Roles of PTH，CRP，OPG/PYR ratio in elderly patients with osteoporosis

doi:10.3969/j.issn.1673-8640.2022.12.009

Abstract

Abstract:

Objective To investigate the roles of parathyroid hormone（PTH），C-reactive protein（CRP），osteoprotegerin（OPG）/pyridinoline（PYR） ratio in elderly patients with osteoporosis（OP）. Methods Totally，137 patients with suspected OP were enrolled and classified into OP group（32 cases） and non-OP group（105 cases） according to the presence or absence of OP. The clinical data were collected，and lumbar spine and femoral neck bone mineral densities（BMD），serum PTH，CRP and OPG levels and urinary PYR levels were determined. OPG/PYR ratio was calculated. Pearson correlation analysis and partial correlation analysis were used to analyze the relationship between each index and lumbar spine and femoral neck BMD. Receiver operating characteristic（ROC） curve was used to analyze the efficiency of OP. Results The proportion of diabetes mellitus and serum PTH and CRP levels were higher in OP group than those in non-OP group（P<0.05），and lumbar spine BMD，femoral neck BMD and OPG/PYR ratio were lower than those in non-OP group（P<0.05）. Between the 2 groups，age，sex，body mass index，the proportion of alcohol consumption history，the proportion of smoking history，the proportion of hyperlipoidemia，the proportion of coronary heart disease and the proportion of hypertension had no statistical significance（P>0.05）. Pearson correlation analysis showed that PTH and CRP were negatively correlated with lumbar spine BMD and femoral neck BMD（P<0.05），and the OPG/PYR ratio was positively correlated with lumbar spine BMD and femoral neck BMD（P<0.05）. The results of partial correlation analysis showed that PTH，CRP and OPG/PYR ratio were correlated with lumbar spine BMD and femoral neck BMD after controlling for the factor of diabetes mellitus（P<0.05）. The results of ROC curve analysis showed that the areas under curves（AUC） of PTH，CRP and OPG/PYR ratio single and combined determinations to diagnose OP were 0.856，0.826，0.861 and 0.912，respectively. Conclusions PTH，CRP，OPG/PYR ratio are correlated to OP，which can be used in the auxiliary diagnosis and disease monitoring of OP.

Key words: Parathyroid hormone, C-reactive protein, Osteoprotegerin/pyridinoline ratio, Osteoporosis, Elder

CLC Number:

R446.1

YAO Hualong. Roles of PTH，CRP，OPG/PYR ratio in elderly patients with osteoporosis[J]. Laboratory Medicine, 2022, 37(12): 1146-1150.

Figures/Tables 5

References 21

1	BARBU C G, ARSENE A L, FLOREA S, et al. Cardiovascular risk assessment in osteoporotic patients using osteoprotegerin as a reliable predictive biochemical marker[J]. Mol Med Rep, 2017, 16(5):6059-6067. DOI PMID
2	寿燕琼, 王雅君, 张燕, 等. 老年人骨质疏松性骨折风险与性别和股骨颈骨密度关系的研究[J]. 浙江医学, 2020, 42(17):1875-1877.
3	屈晓龙, 蒋涛, 曹宗锐, 等. 骨转换标志物与骨密度预测老年女性骨质疏松性骨折的对比研究[J]. 中国骨质疏松杂志, 2020, 26(1):31-36.
4	EL KHASSAWNA T, MERBOTH F, MALHAN D, et al. Osteocyte regulation of receptor activator of NF-κB ligand/osteoprotegerin in a sheep model of osteoporosis[J]. Am J Pathol, 2017, 187(8):1686-1699. DOI PMID
5	王健, 张于刚. 老年患者血清中甲状旁腺激素和骨型碱性磷酸酶水平与骨质疏松骨折及临床预后的关系[J]. 中国卫生检验杂志, 2018, 28(7):833-835.
6	姚彦冰. 骨质疏松与血清IGF-1、ET-1及MMP水平具有相关性[J]. 基因组学与应用生物学, 2018, 37(1):123-128.
7	李智, 曾凡伟, 徐利军, 等. 健康中年人血清炎症标志物与骨密度的相关性研究[J]. 中国骨质疏松杂志, 2020, 26(3):382-384.
8	马远征, 王以朋, 刘强, 等. 中国老年骨质疏松症诊疗指南(2018)[J]. 中国骨质疏松杂志, 2018, 24(12):1541-1567.
9	杨娟, 徐瑾. 绝经后骨质疏松症患者血清铁调素水平变化及临床意义[J]. 检验医学, 2019, 34(1):23-27.
10	顾洁梅, 刘玉娟, 胡云秋, 等. 骨化三醇对绝经后骨量减少或骨质疏松症患者甲状旁腺素和骨转换指标及尿钙变化的影响[J]. 老年医学与保健, 2020, 26(2):204-207.
11	TAY D, CREMERS S, BILEZIKIAN J P. Optimal dosing and delivery of parathyroid hormone and its analogues for osteoporosis and hypoparathyroidism-translating the pharmacology[J]. Br J Clin Pharmacol, 2018, 84(2):252-267. DOI URL
12	张伟, 宋世锋, 李超艺. 老年骨折患者血清25-羟基维生素D和甲状旁腺激素水平与骨质疏松程度的关系[J]. 中国老年学杂志, 2016, 36(10):2480-2481.
13	田志, 杨召旭, 范静, 等. 老年骨折患者血清25OHD和PTH水平与骨质疏松程度的相关性[J]. 重庆医学, 2018, 47(6):767-769.
14	杨志宏, 张小妮, 王小娟, 等. 血清25(OH)D3、超敏C反应蛋白水平与老年2型糖尿病合并骨质疏松的相关性分析[J]. 标记免疫分析与临床, 2019, 26(3):502-505.
15	韩学明, 孙忠良, 徐建华, 等. 老年人血清炎症因子与骨密度变化及骨吸收相关性研究[J]. 中国骨质疏松杂志, 2020, 26(2):221-226.
16	DELIGIORGI M V, PANAYIOTIDIS M I, SIASOS G, et al. Osteoporosis entwined with cardiovascular disease:the implication of osteoprotegerin and the example of statins[J]. Curr Med Chem, 2021, 28(7):1443-1467. DOI URL
17	陈瀚宇, 徐颖鹏, 李鼎鹏, 等. RANK/RANKL/OPG系统在骨性关节炎与骨质疏松相关性中的作用机制[J]. 中国中医骨伤科杂志, 2019, 27(1):86-88.
18	DING Z, SHI H, YANG W. Osteoprotective effect of cimiracemate in glucocorticoid-induced osteoporosis by osteoprotegerin/receptor activator of nuclear factor κ B/receptor activator of nuclear factor kappa-Β ligand signaling[J]. Pharmacology, 2019, 103(3-4):163-172. DOI PMID
19	周昕, 李强, 赵志军, 等. 青海高原成人大骨节病患者尿中吡啶啉、脱氧吡啶啉检测结果分析[J]. 中华地方病学杂志, 2019, 38(8):674-675.
20	侯希贺, 张玲莉, 李慧, 等. 运动训练与骨代谢和脂代谢:运动强度和持续时间是影响的重要因素[J]. 中国组织工程研究, 2018, 22(12):1950-1955.
21	彭俊洋. 中老年女性骨代谢生化指标对早期骨质疏松症的临床诊断价值研究[J]. 中国妇幼保健, 2017, 32(24):6118-6120.

组别	例数	年龄/岁		性别			体质量指数							饮酒史/例		BMD/（mg/cm²）
组别	例数	年龄/岁		男/例		女/例	偏瘦/例		正常/例		超重/例		肥胖/例	饮酒史/例		腰椎		股骨颈
OP组	32	72.46±7.13		12		20	9		7		10		6	18		0.52±0.18		0.47±0.12
非OP组	105	69.92±8.04		45		60	32		29		34		10	63		0.73±0.22		0.60±0.15
统计值		1.604		0.290			2.151							0.143		4.918		4.481
P值		0.111		0.590			0.542							0.706		<0.001		<0.001
组别	既往病史									吸烟史/例		PTH/ （pg/mL）			CRP/ （mg/L）		OPG/PYR 比值
组别	高脂血症/例		糖尿病/例		冠心病/例			高血压/例		吸烟史/例		PTH/ （pg/mL）			CRP/ （mg/L）		OPG/PYR 比值
OP组	11		14		8			6		18		82.54±15.16			11.84±3.87		0.61±0.15
非OP组	30		12		29			13		63		59.54±18.22			6.91±1.15		1.07±0.32
统计值	0.394		16.663		0.085			0.385		0.143		6.485			11.564		7.858
P值	0.530		<0.001		0.770			0.535		0.706		<0.001			<0.001		<0.001

组别	例数	年龄/岁		性别			体质量指数							饮酒史/例		BMD/（mg/cm²）
组别	例数	年龄/岁		男/例		女/例	偏瘦/例		正常/例		超重/例		肥胖/例	饮酒史/例		腰椎		股骨颈
OP组	32	72.46±7.13		12		20	9		7		10		6	18		0.52±0.18		0.47±0.12
非OP组	105	69.92±8.04		45		60	32		29		34		10	63		0.73±0.22		0.60±0.15
统计值		1.604		0.290			2.151							0.143		4.918		4.481
P值		0.111		0.590			0.542							0.706		<0.001		<0.001
组别	既往病史									吸烟史/例		PTH/ （pg/mL）			CRP/ （mg/L）		OPG/PYR 比值
组别	高脂血症/例		糖尿病/例		冠心病/例			高血压/例		吸烟史/例		PTH/ （pg/mL）			CRP/ （mg/L）		OPG/PYR 比值
OP组	11		14		8			6		18		82.54±15.16			11.84±3.87		0.61±0.15
非OP组	30		12		29			13		63		59.54±18.22			6.91±1.15		1.07±0.32
统计值	0.394		16.663		0.085			0.385		0.143		6.485			11.564		7.858
P值	0.530		<0.001		0.770			0.535		0.706		<0.001			<0.001		<0.001

项目	腰椎BMD	股骨颈BMD
PTH
r值	-0.778	-0.754
P值	<0.001	<0.001
CRP
r值	-0.689	-0.706
P值	<0.001	<0.001
OPG/PYR比值
r值	0.845	0.850
P值	<0.001	<0.001

项目	腰椎BMD	股骨颈BMD
PTH
r值	-0.778	-0.754
P值	<0.001	<0.001
CRP
r值	-0.689	-0.706
P值	<0.001	<0.001
OPG/PYR比值
r值	0.845	0.850
P值	<0.001	<0.001

影响因素	偏回归系数	标准误	偏回归系数（标准化）	t值	P值
腰椎BMD
常量	8.335
PTH	-7.894	0.583	-0.722	13.540	<0.001
CRP	-8.656	0.399	-0.609	21.694	<0.001
OPG/PYR比值	9.877	0.603	0.863	16.380	<0.001
股骨颈BMD
常量	7.649
PTH	-6.722	0.311	-0.688	21.614	<0.001
CRP	-5.683	0.308	-0.627	18.451	<0.001
OPG/PYR比值	7.894	0.483	0.841	16.344	<0.001