Predictive analysis of hemoglobin glycation index for secondary adjacent vertebral compression fracture in osteoporotic vertebral compression fracture patients with type 2 diabetes mellitus
Predictive analysis of hemoglobin glycation index for secondary adjacent vertebral compression fracture in osteoporotic vertebral compression fracture patients with type 2 diabetes mellitus
Objective To investigate the influence and prediction of hemoglobin glycation(HbA1c)index(HGI)on adjacent vertebral compression fracture(AVCF)after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fracture(OVCF)with type 2 diabetes mellitus(T2DM).Methods From June 2018 to June 2021,67 patients with OVCF and T2DM were treated with PVP,and divided into AVCF group(n=21)and non AVCF group(n=46)based on whether occurred AVCF at postoperative 1 year.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive effect of HGI on postoperative AVCF,and the independent risk factors for AVCF after PVP were analyzed by logistic regression,and the influence of HGI on postoperative AVCF was analyzed by drawing Kaplan-Meier risk curve.Results The area under the curve(AUC)of HGI for predicting AVCF after PVP surgery was 0.929(95%confidence interval was 0.864-0.994,P<0.05),and the maximum value of Yoeden index was 0.745,and the best cut-off value was 0.237%,and the sensitivity was 0.810,and the specificity was 0.935.Univariate analysis showed that the incidence of AVCF after PVP in patients with high HGI,lower bone mineral density T value,high HbA1c value,thoracic fracture,high bone cement injection amount and no brace wearing was higher than that in non-AVCF group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis of the above 6 factors showed that high HGI,lower bone mineral density T value and high HbA1c value were independent risk factors for AVCF after PVP.Kaplan-Meier risk curve analysis showed that the incidence of AVCF after PVP in patients with high HGI was higher than that in patients with low HGI(Lon-Rank=54.411,P<0.05).Conclusions High HGI,lower bone mineral density and high HBA1c value are independent risk factors for postoperative AVCF in patients with OVCF and T2DM.High HGI can predict the occurrence of AVCF.
维普
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