不同程度老年骨质疏松患者血清BALP、OPG/PYR比值变化及其与骨密度、骨折发生的相关性分析

The Changes of Serum BALP,OPG/PYR Ratio and Their Correlation with Bone Mineral Density and Fracture in Elderly Patients with Different Degrees of Osteoporosis

目的:分析不同程度老年骨质疏松患者血清骨特异性碱性磷酸酶(BALP)、骨保护素(OPG)/吡啶啉(PYR)比值变化及其与骨密度、骨折发生的相关性。方法:选择我院自2020年11月至2023年7月接诊的70例老年骨质疏松患者作为观察组,其中轻-中度骨质疏松44例、重度骨质疏松26例;另选70例老年非骨质疏松者作为对照组。检测所有受试者血清BALP、OPG/PYR比值、腰椎、股骨颈和髋部的骨密度(BMD),分析BALP、OPG/PYR比值与不同骨骼部位BMD的关系,使用受试者工作特征(ROC)曲线分析BALP、OPG/PYR比值对老年骨质疏松骨折的预测效能。结果:观察组血清BALP水平高于对照组,OPG/PYR比值小于对照组(P<0.05);重度骨质疏松组血清BALP水平高于轻-中度骨质疏松组,OPG/PYR比值小于轻-中度骨质疏松组(P<0.05);观察组腰椎、股骨颈及髋部的BMD均小于对照组(P<0.05);经Pearson相关性分析,腰椎、股骨颈及髋部的BMD与血清BALP水平呈负相关(P<0.05),与OPG/PYR比值呈正相关(P<0.05);经ROC曲线分析,血清BALP联合OPG/PYR比值预测老年骨质疏松骨折的AUC为0.890。结论:老年骨质疏松患者血清BALP水平升高、OPG/PYR比值减小,与病情严重程度及骨密度有关,联合预测骨折的效能较好,值得进一步研究应用。

Objective:To analyze the changes of serum bone-specific alkaline phosphatase(BALP),osteopontin(OPG)/Pyridinoline(PYR)ratio and their correlation with bone mineral density and fracture in elderly patients with different degrees of osteoporosis.Methods:A total of 70 elderly patients with osteoporosis admitted to our hospital from November 2020 to July 2023 were selected as the observation group,including 44 cases with mild to moderate osteoporosis and 26 cases with severe osteoporosis.Another 70 non-osteoporosis elderly patients were selected as control group.Serum BALP,OPG/PYR ratio,bone mineral density(BMD)of lumbar spine,femoral neck and hip were measured in all subjects.The relationship between BALP,OPG/PYR ratio and BMD of different bone parts was analyzed.The predictive efficacy of BALP and OPG/PYR ratio in elderly osteoporotic fractures was analyzed using receiver operating characteristic(ROC)curve.Results:The serum BALP level in the observation group was higher than that in the control group,and the OPG/PYR ratio was lower than that in the control group(P<0.05).The serum BALP level in severe osteoporosis group was higher than that in mild-moderate osteoporosis group,and the OPG/PYR ratio was lower than that in mild-moderate osteoporosis group(P<0.05).The BMD of lumbar spine,femoral neck and hip in observation group was lower than that of control group(P<0.05).By Pearson correlation analysis,BMD of lumbar spine,femoral neck and hip was negatively correlated with serum BALP level(P<0.05),and positively correlated with OPG/PYR ratio(P<0.05).According to ROC curve analysis,serum BALP combined with OPG/PYR ratio predicted the AUC of osteoporotic fracture in elderly patients was 0.890.Conclusion:The increase of serum BALP level and the decrease of OPG/PYR ratio in elderly patients with osteoporosis are related to the severity of the disease and bone mineral density,and the combined prediction of fracture is good,worthy of further study and application.