血清N-MID、TPINP与β-CTX水平检测在骨质疏松症中的临床意义OACSTPCD
Clinical significance of detecting serum N-MID,TPINP and β-CTX levels in osteoporosis
目的:探究血清骨钙素N端中分子片段(N-MID)、总I型胶原氨基端前肽(TPINP)、β胶原降解产物(β-CTX)水平检测在骨质疏松症(OP)中的临床意义.方法:选取120 例OP患者为OP组;同期100 名体检无OP者为对照组.比较两组对象血清N-MID、TPINP、β-CTX水平及腰椎L1～4和股骨颈骨密度(BMD);Pearson相关性分析血清N-MID、TPINP、β-CTX水平与腰椎L1～4和股骨颈骨BMD的关系;多因素Logistic回归分析影响OP发生的因素;受试者工作特征(ROC)曲线分析血清N-MID、TPINP、β-CTX水平对OP的诊断价值.结果:OP组患者血清N-MID、TPINP、β-CTX水平高于对照组(P＜0.05);腰椎L1～4及股骨颈BMD低于对照组(P＜0.05).相关性分析显示,血清N-MID、TPINP、β-CTX水平与腰椎L1～4 及股骨颈BMD均呈负相关关系(P＜0.05).回归分析显示,血清N-MID、TPINP、β-CTX、腰椎L1～4及股骨颈BMD均为OP发生的独立影响因素(P＜0.05).ROC曲线分析显示,血清N-MID、TPINP、β-CTX诊断OP的最佳截断值分别为 36.645、49.940、0.545 ng/mL;三项指标联合诊断OP的曲线下面积(AUC)为0.904,敏感度为90.80%,均高于单一指标诊断(P＜0.05).结论:与健康人群比较,OP患者血清N-MID、TPINP、β-CTX水平升高,且与患者BMD密切相关;血清N-MID、TPINP、β-CTX联合检查对OP有较高诊断价值.
Objective:To explore the clinical significance of detecting serum N-terminal mid-fragment of osteocalcin(N-MID),total bone type Ⅰ procollagen amino-terminal elongation peptide(TPINP)and β-isomer of C-terminal telopeptide of type Ⅰ collagen(β-CTX)levels in osteoporosis(OP).Methods:A total of 120 patients with OP(OP group)and 100 healthy individuals(control group)who received physical examination during the same period were included in the study.Serum N-MID,TPINP,β-CTX levels and bone mineral density(BMD)of lumbar spine(L1～4)and femoral neck in the two groups were compared.The relationship between serum N-MID,TPINP,β-CTX levels and bone mineral density(BMD)of lumbar spine(L1～4)and femoral neck was analyzed by Pearson corre-lation,Multivariate Logistic regression was used to analyze the factors that affect the occurrence of OP,and the clinical diagnostic value of serum N-MID,TPINP and β-CTX levels in OP was analyzed using the receiver operating characteristic(ROC)curve.Results:Serum N-MID,TPINP and β-CTX levels in OP group were higher than those in the control group(P＜0.05).The BMD values of lumbar spine(L1～4)and femoral neck in OP group were lower than those in the control group(P＜0.05).Pearson correlation analysis showed that serum N-MID,TPINP and β-CTX levels were negatively correlated with the BMD of lumbar spine(L1～4)and femoral neck(P＜0.05).Multivariate Logistic regression analysis showed that serum N-MID,TPINP and β-CTX,BMD of lumbar spine(L1～4)and femo-ral neck were independent influencing factors of OP(P＜0.05).ROC curve analysis showed that the optimal cutoff values of serum N-MID,TPINP and β-CTX for diagnosing OP were 36.645,49.940 and 0.545 ng/mL.The AUC and sensitivity of combined diagnosis of OP with the three indicators were 0.904 and90.80%,which was higher than those of diagnosis with a single indicator(P＜0.05).Conclusion:Compared with healthy individuals,serum N-MID,TPINP and β-CTX levels are elevated in patients with OP and closely related to their BMD.The combination of serum N-MID,TPINP and β-CTX is of high clinical value in diagnosing OP.
孙耀辉;刘莎莎;赖晓娟;姚华龙
深圳平乐骨伤科医院·深圳市坪山区中医院检验科,广东 深圳 518118
临床医学
骨钙素N端中分子片段总I型胶原氨基端前肽β胶原降解产物骨质疏松
N-terminal mid-fragment of osteocalcinAminoterminal propeptide of type Ⅰ procollagenβ-isomer of C-terminal te-lopeptide of type Ⅰ collagenOsteoporosis
《川北医学院学报》 2024 (007)
904-907 / 4
广东省医学科学技术研究项目(A2020206)
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