老年骨质疏松性骨折患者定量CT法骨密度测量值及血清BALP、IGF1、25(OH)D3水平检测意义

Significance of Quantitative CT Method Bone Mineral Density Measurements and Detection of Serum BALP,IGF1 and 25(OH)D3 Levels in Elderly Patients with Osteoporotic Fractures

目的探究老年骨质疏松性骨折患者定量CT法骨密度测量值及骨特异性碱性磷酸酶(BALP)、胰岛素样生成因子1(IGF1)、25羟维生素D3[25(OH)D3]水平表达意义。方法选取60例骨质疏松性骨折患者作为观察组,另选取同期60例单纯骨质疏松症患者作为对照组。比较两组临床资料、骨密度、BALP、IGF1、25(OH)D3,分析骨质疏松性骨折影响因素,构建Logistic回归模型,评价对骨质疏松性骨折的预测价值,并分析骨密度与BALP、IGF1、25(OH)D3的关系。结果观察组骨密度、IGF1、25(OH)D3较对照组低,BALP较对照组高(P<0.05),单因素分析显示,骨密度、BALP、IGF1、25(OH)D3是骨质疏松性骨折的独立影响因素(P<0.05);采用Logistic回归模型统计分析,得到骨质疏松性骨折发生的预测概率P。根据预测值和真实值绘制ROC曲线,AUC为0.893(95%CI:0.823~0.942),当Log(P)>2.15时,预测敏感度为71.67%,特异度为96.67%。结论骨质疏松性骨折患者定量CT法测量骨密度与BALP、IGF1、25(OH)D3显著相关,且检测骨密度、BALP、IGF1、25(OH)D3,可早期骨质疏松性骨折风险,有助于临床早期采取预防措施。

Objective To investigate the relationship between quantitative CT method bone densitometry values and bone-specific alkaline phosphatase(BALP),insulin-like production factor 1(IGF1),and 25 hydroxyvitamin D3[25(OH)D3]in patients with osteoporotic fractures.Methods 60 patients with osteoporotic fracture were selected as the observation group,and another 60 patients with simple osteoporosis in the same period were selected as the control group.We compared the clinical data,BMD,BALP,IGF1 and 25(OH)D3 between the two groups,analyzed the factors affecting osteoporotic fracture,constructed a logistic regression model,evaluated the predictive value for osteoporotic fracture,and analyzed the relationship between BMD and BAL P,IGF1 and 25(OH)D3.Results In the observation group,BMD,IGF1,25(OH)D3 were lower and BAL P was higher than the control group(P<0.05),Logistic regression analysis,BMD,BAL P,IGF1,25(OH)D3 were independent influencing factors of osteoporotic fracture(P<0.05);Logistic regression model was used for statistical analysis to obtain the osteoporotic The ROC curve was plotted according to the predicted and true values,and the AU C was 0.893(95%CI:0.823-0.942),and the predictive sensitivity was 71.67%and the specificity was 96.67%when Log(P)>2.15.Conclusion Bone mineral density measured by quantitative CT method in patients with osteoporotic fracture is significantly correlated with BALP,IGF1,and 25(OH)D3,and the detection of BMD,BALP,IGF1,and 25(OH)D3 can be used for early osteoporotic fracture risk,which can help clinical early preventive measures.