| 魏翾娣,岳建彪.血清肌酐 /胱抑素 C比值与老年骨质疏松病人骨折风险的倾向性评分匹配分析[J].安徽医药,2025,29(11):2186-2190. |
| 血清肌酐 /胱抑素 C比值与老年骨质疏松病人骨折风险的倾向性评分匹配分析 |
| Tendency score matching analysis of serum creatinine/cystin C ratio and fracture risk in elderly osteoporosis patients |
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| DOI：10.3969/j.issn.1009-6469.2025.11.013 |
| 中文关键词: 骨质疏松性骨折 血清肌酐 /胱抑素 C比值 骨密度 倾向性评分匹配 25羟维生素 D Ⅰ-型胶原羧基端肽 β特殊序列(β-CTX) Ⅰ-型前胶原氨基端延长肽( PINP) 碱性磷酸酶 老年人 |
| 英文关键词: Osteoporotic fractures Serum creatinine/cystatin C ratio Bone density Propensity score matching 25-hydroxyvita-min D Type Ⅰ collagen β-crosslinked telopeptide (β-CTX) Type Ⅰ pre-collagen N-terminal propeptide (PINP) Alkaline phos-phatase Aged |
| 基金项目:四川省干部保健科研课题(川干研 2019-605) |
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| 中文摘要: |
| 目的探讨血清肌酐( Cr)/胱抑素 C(CysC)比值与老年骨质疏松性病人骨折风险的关系。方法选取四川省骨科医院就诊的 160例老年骨质疏松性病人纳入研究，入选时间为 2020年 12月至 2022年 12月，将合并骨折的 56例作为骨折组和无骨折的 104例作为无骨折组。收集两组相关资料、实验室指标［血清 25羟维生素 D、Ⅰ-型胶原羧基端肽 β特殊序列( β-CTX)、 Ⅰ-型前胶原氨基端延长肽( PINP)、碱性磷酸酶( ALP)、血清 Cr、CysC含量及两者比值( Cr/CysC)］及影像学指标(股骨颈、总髋部、腰椎、 Ward三角区骨密度)。同时对病人年龄、性别、身体质量指数、骨质疏松病程等进行倾向性评分匹配后，采用多因素 logistic回归分析评价影响老年骨质疏松病人骨折风险的影响因素，并采用受试者操作特征曲线( ROC曲线)及曲线下面积(AUC)评价血清 Cr/CysC比值与老年骨质疏松骨折风险间的关系。结果倾向性评分匹配后两组配对成功 39对(每组 39例)匹配后基线资料对比差异无统计学意义( P>0.05)；骨折组与无骨折组 β-CTX、PINP、ALP、Cr/CysC(0.75±0.22比 0.90±0.19)、，Ward三角区骨密度对比差异有统计学意义( P<0.05)；多因素 logistic回归分析显示: Ward三角区骨密度［ OR=0.25，95%CI:(0.12，0.53)］、 Cr/CysC［OR=0.39，95%CI:(0.18，0.83)］为老年骨质疏松骨折的保护因素； ALP［OR=1.05，95%CI:(1.00，1.10)］、 β-CTX［OR=1.01，95%CI:(1.00，1.02)］为老年骨质疏松骨折的危险因素(均 P<0.05)且 ROC曲线显示 Cr/CysC预测老年骨质疏松骨折的 AUC为 0.77［95%CI:(0.66，0.86)］。结论血清 Cr/CysC比值与老年骨质病人骨折发生相关，可作为老年骨质疏疏松，松骨折发生风险的潜在预测因子。 |
| 英文摘要: |
| Objective To investigate the relationship between serum creatinine (Cr)/cystatin C (CysC) ratio and fracture risk in elder-ly patients with osteoporosis.Methods A total of 160 elderly osteoporosis patients treated in Sichuan Provincial Orthopaedic Hospitalwere included in the study. The inclusion time was from December 2020 to December 2022. Fifty-six cases with combined fractures were regarded as fracture group and 104 cases without fractures were regarded as non-fracture group.The study collected two sets of rel-evant data and laboratory indicators: serum 25-hydroxy vitamin D, type Ⅰ collagen carboxy-terminal peptide β-specific sequence (type Ⅰ collagen β-crosslinked telopeptide, β-CTX), type Ⅰ pre-collagen N-terminal propeptide (type Ⅰ pre-collagen N-terminal propep-tide, PINP); alkaline phosphatase (ALP); measurement of serum creatinine (Cr) and cysteine-cystine (CysC) levels with calculation oftheir ratio (Cr/CysC); and imaging indicators including bone density in the femoral neck, total hip, lumbar spine, and Ward's triangle.After propensity score matching for age, gender, body mass index, and disease duration of osteoporosis, a multivariate logistic regres-sion analysis was conducted to evaluate factors influencing fracture risk in elderly osteoporotic patients. The relationship between se-rum Cr/CysC ratio and fracture risk in elderly osteoporotic patients was further assessed using receiver operating characteristic curve(ROC curve) and area under the curve (AUC).Results There was no significant difference in baseline data between 39 pairs (39 casesin each group) after matching with propensity score. The comparison of β -CTX, PINP, ALP, Cr/CysC (0.75±0.22 vs. 0.90±0.19) and Ward triangle bone mineral density between the fracture group and the non-fracture group was statistically significant (P<0.05).Multi-variate logistic regression analysis showed that Bone mineral density in Ward's triangle [OR=0.25,95% CI: (0.12,0.53)] and Cr/CysC [OR=0.39,95% CI: (0.18,0.83)] were protective factors for osteoporotic fractures in elderly patients; while ALP [OR=1.05,95% CI: (1.00, 1.10)] and β-CTX [OR=1.01,95% CI: (1.00,1.02)] were risk factors (all P<0.05). ROC curve showed that Cr/CysC predicted an AUC of 0.77 [95% CI: (0.66, 0.86)] for osteoporotic fractures in elderly patients.Conclusion Serum Cr/CysC is associated with fracture in el-derly patients with osteoporosis and can be used as a potential predictor of fracture risk in elderly patients with osteoporosis. |
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