文章摘要

老年骨质疏松性骨折患者血清25(OH)D、TRACP-5b、IL-7与骨代谢标志物的相关性及临床价值

作者: 1,2黄祖启, 2欧阳晓
1 徐州医科大学第一临床学院，江苏 徐州 221000
2 徐州医科大学附属徐州市肿瘤医院/徐州市第三人民医院骨科，江苏 徐州 221000
通讯: 欧阳晓 Email: darz1987@163.com
DOI: 10.3978/j.issn.2095-6959.2022.11.004
基金: 徐州市科技计划项目(KC19188)。

摘要

目的：研究老年骨质疏松(osteoporosis，OP)骨折患者血清25-羟维生素D[25-hydroxyvitamin D，25(OH)D]、抗酒石酸酸性磷酸酶异构体5b(tartrate resistant acid phosphatase 5b，TRACP-5b)、白细胞介素-7(interleukin-7，IL-7)水平变化，分析其与骨代谢标志物的相关性，从而探究以上指标在老年OP骨折患者中的应用价值。方法：前瞻性选择徐州市肿瘤医院2020年2月至2022年2月期间收治的43例老年OP骨折患者作为观察组，另选取40例同期体检为OP无骨折的老年患者为对照组。检测两组患者血清25(OH)D、TRACP-5b、IL-7、骨形成标志物及骨吸收标志物水平，分析25(OH)D、TRACP-5b、IL-7与骨代谢标志物的相关性，采用logistic回归分析老年OP骨折的影响因素。结果：观察组患者70岁以下占比、血清25(OH)D和骨代谢指标钙(calcium，Ca)水平均低于对照组，血清TRACP-5b、IL-7、磷(phosphorus，P)、甲状旁腺激素(parathyroid hormone，PTH)、骨碱性磷酸酶(bone alkaline phosphatase，BALP)、骨钙素(bone gla protein，BGP)、骨形成指标I型前胶原氨基端原肽(I-type precollagen amino terminal propeptide，PINP)、I型胶原羟基端肽β降解产物(C-terminal cross-linking telopeptide of type I collagen，β-CTX)水平均高于对照组，差异均具有统计学意义(均P<0.05)。Logistic回归模型显示：血清25(OH)D及Ca水平均为老年OP骨折的保护因素，血清TRACP-5b、IL-7、P、PTH、BALP、BGP、PINP、β-CTX均为危险因素(均P<0.05)。Person相关性模型显示：骨代谢指标P、PTH、BALP、BGP、PINP、β-CTX水平与血清25(OH)D呈负相关(分别r=−0.730、−0.651、−0.615、−0.631、−0.566、−0.623，均P<0.05)，与TRACP-5b呈正相关(分别r=0.822、0.780、0.759、0.686、0.627、0.699，均P<0.05)；Ca与IL-7呈负相关(r=−0.705，P<0.05)。结论：老年OP患者血清25(OH)D、TRACP-5b、IL-7水平可用于初步判定患者骨代谢情况，从而为前期筛查和发现OP骨折风险提供一定依据，帮助OP患者及早采取干预措施。
关键词： 骨质疏松；25-羟维生素D；骨代谢；相关性

Correlation of serum 25(OH)D, TRACP-5b, and IL-7 with markers of bone metabolism in elderly patients with osteoporotic fractures and the clinical value

Authors: 1,2HUANG Zuqi, 2OUYANG Xiao
1 First Clinical College, Xuzhou Medical University, Xuzhou Jiangsu 221000, China
2 Department of Orthopedics, Xuzhou Cancer Hospital Affiliated to Xuzhou Medical University/Xuzhou Third People’s Hospital, Xuzhou Jiangsu 221000, China

CorrespondingAuthor: OUYANG Xiao Email: darz1987@163.com

DOI: 10.3978/j.issn.2095-6959.2022.11.004

Foundation: This work was supported by the Xuzhou Science and Technology Project, China (KC19188).

Abstract

Objective: To study the serum levels of 25-hydroxyvitamin D [25(OH)D], tartrate resistant acid phosphatase 5b (TRACP-5b), and interleukin-7 (IL-7) in elderly patients with osteoporotic fractures, and to analyze, the correlation between them and markers of bone metabolism in patients for exploring the application value of these indicators in elderly patients with OP fracture. Methods: Forty-three elderly patients with OP fracture admitted to Xuzhou Cancer Hospital from February 2020 to February 2022 were prospectively selected as an observation group, and 40 elderly patients with OP without fracture during physical examination were selected as a control group. The levels of serum 25(OH)D, TRACP-5b, IL-7, bone formation markers, and bone resorption markers in the 2 groups were detected, and the correlation of indicators was analyzed. The influencing factors of OP fracture in the elderly were analyzed by logistic regression. Results: The proportion of patients under 70 years old, the levels of serum 25(OH)D and bone metabolism indexes calcium (Ca) in the observation group were lower than those in the control group, and the serum levels of TRACP-5b, IL-7, phosphorus (P), parathyroid hormone (PTH), bone alkaline phosphatase (BALP), bone gla protein (BGP), I-type precollagen amino terminal propeptide (PINP), and C-terminal cross-linking telopeptide of type I collagen (β-CTX) were higher than those in the control group, with statistical significance (all P<0.05). Logistic regression model showed serum 25(OH)D and Ca level were all protective factors for OP fracture in the elderly, while serum TRACP-5b, IL-7, P, PTH, BALP, BGP, PINP, and β-CTX were risk factors (all P<0.05). The Person correlation model showed the levels of P, PTH, BALP, BGP, PINP, β-CTX were negatively correlated with serum 25(OH)D (r=−0.730, −0.651, −0.615, −0.631, −0.566, −0.623, respectively, all P<0.05). It was positively correlated with TRACP-5B (r=0.822, 0.780, 0.759, 0.686, 0.627, 0.699, respectively, all P<0.05). Ca was negatively correlated with IL-7 (r=−0.705, P<0.05). Conclusion: The detection of serum 25(OH)D, TRACP-5B, and IL-7 levels in elderly OP patients can preliminarily determine the bone metabolism of patients, thus providing a certain basis for early screening and discovering the risk of OP fracture, and helping OP patients to take early intervention measures.

Keywords： osteoporosis; 25-hydroxyvitamin D; bone metabolism; correlation

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