Predictive value of serum bone morphogenetic protein-2(BMP-2)and runt-related transcription factor 2(Runx2)levels in patients with osteoporotic vertebral compression fractures(OVCF)for delayed healing after surgery
Objective To investigate the predictive value of serum bone morphogenetic protein-2(BMP-2)and runt-related transcription factor 2(Runx2)levels in patients with osteoporotic vertebral compressibili-ty fracture(OVCF)for delayed healing after surgery.Methods A total of 260 OVCF patients admitted to the hospital from January 2020 to April 2023 were selected as the research subjects.All patients were trea-ted with percutaneous vertebroplasty(PVP)or percutaneouskyphoplasty(PKP),and the patients were di-vided into a delayed healing group and a normal healing group based on the status of fracture healing at 3 months postoperatively.The influencing factors of delayed fracture healing in OVCF patients and the pre-dictive value of serum BMP-2 and Runx2 levels for delayed fracture healing were analyzed.Decision curves and clinical impact curves were plotted to evaluate the value of serum BMP-2 and Runx2 levels in predic-ting delayed fracture healing postoperatively.Results Among the 260 patients in the study group,there were no lost follow-ups.Delayed fracture healing occurred in 22 patients,with an incidence rate of 8.46％(22/260).The delayed healing group had a higher proportion of patients with older age,smoking,diabe-tes,thyroid disease and vertebral cleft sign than the normal healing group.Additionally,the bone mineral density T-score,preoperative and 3-month postoperative serum BMP-2 and Runx2 levels were lower in the delayed healing group compared to the normal healing group(P＜0.05).Having diabetes and the presence of vertebral cleft sign were independent risk factors for delayed fracture healing in OVCF patients postop-eratively,while bone mineral density T-score,BMP-2 and Runx2 were independent protective factors for delayed fracture healing in OVCF patients postoperatively(P＜0.05).The AUC value of BMP-2 and Runx2 combined in predicting delayed fracture healing in OVCF patients postoperatively was 0.856.With-in the threshold range of 0.10 to 0.63,the net benefit rate of the combined assessment model of BMP-2 and Runx2 in evaluating delayed fracture healing in OVCF patients postoperatively was superior to that of individual testing.At a threshold probability of 0.26,the number of individuals classified as high risk by the model was approximately consistent with the number of true positives.Conclusion Serum levels of BMP-2 and Runx2 were decreased in OVCF patients,and the combined detection of these 2 markers has high predictive value for delayed fracture healing postoperatively.
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