摘要
目的探讨骨质疏松症(OP)并发髋部骨折患者血清miR-23b-3p、miR-125a-5p、miR-142-5p水平及临床意义。方法选取2022年1月至2024年1月在该院治疗的214例OP患者作为研究对象,根据是否发生髋部骨折将其分为骨折组和OP组,各107例。另选取同期在该院体检的107例健康者作为对照组。收集所有研究对象基线资料。检测所有参与者血清miR-23b-3p、miR-125a-5p、miR-142-5p、Ⅰ型胶原羧基末端肽(CTX)、Ⅰ型前胶原氨基端前肽(PⅠNP)、钙(Ca)、磷(P)水平。采用Pearson相关分析OP并发髋部骨折患者血清miR-23b-3p、miR-125a-5p、miR-142-5p水平与骨代谢指标的相关性。采用多因素Logistic回归分析OP患者并发髋部骨折的影响因素。绘制受试者工作特征(ROC)曲线分析血清miR-23b-3p、miR-125a-5p、miR-142-5p对OP患者并发髋部骨折的诊断价值。结果骨折组OP病程长于OP组,有饮酒史、有OP家族史患者比例高于OP组,差异均有统计学意义(P<0.05)。骨折组和OP组血清miR-23b-3p、miR-125a-5p水平高于对照组,且骨折组高于OP组,差异均有统计学意义(P<0.05)。骨折组和OP组血清miR-142-5p水平低于对照组,且骨折组低于OP组,差异均有统计学意义(P<0.05)。骨折组血清CTX、PⅠNP水平高于OP组,Ca水平低于OP组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,OP并发髋部骨折患者血清miR-23b-3p、miR-125a-5p水平与CTX、PⅠNP水平呈正相关(P<0.05),与Ca水平呈负相关(P<0.05),血清miR-142-5p水平与CTX、PⅠNP水平呈负相关(P<0.05),与Ca水平呈正相关(P<0.05)。多因素Logistic回归分析结果显示,有饮酒史及血清miR-23b-3p、miR-125a-5p水平升高为OP患者并发髋部骨折的危险因素(P<0.05),血清miR-142-5p水平升高为OP患者并发髋部骨折的保护因素(P<0.05)。ROC曲线分析结果显示,3项指标联合诊断OP患者并发髋部骨折的曲线下面积(AUC)为0.879,大于血清miR-23b-3p、miR-125a-5p、miR-142-5p单独诊断的AUC(Z=3.576、2.544、3.841,均P<0.05)。结论相比于单纯OP患者,OP并发髋部骨折患者血清miR-23b-3p、miR-125a-5p水平升高,miR-142-5p水平降低,血清miR-23b-3p、miR-125a-5p、miR-142-5p联合对OP患者并发髋部骨折可能具有一定的诊断价值,可用于临床辅助诊断。
Objective To explore the serum miR-23b-3p,miR-125a-5p and miR-142-5p levels and their clinical significance in patients with osteoporosis(OP)complicated with hip fractures.Methods A total of 214 patients with OP treated in the hospital from January 2022 to January 2024 were selected as the research subjects.They were divided into the fracture group and the OP group according to whether they had hip fractures,with 107 cases in each group.Another 107 healthy individuals from the same period of physical examination in the hospital were selected as the control group.Baseline date of all subjects were collected.The levels of serum miR-23b-3p,miR-125a-5p,miR-142-5p,typeⅠcollagen carboxy-terminal peptide(CTX),type I procollagen amino-terminal propeptide(PⅠNP),calcium(Ca)and phosphorus(P)were detected in all participants.Pearson correlation analysis was used to analyze the correlation between the serum miR-23b-3p,miR-125a-5p and miR-142-5p levels of patients with OP complicated with hip fractures and bone metabolism indicators.Multivariable Logistic regression analysis was used to analyze the influencing factors of hip fractures in patients with OP.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum miR-23b-3p,miR-125a-5p and miR-142-5p for OP complicated with hip fractures.Results The duration of OP in the fracture group was longer than that in the OP group,and the proportion of history of alcohol consumption and family history of OP in the fracture group were higher than those in the OP group,and the differences were statistically significant(P<0.05).The serum miR-23b-3p and miR-125a-5p levels in the fracture group and the OP group were higher than those in the control group,and the differences were statistically significant(P<0.05).The serum miR-142-5p levels in the fracture group and the OP group were lower than those in the control group,and the differences were statistically significant(P<0.05).The serum CTX and PⅠNP levels in the fracture group were higher than those in the OP group,and the Ca level was lower than that in the OP group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the serum miR-23b-3p and miR-125a-5p levels of patients with OP complicated with hip fractures were positively correlated with CTX and PⅠNP levels(P<0.05),and negatively correlated with Ca level(P<0.05),the serum miR-142-5p level was negatively correlated with CTX and PⅠNP levels(P<0.05),and positively correlated with Ca level(P<0.05).Multivariable Logistic regression analysis showed that having a history of alcohol consumption and elevated serum miR-23b-3p and miR-125a-5p levels were risk factors for hip fractures in patients with OP(P<0.05),and elevated serum miR-142-5p level was a protective factor for hip fractures in patients with OP(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the combined diagnosis of the three indicators for OP complicated with hip fractures was 0.879,which was greater than the AUC of serum miR-23b-3p,miR-125a-5p and miR-142-5p alone(Z=3.576,2.544,3.841,all P<0.05).Conclusion Compared with patients with simple OP,patients with OP and hip fractures have elevated levels of serum miR-23b-3p and miR-125a-5p and decreased level of miR-142-5p.The combined serum levels of miR-23b-3p,miR-125a-5p,and miR-142-5p may have certain diagnostic value for OP patients with hip fractures and can be used for clinical auxiliary diagnosis.
作者
马文明
张博
边朝辉
MA Wenming;ZHANG Bo;BIAN Zhaohui(Department of Orthopedics,Fangshan Hospital of Beijing University of Chinese Medicine,Beijing 102400,China)
出处
《检验医学与临床》
2026年第3期391-396,403,共7页
Laboratory Medicine and Clinic
