6项骨代谢标志物与老年骨质疏松性骨折的相关性研究

A study on the correlation between six markers of bone metabolism and senile osteoporotic fractures

目的通过检测老年骨质疏松性骨折患者的骨钙素(N-MID)、Ⅰ型前胶原N端肽(PINP)、β-胶原特殊序列(β-CTX)、25-羟维生素D[25-(OH)D]、甲状旁腺素(PTH)、血清钙(Ca)的水平,研究其与老年骨质疏松性骨折发生的相关性。方法选取110例骨质疏松性骨折患者为观察组,取97例体检老年人为对照组,检测25-(OH)D、N-MID、PINP、β-CTX、PTH、Ca,分析这些指标在对照组和观察组之间的差异。结果观察组25-(OH)D不足和缺乏比例β-CTX、N-MID、PINP、PTH水平显著高于对照组(P<0.05),观察组25-(OH)D水平显著低于对照组(P<0.05)。观察组女性N-MID水平显著高于观察组男性(P<0.05),观察组女性平均年龄显著高于观察组男性平均年龄,差异均有统计学意义(P<0.05)。通过二元logistic回归模型进行分析,PINP、PTH为骨质疏松性骨折风险因素(P<0.05),25-(OH)D为骨质疏松骨折保护因素(P<0.05)。结论老年骨折患者存在高比例的25-(OH)D缺乏和不足,老年人骨代谢水平与骨折的发生存在明显相关性;老年女性发生骨折的比例要高于老年男性。

Objective This paper aims to detect the levels of osteocalcin(N-MID),N-terminal peptide of type Ⅰ procollagen(PINP)β-collagen specific sequence(β-CTX),25 hydroxyvitamin D[25-(OH)D],parathyroid hormone(PTH),and serum calcium(Ca)levels to study their correlation with the occurrence of osteoporosis fracture in the elderly.Methods A total of 110 cases of osteoporotic fracture were selected as the observation group and 97 elderly cases for physical examination were selected as the control group.25-(OH)D,N-MID,PINP,β-CTX,PTH and Ca were used to analyze the differences between the control group and the observation group.Results The proportion of 25-(OH)D deficiency and lack,as well as the levels ofβ-CTX,N-MID,PINP and PTH in the observation group were higher than those in the control group(P<0.05),and the 25-(OH)D level in the observation group was lower than that in the control group(P<0.05).The N-MID level of women was higher than that of men in the observation group(P<0.05),and the average age of women was higher than that of men in the observation group,with the differences statistically significant(P<0.05).Through the analysis of binary logistic regression model,PINP and PTH were the risk factors of osteoporosis fracture(P<0.05),and 25-(OH)D was the protective factor of osteoporosis fracture(P<0.05).Conclusion There is a high proportion of 25-(OH)D deficiency and lack in elderly patients with fracture,and there is a significant correlation between the level of bone metabolism and the occurrence of fracture in the elderly.The proportion of fracture in elderly women is higher than that in elderly men.