HIF-1α与VEGF联合预测2型糖尿病发生骨质疏松的价值

HIF-1 α the value of combined prediction of osteoporosis with VEGF in type 2 diabetes

目的探讨缺氧诱导因子(HIF)-1α、血管内皮生长因子(VEGF)联合预测糖尿病性骨质疏松患者发生的价值。方法选取深圳市坪山区人民医院2019年12月至2021年8月收治的2型糖尿病患者125例,使用酶联免疫吸附试验(ELISA)对患者HIF-1α与VEGF水平进行检测。对所有患者进行半年随访,根据是否发生糖尿病性骨质疏松分为观察组与对照组。收集两组患者的一般资料,骨代谢、骨转化以及HIF-1α、VEGF等临床资料,进行统计学对比分析。使用受试者工作特征曲线(ROC)对HIF-1α、VEGF两指标单独以及联合预测糖尿病性骨质疏松的价值进行分析。结果有36例于随访第6个月时被确诊为糖尿病性骨质疏松,纳入观察组,余89例未被诊断为糖尿病性骨质疏松的患者纳入对照组。入组时,观察组患者血清HIF-1α与VEGF水平均高于对照组,差异有统计学意义(P<0.05)。随访第6个月时,观察组患者碱性磷酸酶(ALP)、骨钙素(BGP)水平低于对照组,人1型胶原C端肽(CTX-1)和转化生长因子-β(TGF-β1)水平高于对照组,差异有统计学意义(P<0.05)。HIF-1α的诊断阈值为38.15 ng/L,曲线下面积(AUC)0.654,约登指数为0.554;VEGF的诊断阈值为285.50 ng/L,AUC0.668,约登指数为0.326。联合检测的AUC0.821,约登指数为0.709,高于两项指标单独检测。结论HIF-1α、VEGF指标水平与2型糖尿病患者发生糖尿病性骨质疏松有关,将两项指标联合检测用于预测糖尿病性骨质疏松的发生风险具有较好的效能,能够帮助临床工作人员早期筛查出糖尿病性骨质疏松的高风险人群,从而进行针对性防治手段,提升患者预后。

Objective To investigate the value of hypoxia-inducible factor 1α(HIF-1α)plus vascular endothelial growth factor(VEGF)in predicting the occurrence of diabetic osteoporosis in patients.Methods A total of 125 patients with type 2 diabetes mellitus admitted to Pingshan District People’s Hospital of Shenzhen from December 2019 to August 2021 were selected as study subjects.The levels of HIF-1αand VEGF of these patients were measured by enzyme-linked immunosorbent assay(ELISA).All patients were followed up for six months and divided into observation and control groups according to the presence or absence of diabetic osteoporosis.The general information of patients and their clinical data such as bone metabolism,bone transformation,HIF-1αand VEGF were collected for statistical comparison and analysis.The value of both HIF-1αand VEGF alone and in combination to predict diabetic osteoporosis was analyzed by using the receiver operating characteristic(ROC)curve.Results 36 of 125 subjects were diagnosed with diabetic osteoporosis at the 6th month of follow-up and were included in the observation group,and the remaining 89 patients with no diabetic osteoporosis were included in the control group.At the time of enrollment,the levels of serum HIF-1αand VEGF in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).At the 6th month of follow-up,the levels of alkaline phosphatase(ALP)and bone Gla-protein(BGP)were lower,while the levels of human type 1 collagen C-terminal peptide(CTX-1)and transforming growth factor-β1(TGF-β1)were higher in the observation group than i n the control group,with statistically significant differences(P<0.05).The threshold was 38.15 ng/L,the area under the ROC curve(AUC)was 0.654,and the Youden index was 0.554 for diagnosis with HIF-1α,while the threshold was 285.50 ng/L,the AUC was 0.668,and the Youden index was 0.326 for diagnosis with VEGF.The AUC was 0.821 and the Youden index was 0.709 for combined HIF-1αand VEGF diagnosis,which were higher than those diagnosed with the two indicators alone.Conclusion The levels of HIF-1αand VEGF are related to the occurrence of diabetic osteoporosis in patients with type 2 diabetes mellitus,and the combination of the two indicators in diagnosis is effective in predicting diabetic osteoporosis,which can help clinical staff to screen the high-risk group of diabetic osteoporosis at an early stage,so that targeted prevention and treatment measures can be given to improve the prognosis of patients.