中华骨质疏松和骨矿盐疾病杂志2026，Vol.19Issue(2)：174-182,9.DOI:10.3969/j.issn.1674-2591.2026.02.003
原发性干燥综合征合并骨质疏松的临床特征、危险因素分析及预测模型构建
Osteoporosis in primary Sjögren's syndrome:clinical features,risk factor analysis,and development of a predictive model
摘要
Abstract
Objective To investigate the clinical characteristics,risk factors,and construct predictive models for osteoporosis in patients with primary Sjögren's syndrome(pSS).Methods A retrospective analysis was conducted on 282 patients diagnosed with pSS.Patients were categorized into two groups based on dual-energy X-ray absorptiometry(DXA)measurements of lumbar spine and hip T-scores:pSS with osteoporosis(pSS-OP,n=108)and pSS without oste-oporosis(pSS,n=174).Comparative analyses were utilized to assess differences in clinical features and laboratory pa-rameters between the two groups.Subsequently,independent risk factors for osteoporosis in pSS were determined through multivariate logistic regression,leading to the development of a predictive nomogram.Results Patients in the pSS-OP group showed significantly elevated levels of age,disease duration,erythrocyte sedimentation rate(ESR),immunoglob-ulin(Ig)G,IgA,rheumatoid factor(RF),interleukin(IL)-10,tumor necrosis factorα(TNF-α),IL-17A,IL-6,and interferon-γ(IFN-γ),while exhibiting significantly reduced levels of 25-hydroxyvitamin D[25(OH)D],com-plement C4,and complement C3 compared to the pSS group(P＜0.05 for all).Multivariate logistic regression analysis,in conjunction with receiver operating characteristic(ROC)curve evaluation,identified the following inde-pendent risk factors for osteoporosis in pSS patients:Demographic/clinical factors including age≥50.5 years[area un-der the curve(AUC)=0.75],disease duration≥3.5 years(AUC=0.79),presence of myalgia/fatigue,renal tubular acidosis,and anxiety/depression.Laboratory markers such as ESR≥35.5 mm/h(AUC=0.57),RF≥27.9 IU/mL(AUC=0.63),IL-17A≥1.5 pg/mL(AUC=0.62),and 25(OH)D≤15.78 ng/mL(AUC=0.67)were also identified.The predictive model derived from these variables exhibited robust discriminative capacity,with a C-index of 0.91(95%CI 0.88-0.95).Calibration analysis demonstrated a close alignment between predicted and observed proba-bilities,as indicated by the calibration curve closely approximating the ideal line.Conclusion In patients with pSS,ad-vanced age,prolonged disease duration,increased inflammatory activity,and vitamin D deficiency were identified as sig-nificant risk factors for osteoporosis.A nomogram prediction model,integrating these factors,exhibited high discriminative ability(C-index:0.91)and accurate calibration,indicating its potential for clinical use in identifying pSS patients at ele-vated risk of osteoporosis.关键词
原发性干燥综合征/骨质疏松/临床特征/危险因素/列线图Key words
primary Sjögren's syndrome/osteoporosis/clinical features/risk factors/column chart分类
医药卫生引用本文复制引用
高雅静,白炜,李正芳,武丽君..原发性干燥综合征合并骨质疏松的临床特征、危险因素分析及预测模型构建[J].中华骨质疏松和骨矿盐疾病杂志,2026,19(2):174-182,9.基金项目
新疆常见自身免疫病诊断评估关键技术研发及应用(2022B03002-1) （2022B03002-1）
国家自然科学基金(82260326) （82260326）
