脆性骨折患者骨转换标记物的变化及相关性分析

Analysis of Bone Turnover Markers in Osteopenia Patients with Fragility Fracture

目的研究基于脆性骨折诊断骨质疏松症患者骨转换标记物的变化及与脆性骨折发生的相关性。方法收集2019年1月1日至2022年1月1日于南京中医药大学附属南京中医院门诊和住院治疗的确诊为脆性骨折且骨密度检查为骨量减少的中老年女性患者45例为观察组,同时设立骨密度检查为骨量减少、未发生脆性骨折的中老年女性患者71例为对照组。观察组45例,年龄67~78岁,平均(75.58±8.44)岁。对照组71例,年龄61~91岁,平均(75.34±8.58)岁。对比分析两组患者的年龄、身高、体重、身体质量指数(body mass index,BMI)、骨密度、骨转换标记物[骨钙素(osteocalcin,OC)、碱性磷酸酶(alkaline phosphatase,ALP)、Ⅰ型原胶原氨基端前肽(N-terminal peptide of typeⅠcollagen,P1NP)及β-Ⅰ型胶原交联羧基末端肽(C-terminal peptide of typeⅠcollagen,CTX)]及血清Ca^(2+)浓度的差异。结果两组患者在年龄、体重、身高和骨密度T值之间差异无统计学意义(P>0.05),但是观察组平均BMI较对照组高,差异有统计学意义(P<0.05)。观察组患者的OC、ALP、β-CTX和血清Ca^(2+)高于对照组患者,差异有统计学意义(P<0.05)。观察组患者的P1NP虽然低于对照组患者,但差异无统计学意义(P>0.05)。脆性骨折的发生与体重、OC、ALP、β-CTX、BMI和Ca^(2+)浓度均呈显著的负相关(P<0.05)。结论骨密度检测为骨量减少的患者需检测骨转换指标,破骨指标和成骨指标显著升高的患者发生脆性骨折风险高。脆性骨折的发生与体重、OC、ALP、β-CTX、BMI和Ca^(2+)浓度均呈负相关。

Objective To research the changes of bone turnover markers in osteopenia patients with fragility fracture and its correlation with occurrence rate of fragility fracture.Methods From January 012019 to January 012022,we collected 45 osteopenia older women patients with fragility fracture as the observation group and at the same time we set up 71 osteopenia older women patients without fragility fracture as control group in outpatient and hospitalization in Nanjing Hospital of Chinese Medical Affiliated to Nanjing University of Chinese Medicine.There were 45 cases in the observation group,aged 67~78 years,with an average of(75.58±8.44)years.There were 71 cases in the control group,aged 61~91 years,with an average age of(75.34±8.58)years.Age,height,weight,BMI,bone mineral density,bone turnover indicators:OC(osteocalcin),ALP(alkaline phosphatase),P1NP(N-terminal peptide of typeⅠcollagen)andβ-CTX(C-terminal peptide of typeⅠcollagen)and serum Ca^(2+)concentration were collected and compared.Results There was no significant difference in age,body weight,height and bone mineral density T value between two groups(P>0.05),but the average body mass index(BMI)in observation group was higher than that in control group,the difference was statistically significant(P<0.05).The concentrations of OC,ALP,β-CTX and Ca^(2+)in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05),while the concentration of P1NP in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).The incidence of fragility fracture was significantly negatively correlated with body weight,OC,ALP,β-CTX,BMI and Ca^(2+).Conclusion Bone conversion markers is required to detect in osteopenia patients by BMD.Patients with significantly increased osteoclasts and osteogenesis markers are at high risk of fragility fracture.The occurrence of fragility fracture is negatively correlated with body weight,OC,ALP,β-CTX,BMI and Ca^(2+)concentration.