骨质疏松性骨折患者血清25(OH) D、TGF-β1、网膜素-1与MRI信号特点的相关性分析-东南大学学报医学版

骨质疏松性骨折患者血清25(OH) D、TGF-β1、网膜素-1与MRI信号特点的相关性分析

单位：1. 河南省洛阳正骨医院(河南省骨科医院) 颈肩腰腿痛科, 河南洛阳 471002;
2. 河南省洛阳正骨医院(河南省骨科医院) 骨质疏松科, 河南洛阳 471002;
3. 河南中医药大学中医骨伤系, 河南郑州 450000

分类号：R683

出版年·卷·期（页码）：2020·39·第六期（773-779）

摘要：

目的：探讨骨质疏松性骨折患者血清25羟维生素D[25（OH）D]、转化生长因子-β1（TGF-β1）、网膜素-1水平与磁共振成像（MRI）信号特点的相关性。方法：选取2017年12月至2019年12月河南省洛阳正骨医院164例骨质疏松症患者，根据其是否发生骨折分为骨折组（73例）与非骨折组（91例）。比较两组患者血清25（OH）D、TGF-β1、网膜素-1水平，分析这些指标对骨折的预测价值；比较不同MRI信号强度患者上述血清指标水平，分析其与MRI信号强度的相关性及骨折患者MRI高信号的影响因素。结果：骨折组血清25（OH）D、TGF-β1、网膜素-1水平低于非骨折组（P<0.05）；受试者工作特征曲线显示，3个血清指标联合预测骨质疏松性骨折的曲线下面积为0.889，高于各指标单独预测；不同MRI信号特点患者3个血清指标比较差异有统计学意义（P<0.05）；骨质疏松性骨折患者3个血清指标均与MRI信号强度呈负相关关系（P<0.05）；年龄、性别、骨密度下降、三酰甘油与空腹血糖水平升高、脆性骨折史、糖尿病、高血压、高脂血症及血清25（OH）D、TGF-β1、网膜素-1水平下降均为骨质疏松性骨折患者MRI高信号的影响因素（P<0.05）。结论：骨质疏松性骨折患者血清25（OH）D、TGF-β1、网膜素-1表达能有效预测骨折风险，且与MRI信号强度有关，两者联合应用有助于指导临床诊治工作。

Objective: To investigate the correlation between serum 25-hydroxyvitamin D[25(OH)D], transforming growth factor-β1(TGF-β1), omentin-1 and magnetic resonance imaging(MRI) signal characteristics in patients with osteoporotic fractures. Methods: Between December 2017 and December 2019, 164 patients with osteoporosis in Luoyang Orthopedic-Traumatological Hospital of Henan Province were selected and divided into the fracture group(n=73) and the non-fracture group(n=91) according to whether fractures occurred. Levels of serum 25(OH)D, TGF-β1, and omentin-1 were compared between the two groups, and the predictive power of serum indexes for fracture was analyzed. The serum index levels of patients with different MRI signal intensities were compared, the correlation between the serum index and the MRI signal intensity, and the influencing factors of MRI high signal in fracture patients were analyzed. Results: The levels of serum 25(OH)D, TGF-β1, and omentin-1 in the fracture group were lower than those in the non-fracture group, and the difference was statistically significant(P<0.05). The receiver operating characteristic curve showed that the area under the curve(AUC) of osteoporotic fracture predicted by the combination of serum 25(OH)D, TGF-β1, and omentin-1 levels was 0.889, which was higher than the prediction of each index alone. There were statistically significant differences in serum 25(OH)D, TGF-β1, and omentin-1 levels in patients with different MRI signal characteristics(P<0.05). The serum levels of 25(OH)D, TGF-β1, and omentin-1 in patients with osteoporotic fractures were negatively correlated with the intensity of MRI signals(P<0.05). Age, gender, the decrease of BMD, the increase of triacylglycerol and fasting blood glucose levels, history of fragility fractures, diabetes, hypertension, hyperlipidemia, the decrease of serum 25(OH)D, TGF-β1, and omentin-1 levels were all influencing factors of MRI high signal in patients with osteoporotic fractures(P<0.05). Conclusion: The expression of serum 25(OH)D, TGF-β1, and omentin-1 in patients with osteoporotic fractures can effectively predict the risk of fracture and is related to the intensity of MRI signals. The combined application of the two can help guide clinical diagnosis and treatment.

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