of the control group(P<0.05).Gremlin-1 and dp-ucMGP were negatively correlated with PINP andβ-CTX,and positively correlated with 25-(OH)D,N-MID,OC and BMD(P<0.05).The receiver operating characteristic curve showed that the area under the ROC curve of Gremlin-1 and dp-ucMGP predicting osteoporosis in elderly men was 0.859(95%CI:0.768~0.943),0.833(95%CI:0.748~0.924),and the sensitivity and specificity of both indexes for the diagnosis of osteoporosis were similar(2=1.563,1.215,P>0.05).Multivariate logistic regression analysis showed that low Gremlin-1,low dp-ucMGP,low 25-(OH)D,and highβ-CTX were risk factors for osteoporosis in elderly men[OR and 95%CI:2.18(1.17~4.08),4.14(1.58~10.81),5.62(2.06~10.32),3.06(1.54~6.08)].Conclusion The serum Gremlin-1 and dp-ucMGP of osteoporosis patients are decreased,and Gremlin-1 and dp-ucMGP are closely related to bone metabolism indexes.The decrease of Gremlin-1 and dp-ucMGP are risk factors for osteoporosis in elderly men.