血浆Nesfatin-1、DKK-1水平与股骨头坏死的关系

doi:10.3969/j.issn.1673-8640.2021.012.011

摘要/Abstract

摘要：

目的探讨血浆摄食抑制因子1（Nesfatin-1）、Dickkopf-1（DKK-1）与股骨头坏死（ONFH）的关系。方法选取ONFH患者85例（ONFH组）、体检健康者50名（正常对照组）,检测所有对象血浆Nesfatin-1、DKK-1水平。采用Spearman秩相关分析评估Nesfatin-1、DKK-1与国际骨循环学会（ARCO）分期之间的相关性。采用受试者工作特征（ROC）曲线评估各项指标诊断股骨头塌陷的效能。结果 ONFH组血浆Nesfatin-1、DKK-1水平显著高于正常对照组（P<0.05）。ONFH患者血浆Nesfatin-1、DKK-1水平随着ARCO分期的增高而升高（P<0.05）。股骨头塌陷的ONFH患者血浆Nesfatin-1、DKK-1水平显著高于股骨头未塌陷的ONFH患者（P<0.05）。Spearman秩相关分析结果显示,血浆Nesfatin-1、DKK-1水平与ARCO分期呈正相关（r_s值分别为0.733、0.626,P<0.05）。ROC曲线分析结果显示,血浆Nesfatin-1、DKK-1单项检测及联合检测诊断股骨头塌陷的曲线下面积（AUC）分别为0.707、0.643、0.889。结论血浆Nesfatin-1、DKK-1水平与ONFH有一定关系。

关键词: 摄食抑制因子1, Dickkopf-1, 股骨头坏死

Abstract:

Objective To investigate the relationship between plasma Nesfatin-1,Dickkopf-1（DKK-1） and osteonecrosis of the femoral head（ONFH）. Methods A total of 85 patients with ONFH（ONFH group） and 50 healthy subjects（control group） were enrolled. The levels of plasma Nesfatin-1 and DKK-1 were determined. Spearman rank correlation analysis was used to evaluate the correlation between Nesfatin-1,DKK-1 and the Association Research Circulation Osseous（ARCO）staging. Receiver operating characteristic（ROC） curve was used to evaluate the efficiency of each index in the diagnosis of femoral head collapse. Results The plasma levels of Nesfatin-1 and DKK-1 in ONFH group were higher than those in control group（P<0.05）. The plasma levels of Nesfatin-1 and DKK-1 in ONFH group increased with the increase of ARCO staging（P<0.05）. The plasma levels of Nesfatin-1 and DKK-1 in patients with femoral head collapse were higher than those without femoral head collapse（P<0.05）. Spearman rank correlation analysis results showed that plasma Nesfatin-1 and DKK-1 levels were positively correlated with ARCO staging（r_s=0.733 and 0.626,P<0.05）. ROC curve analysis showed that the areas under curves（AUC）of Nesfatin-1,DKK-1 single and combined determinations in the diagnosis of femoral head collapse were 0.707,0.643 and 0.889,respectively. Conclusions The plasma Nesfatin-1 and DKK-1 levels are related to ONFH.

Key words: Nesfatin-1, Dickkopf-1, Osteonecrosis of the femoral head

中图分类号:

R446.1

庞士龙, 王汉, 张志强, 李强, 朱如森. 血浆Nesfatin-1、DKK-1水平与股骨头坏死的关系[J]. 检验医学, 2021, 36(12): 1248-1252.

PANG Shilong, WANG Han, ZHANG Zhiqiang, LI Qiang, ZHU Rusen. Relationship between plasma Nesfatin-1 and DKK-1 levels and osteonecrosis of the femoral head[J]. Laboratory Medicine, 2021, 36(12): 1248-1252.

图/表 4

参考文献 21

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组别	例数	Nesfatin-1/（ng/L）	DKK-1/（pg/mL）
ONFH组	85	61.24±13.71	72.14±15.26
正常对照组	50	35.12±6.35	43.26±7.46
t值		12.681	12.517
P值		0.000	0.000

组别	例数	Nesfatin-1/（ng/L）	DKK-1/（pg/mL）
ONFH组	85	61.24±13.71	72.14±15.26
正常对照组	50	35.12±6.35	43.26±7.46
t值		12.681	12.517
P值		0.000	0.000

临床参数	例数	Nesfatin-1/（ng/L）	DKK-1/（pg/mL）
性别
男性	36	61.19±13.42	72.09±15.06
女性	49	61.27±14.36	72.18±15.33
t值		0.026	0.027
P值		0.979	0.979
年龄
≥35岁	42	61.42±13.95	72.81±15.43
<35岁	43	61.03±13.01	71.49±14.58
t值		0.133	0.405
P值		0.894	0.686
病因
激素性	39	61.21±13.12	72.21±15.29
酒精性	21	61.12±13.23	72.29±15.44
创伤性	15	61.14±13.11	72.30±15.23
特发性	10	61.76±13.52	71.31±15.27
F值		0.682	0.351
P值		0.532	0.823
ARCO分期
Ⅱ期	21	50.63±10.42	64.20±12.14
Ⅲ期	36	62.35±13.02^*	71.24±14.15^*
Ⅳ期	28	67.77±15.24^*#	79.25±18.62^*#
F值		13.264	15.243
P值		0.000	0.000
股骨头塌陷
是	50	66.24±16.32	76.15±16.35
否	35	54.10±11.53	66.41±14.23
t值		3.836	2.848
P值		0.000	0.006

临床参数	例数	Nesfatin-1/（ng/L）	DKK-1/（pg/mL）
性别
男性	36	61.19±13.42	72.09±15.06
女性	49	61.27±14.36	72.18±15.33
t值		0.026	0.027
P值		0.979	0.979
年龄
≥35岁	42	61.42±13.95	72.81±15.43
<35岁	43	61.03±13.01	71.49±14.58
t值		0.133	0.405
P值		0.894	0.686
病因
激素性	39	61.21±13.12	72.21±15.29
酒精性	21	61.12±13.23	72.29±15.44
创伤性	15	61.14±13.11	72.30±15.23
特发性	10	61.76±13.52	71.31±15.27
F值		0.682	0.351
P值		0.532	0.823
ARCO分期
Ⅱ期	21	50.63±10.42	64.20±12.14
Ⅲ期	36	62.35±13.02^*	71.24±14.15^*
Ⅳ期	28	67.77±15.24^*#	79.25±18.62^*#
F值		13.264	15.243
P值		0.000	0.000
股骨头塌陷
是	50	66.24±16.32	76.15±16.35
否	35	54.10±11.53	66.41±14.23
t值		3.836	2.848
P值		0.000	0.006

指标	AUC（95%可信区间）	P值	最佳临界值	敏感性/%	特异度/%	约登指数
Nesfatin-1	0.707（0.593~0.821）	0.001	60.02 ng/L	60.00	82.86	0.43
DKK-1	0.643（0.524~0.763）	0.025	71.02 pg/mL	58.00	77.14	0.35
联合检测	0.889（0.814~0.964）	0.000		84.00	94.29	0.78