围绝经期骨质疏松症影响因素及联合双能X线骨密度仪和血清骨硬化蛋白的诊断价值

Influencing Factors of Perimenopausal Osteoporosis and the Diagnostic Value of Combined Dual-energy X-ray Absorptiometry and Serum Osteoshardening Protein

目的探讨围绝经期骨质疏松症(OP)影响因素及联合双能X线骨密度仪和骨硬化蛋白的诊断价值。方法回顾性收集120例2019年6月~2021年6月我院就诊的围绝经期女性,将其分为非OP组(n=62)和OP组(n=48)。分析围绝经期OP的影响因素,同时探讨双能X线骨密度仪结合骨硬化蛋白的诊断价值。结果OP组饮食结构不合理、年龄≥60岁、糖尿病史、吸烟史、绝经年限、性激素降低占比均高于非OP组,差异明显(P<0.05);而两组慢性疾病史、营养不良、饮酒史占比比较无差异(P>0.05)。将围绝经期OP作为因变量,将饮食结构不合理、年龄≥60岁、糖尿病史、吸烟史、绝经年限、性激素降低作为自变量。年龄≥60岁、吸烟史、性激素降低是围绝经期OP的危险因素(OR=3.811、3.380、3.511,P<0.05)。OP组BMD指标短于非OP组,血清骨硬化蛋白指标高于非OP组,差异明显(P<0.05),根据ROC曲线,2项指标联合检测的AUC值为0.968,高于双能X线骨密度仪、骨硬化蛋白指标单一检测0.872、0.826(P<0.05)。且2项指标联合检测的特异度(95.86%)、灵敏度(91.32%)高于双能X线骨密度仪、骨硬化蛋白指标单一检测(88.47%、85.63%)与(81.33%、73.42%)(P<0.05)。结论围绝经期OP的影响因素包括年龄≥60岁、吸烟史、性激素降低等,临床需尽早识别影响绝经期OP的相关危险因素,并予以双能X线骨密度仪联合血清骨硬化蛋白诊断。

Objective To investigate the influencing factors of perimenopausal osteoporosis(OP)and the diagnostic value of combined dual-energy X-ray absorptiometry and osteoshardening protein.Methods A total of 120 perimenopausal women admitted to our hospital from June 2019 to June 2021 were retrospectively collected and divided into non-OP group(n=62)and OP group(n=48).To analyze the influencing factors of perimenopausal OP,and to explore the diagnostic value of dual energy X-ray absorptiometry combined with osteoshardening protein.Results The proportions of unreasonable diet structure,age≥60 years old,diabetes history,smoking history,menopause years and decreased sex hormone in OP group were higher than those in non-OP group,and the differences were significant(P<0.05).There were no differences in chronic disease history,malnutrition and drinking history between the two groups(P>0.05).Perimenopausal OP was used as the dependent variable,and unreasonable diet,age≥60 years old,history of diabetes,smoking history,menopause years,and decreased sex hormones were used as independent variables.Age≥60 years old,smoking history and decreased sex hormone were risk factors for OP in perimenopause(OR=3.811,3.380,3.511,P<0.05).The BMD index in OP group was shorter than that in non-OP group,and the serum osteoshardening protein index was higher than that in non-OP group,the difference was significant(P<0.05).According to ROC curve,the AUC value of the combined detection of the two indexes was 0.968,which was higher than that of dual energy X-ray absorptiometry and single detection of osteoshardening protein index of 0.872 and 0.826(P<0.05).The specificity(95.86%)and sensitivity(91.32%)of the combined detection of the two indexes were higher than those of dual-energy X-ray absorptiometry and single detection of osteossclerosis protein index(88.47%,85.63%)and(81.33%,73.42%)(P<0.05).Conclusions The influencing factors of perimenopausal OP include age≥60 years old,smoking history,decreased sex hormones,etc.It is necessary to identify the related risk factors of menopausal OP as early as possible,and to diagnose it with dual-energy X-ray absorptiometry combined with serum osteoshardening protein.