摘要
目的分析骨质疏松性胸腰椎压缩性骨折患者血清过氧化物酶体增殖物激活受体γ辅激活因子1α(peroxisome proliferator-activated receptorγcoactivator 1α,PGC-1α)、白介素-17(interleukin-17,IL-17)表达水平及其与骨代谢的关系。方法将2014年1月至2019年4月湖北省中西医结合医院诊治的58例骨质疏松性胸腰椎压缩性骨折患者纳入骨折组,将该院同期67例单纯骨质疏松患者纳入骨质疏松组,将该院同期62例体检健康者纳入健康对照组。比较三组研究对象血清PGC-1α、IL-17表达水平,并分析其与骨代谢标志物——Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprocollagen,PINP)、骨钙素(osteocalcin,OCN)、Ⅰ型胶原羟基端肽β降解产物(β-isomerised C-terminal telopeptide of collagen typeⅠ,β-CTX)、25-羟维生素D[25-hydroxy vitamin D,25(OH)D]、甲状旁腺激素(parathyroid hormone,PTH)之间的相关性,评估PGC-1α、IL-17对骨质疏松性胸腰椎压缩性骨折的预测价值。结果三组研究对象血清PGC-1α、25(OH)D水平依次为:骨折组<骨质疏松组<健康对照组(均P<0.05),IL-17、PINP、OCN、β-CTX和PTH水平依次为:骨折组>骨质疏松组>健康对照组(均P<0.05)。Pearson相关性分析显示,PGC-1α水平与PINP、OCN、β-CTX、PTH水平均呈负相关(均P<0.01),与25(OH)D水平呈正相关(P<0.01);IL-17水平与PINP、OCN、β-CTX、PTH水平均呈正相关(均P<0.01),与25(OH)D水平呈负相关(P<0.01)。受试者操作特征曲线显示,PGC-1α、IL-17对骨质疏松性胸腰椎压缩性骨折具有一定的预测价值[曲线下面积(area under the curve,AUC)=0.887、0.835],且两项指标联合的预测价值更高(AUC=0.948)。结论PGC-1α、IL-17与骨代谢关系密切,可能参与骨质疏松性胸腰椎压缩性骨折的病理生理过程,且两项指标联合检测对骨质疏松性胸腰椎压缩性骨折具有更好的预测价值。
Objective To analyze the expression of serum peroxisome proliferator-activated receptorγcoactivator 1α(PGC-1α)and interleukin-17(IL-17)in patients with osteoporotic thoracolumbar compression fracture and their relationship with bone metabolism.Method Fifty-eight patients with osteoporotic thoracolumbar compression fracture diagnosed and treated in Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2014 to April 2019 were included in fracture group,67 patients with simple osteoporosis were included in osteoporosis group in the same period,and 62 healthy subjects who underwent physical examination in the same period were included in healthy control group,the expression levels of serum PGC-1αand IL-17 were compared and their correlation with bone metabolic markers,such as N-terminal propeptide of typeⅠprocollagen(PINP),osteocalcin(OCN),β-isomerised C-terminal telopeptide of collagen typeⅠ(β-CTX),25-hydroxy vitamin D[25(OH)D],parat-hyroid hormone(PTH)were analyzed,and the predictive value of PGC-1αand IL-17 in osteoporotic thoracolumbar compression fracture were evaluated.Result The levels of serum PGC-1αand 25(OH)D in the three groups were fracture group<osteoporosis group<healthy control group(all P<0.05),the levels of serum IL-17,PINP,OCN,β-CTX and PTH were fracture group>osteoporosis group>healthy control group(all P<0.05).Pearson correlation analysis showed that the level of PGC-1αwas negatively correlated with the levels of PINP,OCN,β-CTX and PTH(all P<0.01),and positively correlated with the level of 25(OH)D(P<0.01);the level of IL-17 was positively correlated with the levels of PINP,OCN,β-CTX and PTH(all P<0.01),and negatively correlated with the level of 25(OH)D(P<0.01).The receiver operator characteristic curve showed that PGC-1αand IL-17 had certain predictive value for osteoporotic thoracolumbar compression fracture[area under the curve(AUC)=0.887,0.835],and the predictive value of the combination of the two indexes was higher(AUC=0.948).Conclusion PGC-1αand IL-17 are closely related to bone metabolism and may be involved in the pathophysiological process of osteoporotic thoracolumbar compression fracture,and the combined detection of the two indexes has a good predictive value for osteoporotic thoracolumbar compression fracture.
作者
徐红辉
宋建东
李停
李海东
魏兵
华寒冰
Xu Honghui;Song Jiandong;Li Ting;Li Haidong;Wei Bing;Hua Hanbing(Department of Orthopedics,Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430015,China;Department of Orthopedics,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Orthopedics,Xiangyang Central Hospital,Hubei,Xiangyang 441021,China)
出处
《中国医学前沿杂志（电子版）》
2020年第7期102-106,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
湖北省卫生计生委科研项目(JX6B36)。
