胸腰椎骨质疏松性骨折血清网膜素-1、转化生长因子-β1、铁蛋白与骨转换关系的临床研究
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摘要
目的 分析胸腰椎骨质疏松性骨折血清网膜素-1(Omentin-1)、转化生长因子-β1(TGF-β1)、铁蛋白(SF)与骨转换关系。方法 河池市人民医院创伤骨科2016年1月—2018年5月收治69例胸腰椎骨质疏松性骨折患者作为骨质疏松性骨折组,另外选择85例骨质疏松症患者(骨质疏松组)及38例健康体检者(健康组)作为对照,比较三组血清Omentin-1、TGF-β1、SF与骨转换指标,并分析胸腰椎骨质疏松性骨折患者血清Omentin-1、TGF-β1、SF与骨转换的关系。结果 骨质疏松性骨折组血清Omentin-1、TGF-β、平均骨密度BMD分别为(30.19±3.93) ng/mL、(4.31±0.62)ng/mL、(0.48±0.06) g/cm~2,骨质疏松组分别为(46.93±6.73)ng/mL、(9.65±1.56) ng/mL、(0.55±0.07) g/cm~2,健康组分别为(62.14±9.15) ng/mL、(18.71±2.76) ng/mL、(0.63±0.09)g/cm~2,骨质疏松性骨折组均显著低于骨质疏松组和健康组,差异有统计学意义(P<0.05)。骨质疏松性骨折组血清SF、β-CTX及PINP分别为(289.07±40.11)ng/mL、(0.63±0.11)ng/mL、(68.70±9.75) ng/mL,骨质疏松组分别为(193.46±27.06) ng/mL、(0.51±0.08) ng/mL、(57.09±6.86) ng/mL,健康组分别为(134.18±17.84) ng/mL、(0.32±0.05)ng/mL、(42.14±5.40)ng/mL,骨质疏松性骨折组均显著高于骨质疏松组和健康组,差异均有统计学意义(P<0.05)。胸腰椎骨质疏松性骨折患者血清Omentin-1、TGF-β1与骨转换指标呈负相关,SF与骨转换指标呈正相关。多元线性回归分析显示Omentin-1、TGF-β1、SF、年龄可作为骨转换的独立影响因素。结论 胸腰椎骨质疏松性骨折患者骨转换水平高,血清Omentin-1、TGF-β1、SF和骨转换有良好相关性,可能是预测胸腰椎骨质疏松性骨折风险的参考指标。
Objective To analyze the relationship between serum omentin-1(Omentin-1), transforming growth factor-β1(TGF-β1), ferritin(SF) and bone transformation in thoracolumbar osteoporotic fractures. Methods Sixty-nine patients with thoracolumbar osteoporotic fracture treated from Jan.2016 to May 2016 in our hospital were taken as thoracolumbar osteoporotic fracture group, 85 patients with osteoporosis were taken as osteoporosis group and 38 healthy subjects as control group. The serum Omentin-1, TGF-β1, SF and bone-conversion in three groups were compared, and the relationship between serum Omentin-1, TGF-β1, SF and bone transformation was analyzed. Results The serum Omentin-1,TGF-β1 and BMD in the thoracolumbar osteoporotic fracture group were lower than those in the osteoporosis group and the control group(30.19±3.93)vs.(46.93±6.73)vs.(30.19±3.93)ng/mL,(4.31±0.62)vs.(9.65±1.56)vs.(18.71±2.76)ng/mL,(0.48±0.06)vs.(0.55±0.07)vs.(0.63±0.09) g/cm2,and the serum SF, β-CTX and PINP in the thoracolumbar osteoporotic fracture group were higher than those in the osteoporosis group and the control group(289.07±40.11)vs.(193.46±27.06)vs.(134.18±17.84)ng/mL,(0.63±0.11)vs.(0.51±0.08)vs.(0.32±0.05)ng/mL,(8.70±9.75)vs.(57.09±6.86)vs.(42.14±5.40)ng/mL(P<0.05). In patients with thoracolumbar osteoporotic fracture, serum Omentin-1 and TGF-β1 were negatively correlated with bone conversion index, while SF was positively correlated with bone conversion index. Multivariate linear regression analysis showed that Omentin-1, TGF-β1, SF and age could be the independent factors of bone transformation. Conclusion The bone conversion level of patients with thoracolumbar osteoporotic fracture is high. The correlation between serum Omentin-1, TGF-β1, SF and bone conversion is good, which may be a reference index to predict the risk of thoracolumbar osteoporotic fracture.
Objective To analyze the relationship between serum omentin-1(Omentin-1), transforming growth factor-β1(TGF-β1), ferritin(SF) and bone transformation in thoracolumbar osteoporotic fractures. Methods Sixty-nine patients with thoracolumbar osteoporotic fracture treated from Jan.2016 to May 2016 in our hospital were taken as thoracolumbar osteoporotic fracture group, 85 patients with osteoporosis were taken as osteoporosis group and 38 healthy subjects as control group. The serum Omentin-1, TGF-β1, SF and bone-conversion in three groups were compared, and the relationship between serum Omentin-1, TGF-β1, SF and bone transformation was analyzed. Results The serum Omentin-1,TGF-β1 and BMD in the thoracolumbar osteoporotic fracture group were lower than those in the osteoporosis group and the control group(30.19±3.93)vs.(46.93±6.73)vs.(30.19±3.93)ng/mL,(4.31±0.62)vs.(9.65±1.56)vs.(18.71±2.76)ng/mL,(0.48±0.06)vs.(0.55±0.07)vs.(0.63±0.09) g/cm2,and the serum SF, β-CTX and PINP in the thoracolumbar osteoporotic fracture group were higher than those in the osteoporosis group and the control group(289.07±40.11)vs.(193.46±27.06)vs.(134.18±17.84)ng/mL,(0.63±0.11)vs.(0.51±0.08)vs.(0.32±0.05)ng/mL,(8.70±9.75)vs.(57.09±6.86)vs.(42.14±5.40)ng/mL(P<0.05). In patients with thoracolumbar osteoporotic fracture, serum Omentin-1 and TGF-β1 were negatively correlated with bone conversion index, while SF was positively correlated with bone conversion index. Multivariate linear regression analysis showed that Omentin-1, TGF-β1, SF and age could be the independent factors of bone transformation. Conclusion The bone conversion level of patients with thoracolumbar osteoporotic fracture is high. The correlation between serum Omentin-1, TGF-β1, SF and bone conversion is good, which may be a reference index to predict the risk of thoracolumbar osteoporotic fracture.
引文
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[13] 邵金双,邸阜生.网膜素抗炎作用及与代谢相关疾病的关系[J].国际内分泌代谢杂志,2014,34(1):29-31.
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[16] 常小女,范志宏,王瑛,等.网膜素的研究进展[J].中国药物与临床,2013,13(11):1437-1438.
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[18] 张萌萌,毛未贤,高远,等.ON、PINP、OPG、IGF-1、TGF-β与股骨颈BMD相关性研究[J].中国骨质疏松杂志,2014,20(8):880-884.
[19] 钟如意,伍西羽,陈胜,等.女性护骨素和转化生长因子-β水平对骨转换率的影响[J].中国骨质疏松杂志,2014,20(4):387-391.
[20] 龙海燕,张红,伍贤平,等.女性血清护骨素和转化生长因子β1与骨丢失率的关系[J].中国骨质疏松杂志,2014,20(1):5-11.
[21] 赵国阳,秦艳,沈光思,等.240例绝经后髋部脆性骨折患者血清铁蛋白与维生素D水平的相关性研究[J].中国骨质疏松杂志,2015,21(11):1369-1373.
[22] 刘栋,孙永明,华俊,等.胸、腰椎骨质疏松性骨折患者椎体骨铁含量、血清铁蛋白与骨密度的相关性[J].中华骨质疏松和骨矿盐疾病杂志,2017,10(2):104-109.
[23] Hong N,Kim BJ,Kim CH,et al.Low plasma lLevel of lLeucine-rich repeat-containing 17 (LRRc17) is an independent and additive risk factor for osteoporotic fractures in postmenopausal women[J].J Bone Miner Res,2016,31(12):2106-2114.
[2] Wáng JQ,Káplár Z,Deng M,et al.Thoracolumbar intervertebral disc area morphometry in elderly chinese men and women:radiographic quantifications at baseline and changes at year-4 follow-up[J].Spine (Phila Pa 1976),2018,43(10):E607-614.
[3] Mendoza ES,Lopez AA,Valdez VA,et al.Osteoporosis and prevalent fractures among adult filipino men screened for bone mineral density in a tertiary hospital[J].Endocrinol Metab (Seoul),2016,31(3):433-438.
[4] Seo JY,Kwon YS,Kim KJ,et al.Clinical importance of posterior vertebral height loss on plain radiography when conservatively treating osteoporotic vertebral fractures[J].Injury,2017,48(7):1503-1509.
[5] 李浩彦,任明.血清网膜素-1相关研究进展[J].中西医结合心脑血管病杂志,2016,14(7):722-725.
[6] Lim Y,Kim CH,Lee SY,et al.Decreased plasma levels of sclerostin but not dickkopf-1 are associated with an increased prevalence of osteoporotic fracture and lower bone mineral density in postmenopausal Korean women[J].Calcif Tissue Int,2016,99(4):350-359.
[7] 张林林,姜习凤,艾红珍,等.绝经后髋部脆性骨折中铁过载指标与骨密度骨转换指标关系的研究[J].中华外科杂志,2013,51(6):518-521.
[8] 邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(全文)(骨质疏松性骨折诊断及治疗原则)[J].中华关节外科杂志(电子版),2015,9(6):795-798.
[9] Oei L,Koromani F,Breda SJ,et al.Osteoporotic vertebral fracture prevalence varies widely between qualitative and quantitative radiological assessment methods:the rotterdam study[J].J Bone Miner Res,2018,33(4):560-568.
[10] 吴定宇,温运年,曹恒昌,等.定量超声测定跟骨骨密度对骨质疏松性骨折的判断价值及其与血清骨代谢、骨转化指标的相关性[J].海南医学,2016,27(22):3703-3705.
[11] Gunathilake R,Epstein E,McNeill S,et al.Factors associated with receiving anti-osteoporosis treatment among older persons with minimal trauma hip fracture presenting to an acute orthogeriatric service[J].Injury,2016 ,47(10):2149-2154.
[12] 唐颂军,宋力轶,朱文峰,等.骨转换标志物PINP和β-CTX的测定在预测骨质疏松性骨折中的价值[J].实用临床医药杂志,2015,19(21):17-19.
[13] 邵金双,邸阜生.网膜素抗炎作用及与代谢相关疾病的关系[J].国际内分泌代谢杂志,2014,34(1):29-31.
[14] 张云林,唐四元,蒋岳霞.血清Omentin-1与代谢性风险因素的关系[J].实用预防医学,2014,21(2):235-238.
[15] 应大文,刘芳.血清Omentin-1水平与2型糖尿病并发骨质疏松症的相关性研究[J].中国骨质疏松杂志,2017,23(2):141-144.
[16] 常小女,范志宏,王瑛,等.网膜素的研究进展[J].中国药物与临床,2013,13(11):1437-1438.
[17] 王涛,王永胜,刘志斌.白细胞介素、转化生长因子在骨质疏松性股骨骨折患者中的诊断意义[J].中国实验诊断学,2014,18(8):1328-1330.
[18] 张萌萌,毛未贤,高远,等.ON、PINP、OPG、IGF-1、TGF-β与股骨颈BMD相关性研究[J].中国骨质疏松杂志,2014,20(8):880-884.
[19] 钟如意,伍西羽,陈胜,等.女性护骨素和转化生长因子-β水平对骨转换率的影响[J].中国骨质疏松杂志,2014,20(4):387-391.
[20] 龙海燕,张红,伍贤平,等.女性血清护骨素和转化生长因子β1与骨丢失率的关系[J].中国骨质疏松杂志,2014,20(1):5-11.
[21] 赵国阳,秦艳,沈光思,等.240例绝经后髋部脆性骨折患者血清铁蛋白与维生素D水平的相关性研究[J].中国骨质疏松杂志,2015,21(11):1369-1373.
[22] 刘栋,孙永明,华俊,等.胸、腰椎骨质疏松性骨折患者椎体骨铁含量、血清铁蛋白与骨密度的相关性[J].中华骨质疏松和骨矿盐疾病杂志,2017,10(2):104-109.
[23] Hong N,Kim BJ,Kim CH,et al.Low plasma lLevel of lLeucine-rich repeat-containing 17 (LRRc17) is an independent and additive risk factor for osteoporotic fractures in postmenopausal women[J].J Bone Miner Res,2016,31(12):2106-2114.