绝经后骨质疏松患者血清Ⅰ型胶原氨基末端、Ⅰ型胶原羧基末端及骨钙素的表达变化及临床意义

The Expression Changes and Clinical Significance of Serum TypeⅠCollagen Amino Terminal,TypeⅠCollagen Carboxyl Terminal,and Osteocalcin in Postmenopausal Osteoporosis Patients

目的:探讨绝经后骨质疏松患者血清Ⅰ型胶原氨基末端(NTx)、Ⅰ型胶原羧基末端(CTX)及骨钙素(BGP)的表达变化及临床意义。方法:选取我院2017年8月-2022年8月收治的60例绝经后骨质疏松患者作为研究对象,将其分为观察组,另选取同期来我院体检的60名绝经后健康志愿者作为对照组。对比两组患者NTx、CTX、BGP表达水平,并建立受试者特征工作(ROC)曲线分析NTx、CTX、BGP对绝经后骨质疏松的诊断效能。3个月后对所有患者进行门诊复查随访,将症状明显明显减轻,X线检查明显改善,骨密度值明显增加的35例绝经后骨质疏松患者分为预后良好组,将其余25例未达到上述标准的患者分为预后不良组,对比两组患者临床一般情况,并应用Logistic回归分析NTx、CTX、BGP对绝经后骨质疏松的预后预测价值。结果:两组受检者NTx、CTX、BGP表达水平对比差异显著,观察组NTx、CTX高于对照组,BGP低于对照组(P<0.05);NTx、CTX、BGP三者联合对绝经后骨质疏松的诊断效能优于单一检测(P<0.05);预后良好组与预后不良组患者年龄、BMⅠ、合并基础疾病、病程、Ca表达水平对比无明显差异(P>0.05),预后良好组与预后不良组患者病情严重程度、骨密度T值、雌二醇、血清NTx、CTX、BGP表达水平对比差异显著(P<0.05);logistic回归分析结果表明:CTX、BGP为绝经后骨质疏松的预后不良的独立影响因素(P<0.05)。结论:绝经后骨质疏松患者血清Ⅰ型胶原氨基末端、Ⅰ型胶原羧基末端表达水平高于非骨质疏松群体,骨钙素低于非骨质疏松群体,三者联合可提升绝经后骨质疏松的诊断效能。另外,CTX、BGP作为绝经后骨质疏松的预后不良的独立影响因素,CTX水平越高、BGP水平越低可能预示患者预后不良,因此临床需针对此类患者及时改良治疗措施,提升其预后水平。

Objective:To investigate the expression changes and clinical significance of serum N-terminus of typeⅠcollagen(NTx),C-terminus of typeⅠcollagen(CTX),and osteocalcin(BGP)in postmenopausal osteoporosis patients.Methods:Sixty post-menopausal osteoporosis patients admitted to our hospital from August 2017 to August 2022 were selected as the study subjects and divided into the observation group,and another 60 postmenopausal healthy volunteers who came to our hospital for physical examination during the same period were selected as the control group.The expression levels of NTx,CTX and BGP were compared between the two groups,and subject work characteristic(ROC)curves were established to analyze the diagnostic efficacy of NTx,CTX and BGP on post-menopausal osteoporosis.35 postmenopausal osteoporosis patients with obvious and significant symptom reduction,significant improve-ment in X-ray examination and significant increase in BMD values were divided into the good prognosis group,and the remaining 25 patients who did not meet the above criteria were divided into the poor prognosis group.The clinical general conditions of the two groups were compared,and logistic regression was applied to analyze the prognostic predictive value of NTx,CTX and BGP on postmenopausal osteoporosis.Results:The comparison of NTx,CTX and BGP expression levels between the two groups of subjects was significantly dif-ferent,with NTx and CTX higher in the observation group and BGP lower in the control group(P<0.05);the diagnostic efficacy of the combination of NTx,CTX and BGP for postmenopausal osteoporosis was better than that of a single test(P<0.05);the comparison of age,BMI,combined underlying disease,and Ca expression levels between the good prognosis group and the poor prognosis group was not significantly different(P>0.05),There was no significant difference between the good prognosis group and the poor prognosis group in terms of age,BMI,combined underlying disease,disease duration,Ca expression level(P>0.05),and significant difference between the good prognosis group and the poor prognosis group in terms of severity of disease,BMD T value,estradiol,serum NTx,CTX,BGP expression level(P<0.05);logistic regression analysis showed that CTX and BGP were independent influences on poor prognosis of post-menopausal osteoporosis factors(P<0.05).Conclusion:The expression levels of typeⅠcollagen amino terminal and typeⅠcollagen car-boxyl terminal in serum of postmenopausal osteoporosis patients are higher than those of non osteoporosis groups,and osteocalcin is lower than that of non osteoporosis groups.The combination of the three can improve the diagnostic efficacy of postmenopausal osteoporosis.In addition,CTX and BGP are independent influencing factors for poor prognosis of postmenopausal osteoporosis.Higher levels of CTX and lower levels of BGP may indicate poor prognosis in patients.Therefore,timely improvement of treatment measures is necessary in clinical practice to improve the prognosis of such patients.