血液高RDW和高N-MID OC/β-CTX比值在老年女性椎体骨折中的诊断价值

Relationship between high RDW and high N-MID OC/β-CTX ratio and osteoporotic vertebral fracture in elderly women

目的 探讨血液红细胞分布宽度(RDW)及骨钙素N段中分子片段(N-MID OC)/Ⅰ型胶原羧基端肽β特殊序列(β-CTX)比值联合检测对老年女性骨质疏松椎体骨折(OPVF)的诊断价值。方法 纳入2021年1月—2021年12月我院≥60岁女性骨质疏松住院患者786例,分为无骨折组(A组,378例)和OPVF组(B组,388例)。N-MID OC、β-CTX、NMID-OC/β-CTX比值、红细胞计数(RBC)、红细胞压积(HCT)、血红蛋白(Hb)、红细胞平均体积(MCV)、平均血红蛋白浓度(MCHC)、平均血红蛋白量(MCH)、红细胞分布宽度(RDW-CV)、钙(Ca)、磷(P)及镁(Mg)。结果 与A组相比,B组Ca、P、Hb、HCT、MCV、MCH、MCHC含量降低,RDW-CV、N-MID OC/β-CTX含量增加,差异有统计学意义(均P<0.05)。OPVF与β-CTX、Ca、P呈负相关,与RDW-CV、N-MID OC/β-CTX呈正相关(均P<0.05)。骨折患者RDW与N-MID OC、β-CTX、Ca、P、Mg呈负相关(均P<0.05)。RDW、N-MID-OC/β-CTX为OPVF的风险因素(均P<0.05),OR分别为1.38、1.005。二者含量越高,椎体骨折风险越高,最高层是最低层的约3倍和2倍,OR为2.818,1.734。二者联合检测可提高对OPVF的诊断性能,其AUC敏感性、特异性、阳性预示值、阴性预示值分别为0.64、42.78%、82.01%、70.9%、58.3%。结论 血液高RDW和高N-MID OC/β-CTX比值与老年女性骨质疏松性椎体骨折明显相关,是其危险因素,可用于辅助诊断及预测其发生。

Objective To explore the diagnostic value of blood RDW and N-MID OC/β-CTX ratio combination test for osteoporotic vertebral fracture(OPVF)in elderly women.Methods In 2021,786 female osteoporosis inpatients over 60 years were included,which were divided into 378 patients in the non-fracture group(Group A)and 388 patients in the OPVF group(Group B).The medium molecular fragment of osteocalcin N segment(N-MID OC),special sequenceβCarboxyterminal peptide of collagen I(β-CTX),N-MID OC/β-CTX ratio,red blood cell count(RBC),hematocrit(HCT),hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin concentration(MCHC),mean corpuscular hemoglobin(MCH),and red blood cell distribution width(RDW-CV),calcium(Ca),phosphorus(P)and magnesium(Mg)were detected.Results The contents of Ca,P,Hb,HCT,MCV,MCH and MCHC in group B were lower than group A,RDW-CV and N-MID OC/β-CTX were higher than group A and the differences were statistically significant(P<0.05).OPVF was negatively correlated withβ-CTx,Ca and P,and positively correlated with RDW-CV and NMID-OC/β-CTX(P<0.05).RDW-CV and NMID-OC/β-CTX were risk factors for OPVF,OR were 1.38 and 1.005,respectively,both P<0.05.The higher the content of the two factors,the higher the risk of vertebral fracture,the highest layer is about 3 times and 2 times that of the lowest level,the OR was 2.818,1.734.The combined detection of the two factors can improve the diagnostic performance of OPVF,and its AUC,sensitivity,specificity,positive predictive value,and negative predictive value were 0.64,42.78%,82.01%,70.9%,and 58.3%,respectively.Conclusion High blood RDW and high NMID-OC/β-CTX ratio are significantly associated with osteoporotic vertebral fractures in elderly women,which are risk factors and can be used to assist diagnosis and predict their occurrence.