血清25羟维生素D、TRACP-5b、PINP、β-CTX在绝经期骨质疏松病人中的检测意义

Clinical value of serum 25-hydroxyvitamin D,TRACP-5b,PINP,β-CTX in diagnosis of postmenopausal osteoporosis

目的分析25羟维生素D[25(OH)D]、血清抗酒石酸酸性磷酸酶5b(TRACP-5b)、Ⅰ型前胶原氨基端原肽(PINP)、β胶原降解产物(β-CTX)诊断绝经后骨质疏松(osteoporosis,OP)的临床价值。方法选取2019年3月至2021年7月在我院骨质疏松专病门诊诊疗的150例OP病人为绝经后OP组,另选取同时期体检骨量正常的150名绝经女性纳入对照组。所有受试者均进行骨密度(BMD)、25(OH)D、TRACP-5b、PINP、β-CTX检测,采用Logistic回归分析以上指标与OP的相关性,采用ROC曲线分析25(OH)D及骨代谢指标对OP的诊断效能。结果OP组血清BMD及25(OH)D水平低于对照组,TRACP-5b、PINP、β-CTX水平高于对照组。Pearson相关分析得出,绝经后OP病人血清25(OH)D含量与BMD呈正相关,TRACP-5b、PINP、β-CTX水平与BMD呈负相关。Logistic回归分析显示,血清25(OH)D含量降低及TRACP5b、PINP、β-CTX水平升高可能是造成绝经后OP发生的影响因素。ROC曲线分析显示,上述四个指标单独用于诊断OP的AUC分别为0.82、0.87、0.82、0.70,联合诊断效能达到0.90。结论血清25(OH)D、TRACP-5b、PINP、β-CTX可联合用于诊断绝经后OP,为临床预防、干预治疗提供一定的依据。

Objective To analyze the clinical value of 25-hydroxyvitamin D[25(OH)D],serum tartrate-resistant acid phosphatase 5b(TRACP-5b),typeⅠprocollagen amino-terminal propeptide(PINP)andβ-isomerized C-terminal telopeptides(β-CTX)in the diagnosis of postmenopausal osteoporosis(OP).Methods A total of 150 patients diagnosed as postmenopausal OP(T≤-2.5 SD)in our hospital from March 2019 to July 2021 were selected as the OP group,and 150 postmenopausal women with normal bone mass density(BMD)during physical examination at the same period were selected as the control group.The levels of BMD,25(OH)D,TRACP-5b,PINP andβ-CTX were detected in all subjects.The relationship of all indexes of bone metabolism with OP were analyzed by Logistic regression,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of 25(OH)D,TRACP-5b,PINP andβ-CTX for OP.Results The serum levels of BMD and 25(OH)D in the OP group were significantly lower,and the serum levels of TRACP-5b,PINP andβ-CTX were significantly higher than those in the control group.Pearson correlation analysis showed that serum level of 25(OH)D was positively correlated with BMD,and the levels of TRACP-5b,PINP andβ-CTX were negatively correlated with BMD in the OP patients.Logistic regression analysis showed that the decrease of serum 25(OH)D and the increase of TRACP-5b,PINP andβ-CTX may be the influencing factors for the occurrence of postmenopausal OP.ROC curve analysis showed that the efficiency of the above four indicators alone for diagnosing OP was 0.82,0.87,0.82,0.70,respectively,and the combined diagnostic efficiency reached 0.90.Conclusions Serum levels of 25(OH)D,TRACP-5b,PINP andβ-CTX can be used in combination to diagnose postmenopausal OP,and can provide some basis for clinical prevention and intervention.