血清IL-32γ、SOST及H2S与老年慢性心力衰竭患者骨质疏松的关系

Relationship between serum IL⁃32γ,SOST and H2S level and osteoporosis in elderly patients with chronic heart failure

目的探讨血清白细胞介素(IL)-32γ、骨硬化蛋白(SOST)及血清硫化氢(H2S)与老年慢性心力衰竭(CHF)患者骨质疏松(OP)的关系。方法选取2019年1月至2022年12月收治的老年CHF患者122例,根据OP情况分为OP组(n=66)和非OP组(n=56)。比较两组一般资料和血清IL-32γ、SOST及H2S水平,采用logistic回归模型分析老年CHF患者合并OP的影响因素。绘制受试者操作特征(ROC)曲线分析血清IL-32γ、SOST及H2S水平对老年CHF患者合并OP的预测效能。结果OP组血清IL-32γ和H2S水平均低于非OP组(t=5.446,4.254,均P<0.05),而其女性占比、年龄、吸烟史占比、慢性心力衰竭病程、空腹血糖、糖化血红蛋白、总胆固醇及血清SOST水平则高于非OP组(χ^(2)/t=5.611,6.169,5.855,5.283,4.576,5.805,5.380,均P<0.05)。logistic回归分析结果显示,血清IL-32γ和H2S水平是老年CHF患者合并OP的独立保护因素,而年龄、吸烟史、慢性心力衰竭病程及血清SOST水平则是老年CHF患者合并OP的独立危险因素(均P<0.05)。ROC曲线分析结果显示,血清IL-32γ、SOST联合H2S水平对老年CHF患者合并OP预测价值较高,曲线下面积为0.849(95%CI:0.776~0.921)。结论血清IL-32γ、SOST及H2S均与老年CHF患者骨质疏松密切相关,三者联合检测可作为老年CHF患者合并OP早期预测指标。

Objective To explore the relationship between serum interleukin(IL)⁃32γ,scleros⁃tin(SOST)and hydrogen sulfide(H2S)level and osteoporosis in elderly patients with chronic heart failure.Methods 122 elderly patients with CHF admitted from January 2019 to December 2022 were divided into the OP group(n=66)and the non⁃OP group(n=56)according to OP status.The general data and serum IL⁃32γ,SOST and H2S levels between the two groups were compared.The influencing factors of OP in elderly CHF pa⁃tients were analyzed by logistic regression model.The ROC curve was drawn to analyze value of serum IL⁃32γ,SOST and H2S levels predicting the OP in elderly CHF patients.Results Serum IL⁃32γand H2S levels in the OP group were lower than those in the non⁃OP group(t=5.446,4.254,P<0.05),while the proportion of wom⁃en,age,smoking history rate,chronic heart failure course,fasting blood glucose,glycosylated hemoglobin,total cholesterol and serum SOST level in the OP group were higher than those in the non⁃OP group(χ^(2)/t=5.611,6.169,5.855,5.283,4.576,5.805,5.380,P<0.05).The results of logistic regression analysis showed that serum IL⁃32γand H2S level were independent protective factors of OP in elderly CHF patients,while age,smok⁃ing history,chronic heart failure course and serum SOST level were independent risk factors of OP in elderly CHF patients(P<0.05).The results of ROC curve analysis showed that serum IL⁃32γ,SOST combined with H2S levels had a higher predictive value for OP in elderly CHF patients,and the area under the curve was 0.849(95%CI:0.776~0.921).Conclusion Serum IL⁃32γ,SOST and H2S levels are closely related to osteoporosis in elderly CHF patients,and the combined detection of the above three factors may be used as early predictor of OP in elderly CHF patients.