Predictive values of serum CTRP3 and DKK-1 levels for the occurrence of fractures in postmenopausal osteoporosis patients

doi:10.3969/j.issn.1673-8640.2024.10.005

Abstract

Abstract:

Objective To determine the levels of C1q tumor necrosis factor related protein 3（CTRP3） and Dickkopf related protein 1（DKK-1） in serum，and to investigate their predictive values for the occurrence of fractures in postmenopausal osteoporosis（PMOP） patients. Methods From June 2020 to December 2022，126 PMOP patients from Jiangxi Armed Police Corps Hospital were enrolled as PMOP group. They were classified into fracture group（41 cases） and non-fracture group（85 cases），and another 118 volunteers who underwent physical examination（females without osteoporosis and with a natural menopause of more than 1 year） were enrolled as control group. The levels of serum CTRP3，DKK-1 and lumbar spine（L₁~L₄）bone mineral density（BMD） were determined and compared. Spearman analysis was used to analyze the correlation between serum levels of CTRP3 and DKK-1 and the occurrence of fractures in PMOP patients. Multivariate Logistic regression was used to analyze the influencing factors of fractures in PMOP patients. Receiver operating characteristic（ROC） curve was used to analyze the clinical values of serum CTRP3，DKK-1 levels and BMD in predicting fracture occurrence in PMOP patients. Results Compared with control group，the levels of 25-hydroxyvitamin D [25-（OH）D]，CTRP3 and BMD in PMOP group were decreased（P<0.001），and the level of DKK-1 was increased（P<0.001），and there was no statistical significance in the other indicators between the 2 groups（P>0.05）. Compared with non-fracture group，BMD and serum CTRP3 level in fracture group were decreased（P<0.001），and DKK-1 level was increased（P<0.001）. Serum CTRP3 level was negatively correlated with fracture in PMOP patients（r=-0.574，P<0.05），and serum DKK-1 level was positively correlated with fracture in PMOP patients（r=0.658，P<0.05）. Increased DKK-1，decreased serum CTRP3 and decreased BMD were risk factors for fracture in PMOP patients [odds ratios（OR） were 2.249，0.529，0.424，95% confidence intervals（CI） were 1.199-4.219，0.299-0.936，0.188-0.958，respectively]. The areas under curves（AUC） of serum CTRP3，DKK-1 and BMD single and combined determinations were 0.871，0.904，0.806 and 0.974，respectively. Conclusions Serum CTRP3 is decreased，and DKK-1 is increased in PMOP patients. The combined determination of serum CTRP3，DKK-1 and BMD has a high predictive effect on the occurrence of fractures in PMOP patients，which helps clinic to intervene in high-risk PMOP patients who may experience fractures.

Key words: C1q tumor necrosis factor related protein 3, Dickkopf related protein 1, Postmenopausal osteoporosis

CLC Number:

R446.1

HUANG Qian, SHEN Qin, HU Qiuyun, SUN Jing, WAN Pingyin. Predictive values of serum CTRP3 and DKK-1 levels for the occurrence of fractures in postmenopausal osteoporosis patients[J]. Laboratory Medicine, 2024, 39(10): 950-955.

Figures/Tables 6

References 18

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组别	例数	年龄/岁	BMI/（kg·m^-2）	绝经年限/年	吸烟史/[例（%）]
正常对照组	118	66.20±7.94	24.26±3.51	6.22±1.34	36（30.51）
PMOP组	126	65.81±8.62	23.67±3.46	6.25±1.39	43（34.13）
统计值		0.367	1.332	1.886	0.364
P值		0.714	0.187	0.061	0.546
组别	饮酒史/ [例（%）]	空腹血糖/（mmol·L^-1）	总胆固醇/（mmol·L^-1）	三酰甘油/（mmol·L^-1）	血钙/ （mmol·L^-1）
正常对照组	47（39.83）	7.46±1.73	3.55±0.67	1.98±0.52	2.36±0.64
PMOP组	56（44.44）	7.81±1.78	3.73±0.95	2.07±0.57	2.32±0.61
统计值	0.532	1.556	1.700	1.286	0.500
P值	0.466	0.121	0.090	0.200	0.618
组别	血磷/ （mmol·L^-1）	25-（OH）D/（nmol·L^-1）	CTRP3/（ng·mL^-1）	DKK-1/（ng·mL^-1）	骨密度/ （g·cm^-2）
正常对照组	1.13±0.29	83.96±10.95	176.98±29.87	5.26±1.65	1.21±0.28
PMOP组	1.19±0.28	61.76±7.19	114.73±19.64	11.96±3.72	0.88±0.19
统计值	1.644	18.833	19.351	17.977	10.832
P值	0.101	<0.001	<0.001	<0.001	<0.001

组别	例数	年龄/岁	BMI/（kg·m^-2）	绝经年限/年	吸烟史/[例（%）]
正常对照组	118	66.20±7.94	24.26±3.51	6.22±1.34	36（30.51）
PMOP组	126	65.81±8.62	23.67±3.46	6.25±1.39	43（34.13）
统计值		0.367	1.332	1.886	0.364
P值		0.714	0.187	0.061	0.546
组别	饮酒史/ [例（%）]	空腹血糖/（mmol·L^-1）	总胆固醇/（mmol·L^-1）	三酰甘油/（mmol·L^-1）	血钙/ （mmol·L^-1）
正常对照组	47（39.83）	7.46±1.73	3.55±0.67	1.98±0.52	2.36±0.64
PMOP组	56（44.44）	7.81±1.78	3.73±0.95	2.07±0.57	2.32±0.61
统计值	0.532	1.556	1.700	1.286	0.500
P值	0.466	0.121	0.090	0.200	0.618
组别	血磷/ （mmol·L^-1）	25-（OH）D/（nmol·L^-1）	CTRP3/（ng·mL^-1）	DKK-1/（ng·mL^-1）	骨密度/ （g·cm^-2）
正常对照组	1.13±0.29	83.96±10.95	176.98±29.87	5.26±1.65	1.21±0.28
PMOP组	1.19±0.28	61.76±7.19	114.73±19.64	11.96±3.72	0.88±0.19
统计值	1.644	18.833	19.351	17.977	10.832
P值	0.101	<0.001	<0.001	<0.001	<0.001

组别	例数	CTRP3/（ng·mL^-1）	DKK-1/（ng·mL^-1）	骨密度/（g·cm^-2）
骨折组	41	89.55±16.79	15.99±4.98	0.67±0.19
无骨折组	85	126.88±29.94	10.01±2.66	0.98±0.26
t值		7.430	8.793	6.803
P值		<0.001	<0.001	<0.001

组别	例数	CTRP3/（ng·mL^-1）	DKK-1/（ng·mL^-1）	骨密度/（g·cm^-2）
骨折组	41	89.55±16.79	15.99±4.98	0.67±0.19
无骨折组	85	126.88±29.94	10.01±2.66	0.98±0.26
t值		7.430	8.793	6.803
P值		<0.001	<0.001	<0.001

影响因素	β值	标准误	Wald值	P值	OR值（95%CI）
25-（OH）D	-0.338	0.205	2.723	0.099	0.713（0.477~1.066）
CTRP3	-0.637	0.291	4.788	0.029	0.529（0.299~0.936）
DKK-1	0.810	0.321	6.375	0.012	2.249（1.199~4.219）
骨密度	-0.858	0.416	4.254	0.039	0.424（0.188~0.958）