| 摘要: |
| ［摘要］ 目的 探讨老年女性绝经后骨质疏松（PMO）患者血清白细胞介素-33（IL-33）水平和骨转换标志物表达水平与骨折风险的关联性。方法 招募2019年6月至2021年3月上海市健康医学院附属崇明医院收治的277例因跌倒发生脆性骨折的老年女性PMO患者作为骨折组，另外纳入同期无骨折记录的老年女性PMO患者作为对照组（250例）。比较两组血清IL-33水平，采用Spearman秩相关分析探讨血清IL-33水平与骨转换标志物水平的相关性，采用多因素logistic回归分析影响PMO女性发生骨折的危险因素，采用受试者工作特征（ROC）曲线分析血清IL-33水平预测PMO女性发生骨折的效能。结果 骨折组患者血清甲状旁腺激素（PTH）、1型胶原蛋白C末端肽（CTX-1）、1型前胶原氨基端肽（P1NP）、骨钙素（OC）、骨特异碱性磷酸酶（BALP）水平高于对照组，血清25-羟基维生素D［25(OH)D］水平和骨密度（BMD）低于对照组，差异有统计学意义（P<0.05）。Spearman秩相关分析结果显示，骨折组患者血清IL-33水平与血清25(OH)D水平呈正相关（rs=0.158，P=0.009），与血清CTX-1（rs=-0.233，P<0.001）、OC（rs=-0.357，P<0.001）、PTH（rs=-0.326，P<0.001）水平呈负相关。多因素logistic回归分析结果显示，较高水平的血清IL-33（OR=0.125）和BMD（OR=0.554）是抑制PMO女性发生骨折的保护因素（P<0.05）。ROC曲线分析结果显示，血清IL-33水平具有预测PMO女性发生骨折风险的应用价值（P<0.05），最佳截断值为6.57 pg/ml，其对应的灵敏度和特异度分别为94.80%和91.30%。结论 PMO女性人群血清IL-33和骨转移标志物水平与骨折风险具有关联性，对其水平进行监测有助于临床医师对风险患者予以及时干预。 |
| 关键词: 绝经后骨质疏松 老年 骨折 白细胞介素-33 骨转移标志物 |
| DOI：10.3969/j.issn.1674-3806.2023.04.11 |
| 分类号:R 683 |
| 基金项目:上海市科学技术发展资金项目（编号：CKY2014-07） |
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| A study on the association of serum IL-33 levels and expression levels of bone turnover markers with fracture risk in elderly women with post-menopausal osteoporosis |
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YIN Le, ZHANG Hao-jie, ZHANG Ping-chao, et al.
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Department of Orthopedics, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai 202150, China
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| Abstract: |
| ［Abstract］ Objective To investigate the association of serum interleukin-33(IL-33) levels and expression levels of bone turnover markers with fracture risk in elderly women with post-menopausal osteoporosis(PMO). Methods Two hundred and seventy-seven elderly female PMO patients with fragility fractures due to falls who were admitted to Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences from June 2019 to March 2021 were recruited as the fracture group, and other 250 elderly female PMO patients with no fracture records during the same period were included as the control group. The serum IL-33 levels were compared between the two groups. Spearman rank correlation analysis was used to explore the correlation between serum IL-33 levels and the levels of bone turnover markers. Multivariate logistic regression was used to analyze the risk factors of fracture in the PMO women. Receiver operating characteristic(ROC) curve was used to analyze the efficacy of serum IL-33 levels in predicting fractures in the women with PMO. Results The levels of serum parathyroid hormone(PTH), C-terminal telopeptide of type 1 collagen(CTX-1), procollagen type 1 N-terminal propeptide(P1NP), osteocalcin(OC) and bone-specific alkaline phosphatase(BALP) in the fracture group were higher than those in the control group, and the serum 25-hydroxyvitamin D［25(OH)D］ levels and bone mineral density(BMD) in the fracture group were lower than those in the control group, and the differences were statistically significant(P<0.05). The results of Spearman rank correlation analysis showed that the serum IL-33 level in the fracture group was positively correlated with the serum 25(OH)D level(rs=0.158, P=0.009), and was negatively correlated with the serum levels of CTX-1(rs=-0.233, P<0.001), OC(rs=-0.357, P<0.001) and PTH(rs=-0.326, P<0.001). The results of multivariate logistic regression analysis showed that higher levels of serum IL-33(OR=0.125) and BMD(OR=0.554) were the protective factors for inhibiting fractures in the PMO women(P<0.05). The results of ROC curve analysis showed that serum IL-33 level has the application value in predicting the risk of fracture in the PMO women(P<0.05). The optimal cut-off value was 6.57 pg/ml, and the corresponding sensitivity and specificity were 94.80% and 91.30%, respectively. Conclusion Serum levels of IL-33 and the levels of bone turnover markers are associated with fracture risk in a female population with PMO, and monitoring their levels is helpful for clinicians to timely intervene in at-risk patients. |
| Key words: Post-menopausal osteoporosis(PMO) Old age Fracture Interleukin-33(IL-33) Bone turnover markers |
