绝经后骨质疏松症患者血清Cathe K、25(OH)D、基质Gla蛋白变化及临床意义

Change and clinical significance of serum Cathe K,25(OH)D and matrix gla protein in postmenopausal patients with osteoporosis

目的探究绝经后骨质疏松症患者血清组织蛋白酶K(Cathepsin K,Cathe K)、25羟维生素D[25 hydroxyvitamin D,25(OH)D]及基质Gla蛋白(matrix gla protein,MGP)变化及其临床意义。方法选择2020年5月至2023年5月山西省妇幼保健院收治60例绝经后骨质疏松症患者作为观察组,对照组则选择医院同期收治75例单纯绝经妇女。采用酶联免疫吸附法测定研究对象血清Cathe K、25(OH)D、MGP水平,电化学发光法测定骨代谢指标[Ⅰ型前胶原氨基末端前肽(N-terminal propeptide of typeⅠprecollagen,PINP)、β-胶原降解产物(β-collagen degradation product,β-CTX)、骨碱性磷酸酶(bone alkaline phosphate,BALP)和骨钙素(osteocalcin,OC)],比较两组Cathe K、25(OH)D、MGP水平及骨代谢指标,以Pearson相关性分析Cathe K、25(OH)D、MGP水平与骨代谢指标相关性。受试者工作特征曲线分析Cathe K、25(OH)D、MGP水平对骨质疏松症预测价值;多元Logistic回归分析Cathe K、25(OH)D、MGP对骨质疏松影响。结果观察组血清Cathe K(27.27±4.82)μg/L高于对照组(20.84±4.17)μg/L,25(OH)D(25.81±5.33)ng/mL、MGP(7.26±1.53)ng/mL则低于对照组(31.62±5.92)ng/mL、(10.75±2.31)ng/mL(t=5.22,P<0.001;t=4.88,P<0.05;t=7.58,P<0.05);观察组骨代谢指标PINP、β-CTX、OC高于对照组,而BALP低于对照组;Pearson相关性分析显示,Cathe K与PINP、β-CTX、OC正相关,与BALP负相关(r=0.53、0.45、0.61、-0.75,P<0.05);25(OH)D与PINP、β-CTX、OC负相关,与BALP正相关(r=-0.41、-0.63、-0.43、0.38,P<0.05);MGP与PINP、β-CTX、OC正相关,与BALP负相关(r=-0.77、-0.59、-0.61、0.52,P<0.05);受试者工作特征曲线显示,血清Cathe K、25(OH)D、MGP用于预测骨质疏松症曲线下面积值分别为0.715、0.694、0.789。结论绝经后骨质疏松症患者血清Cathe K、25(OH)D、MGP水平异常,可用于预测骨质疏松症发生,且与患者骨代谢指标关系密切,可为患者治疗提供参考。

ObjectiveTo investigate the change and clinical significance of serum Cathepsin K(Cathe K),25 hydroxyvitamin D(25(OH)D)and matrix gla protein(MGP)in postmenopausal patients with osteoporosis.MethodsSixty postmenopausal patients with osteoporosis admitted to the hospital from May.2020 to May.2023 were selected as the study group,and 75 simple menopausal women were selected to the control group at the same period.Serum Cathe K,25(OH)D and MGP levels of the subjects were determined by enzyme-linked immunosorbent assay(ELISA).Bone metabolism indexes[N-terminal propeptide of typeⅠprecollagen(PINP),βisomer of the C-terminal telopep-tide of typeⅠcollagen(β-CTX),bone alkaline phosphatase,(BALP)and osteocalcin(OC)]were detected.The levels of Cathe K,25(OH)D and MGP and bone metabolism indexes were compared and their correlation was analyzed by Pearson correlation.The predictive value of Cathe K,25(OH)D and MGP levels in osteoporosis were analyzed and their effects on osteoporosis were analyzed by multiple Logistic regression.ResultsSerum Cathe K in the study group was higher[(27.27±4.82)μg/L vs.(20.84±4.17)μg/L],25(OH)D and MGP were lower[(25.81±5.33)ng/mL,(7.26±1.53)ng/mL vs.(31.62±5.92)ng/mL,(10.75±2.31)ng/mL](t=5.22,P<0.001;t=4.88,P<0.05;t=7.58,P<0.05);The bone metabolism indexes PINP,β-CTX and OC in the study group were higher,while BALP was lower;Pearson correlation analysis showed that Cathe K was positively correlated with PINP,β-CTX and OC,and negatively correlated with BALP(r=0.53,0.45,0.61,-0.75,P<0.05);25(OH)D was negatively correlated with PINP,β-CTX,OC,and positively correlated with BALP(r=-0.41,-0.63,-0.43,0.38,P<0.05);MGP was positively correlated with PINP,β-CTX and OC,and negatively correlated with BALP(r=-0.77,-0.59,-0.61,0.52,P<0.05);The area under the curve of serum Cathe K,25(OH)D and MGP for predicting osteoporosis were 0.715,0.694 and 0.789,respectively.ConclusionThe abnormal levels of serum Cathe K,25(OH)D and MGP in postmenopausal patients with osteoporosis can be used to predict the occurrence of osteoporosis,and are closely related to the bone metabolism indexes of patients,which can provide a reference for the treatment of patients.