首页|血清亚精胺作为绝经后女性髋部骨折潜在预测指标的初步研究

血清亚精胺作为绝经后女性髋部骨折潜在预测指标的初步研究

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目的 通过代谢组学确定与绝经后女性骨质疏松性骨折风险有关的替代指标,确定候选代谢物的预测价值.方法 2018年12月~2021年8月收治的158例非创伤性髋部骨折的绝经后女性为分析对象(骨折组),另纳入197例非骨折绝经后女性为对照(非骨折组).使用Abso-luteIDQTM p180试剂盒和靶向代谢组学法进行血清代谢物进行定量分析.采用单因素及多因素Logistic回归分析绝经后女性骨质疏松性骨折的影响因素,Spearman、Pearson分析其相关性.结果 与非骨折组相比,骨折组只有血清精氨酸[(105.2±22.4)µmol/L vs.(96.3±23.5)μmol/L]、亮氨酸[(180.9±50.0)µmol/L vs.(156.7±39.5)µmol/L]和亚精胺[(1.03±0.67)μmol/L vs.(0.51±0.12)μmol/L]水平显著升高(P<0.05).Logistic回归分析结果显示,在调整年龄、BMI、并发症、吸烟状况后,只有血清亚精胺浓度与髋部骨折风险显著相关(HR=1.35,95%CI=1.03~1.65,P=0.020).经受试者工作特性曲线分析,血清亚精胺水平预测绝经后女性发生髋部骨折的曲线下面积为0.882(95%CI:0.847~0.916).经Spearman分析,全髋T值与血清亚精胺水平呈显著负相关(r=-0.192,P<0.001).血清亚精胺低水平亚组病人血清精胺和腐胺水平均较高水平亚组升高;经Pearson相关性分析,骨折组病人血清亚精胺水平与精胺(r=-0.237,P<0.001)和腐胺(r=-0.189,P=0.004)呈负相关.经单因素和多因素Logistic回归分析,血清亚精胺水平≥0.58 µmol/L是绝经后女性发生髋部骨折风险增加的独立危险因素(P<0.001).结论 绝经后女性基线血清亚精胺水平升高与髋部骨折发生风险增加相关,对预测绝经后女性脆性骨折的发生有良好效能.
A preliminary study of serum spermidine as a potential predictor of hip fracture in postmenopausal women
Objective To Identify alternative indicators related to the risk of osteoporosis fractures in postmenopausal women through metabolomics and attempting to determine the predictive value of candidate metabolites.Methods From December 2018 to August 2021,158 postmenopausal women with non-traumatic hip fracture(fracture group)were enrolled in our hospital,and 197 postmenopausal women without fracture(non-fracture group)were enrolled.Quantitative analysis of serum metabolites was performed using AbsoluteIDQTM p180 kit and targeted metabolomics approach.Univariate and Multivariate Logistic regression were used to analyze the influencing factors of osteoporotic fracture in postmenopausal women,and Spearman and Pearson analysis were used to analyze their correlation.Results Compared with the non-fracture group,Only serum arginine[(105.2±22.4)μmol/L vs.(96.3±23.5)µmol/L],leucine[(180.9±50.0)µmol/L vs.(156.7±39.5)μmol/L)and spermine[(1.03± 0.67)μmol/L vs.(0.51±0.12)μmol/L]were significantly increased in the fracture group(P<0.05).Logistic regression analysis showed that only serum spermidine concentration was significantly associated with hip fracture risk after adjustment for age,BMI,complications,and smoking status(HR=1.35,95%CI=1.03 to 1.65,P=0.020).According the receiver operating characteristic,serum spermidine level predicted hip fracture in postmenopausal women with an area under the curve of 0.882(95%CI:0.847 to 0.916).Spearman analysis showed that T value of hip was negatively correlated with serum spermidine level(r=-0.192,P<0.001).The levels of serum spermine and putrescine in patients of low spermine level group were increased than those in high spermine level group.Pearson correlation analysis showed that serum spermidine level was negatively correlated with spermidine(r=-0.237,P<0.001)and putrescine(r=-0.189,P=0.004)in fracture group.Univariate and multivariate Logistic regression analysis showed that serum spermidine ≥0.58 μmol/L was an independent risk factor for an increased risk of fragility hip fracture in postmenopausal women(P<0.001).Conclusion Elevated baseline serum spermidine level are associated with increased risk of hip fracture in postmenopausal women and may be useful in predicting fragility fracture in postmenopausal women.

postmenopausalhip fracturespermidinefracture risk assessmentprediction

张丹龙、梁少博、魏巍、庄岩、张堃

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710054 西安交通大学医学院附属红会医院创伤骨科

绝经后 髋部骨折 亚精胺 骨折风险评估 预测

陕西省重点研发计划

2017SF-050

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(5)
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