[1]周浩然,郑志杰,李瑞忠.血清PTX3、ANXA2、IL-33在老年骨质疏松症患者中的表达变化及其预测并发骨折价值[J].陕西医学杂志,2025,54(6):819-824.[doi:DOI:10.3969/j.issn.1000-7377.2025.06.019]
　ZHOU Haoran,ZHENG Zhijie,LI Ruizhong.Expression of serum PTX3,ANXA2 and IL-33 in elderly patients with osteoporosis and their predictive value for fracture[J].,2025,54(6):819-824.[doi:DOI:10.3969/j.issn.1000-7377.2025.06.019]
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血清PTX3、ANXA2、IL-33在老年骨质疏松症患者中的表达变化及其预测并发骨折价值

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年6期
页码:
819-824
栏目:
临床检验
出版日期:
2025-06-05

文章信息/Info

Title:
Expression of serum PTX3,ANXA2 and IL-33 in elderly patients with osteoporosis and their predictive value for fracture
作者:
周浩然1; 郑志杰1; 李瑞忠2
（1.中山市人民医院骨一科，广东 中山 528400；2.中山市人民医院骨二科，广东 中山 528400）
Author(s):
ZHOU Haoran1; ZHENG Zhijie1; LI Ruizhong2
(1.The First Department of Osteology,Zhongshan People’s Hospital,Zhongshan 528400,China;2.The Second Department of Osteology,Zhongshan People’s Hospital,Zhongshan 528400,China)
关键词:
骨质疏松症; 正五聚蛋白3; 膜联蛋白A2; 白细胞介素-33; 老年; 骨折
Keywords:
Osteoporosis; Pentraxin 3; Annexin A2; Interleukin-33; Elderly; Fracture
分类号:
R 58
DOI:
DOI:10.3969/j.issn.1000-7377.2025.06.019
文献标志码:
A
摘要:
目的：探究血清正五聚蛋白3（PTX3）、膜联蛋白A2（ANXA2）、白细胞介素-33（IL-33）在老年骨质疏松症患者中的表达变化及其预测并发骨折价值。方法：将老年骨质疏松症患者207例和骨密度（BMD）正常者207例分别作为观察组与对照组。比较两组血清PTX3、ANXA2、IL-33水平及BMD，分析血清PTX3、ANXA2、IL-33水平与BMD的相关性。随访2年，根据老年骨质疏松症患者是否发生骨折分为发生亚组与未发生亚组，比较发生与未发生亚组患者临床资料、BMD、骨质疏松标志物[Ⅰ型胶原交联羧基末端肽（CTX）、骨碱性磷酸酶（BALP）、全段甲状腺旁激素（iPTH）]及血清PTX3、ANXA2、IL-33水平，分析血清PTX3、ANXA2、IL-33水平与骨质疏松标志物及老年骨质疏松症患者骨折的关系。绘制受试者工作特征（ROC）曲线评价血清PTX3、ANXA2、IL-33预测老年骨质疏松症患者骨折的价值。结果：观察组血清PTX3、ANXA2水平高于对照组，血清IL-33水平及BMD低于对照组（均P＜0.05）。骨质疏松症患者血清PTX3、ANXA2水平与BMD呈负相关，血清IL-33与BMD呈正相关（均P＜0.05）。207例老年骨质疏松症患者随访2年，失访7例，其中88例发生骨折（发生亚组），112例未发生骨折（未发生亚组）。发生亚组女性比例、年龄及血清CTX、BLAP、iPTH、PTX3、ANXA2水平高于未发生亚组，血清IL-33水平及BMD低于未发生亚组（均P＜0.05）。老年骨质疏松症患者血清PTX3、ANXA2水平与骨质疏松标志物CTX、BLAP、iPTH呈正相关，血清IL-33水平与骨质疏松标志物CTX、BLAP、iPTH呈负相关（均P＜0.05）。Logistic回归分析显示，校正其他混杂因素后，血清PTX3、ANXA2、IL-33仍为老年骨质疏松症患者骨折的独立影响因素（均P＜0.05）。血清PTX3、ANXA2、IL-33联合预测老年骨质疏松症患者骨折的曲线下面积（AUC）最大，为0.918，预测价值明显优于血清PTX3、ANXA2、IL-33单项（均P＜0.05）。结论：老年骨质疏松症患者血清PTX3、ANXA2水平升高，IL-33水平下降，与骨折风险有关，三项联合对骨折风险的预测价值较高。
Abstract:
Objective:To investigate the expression changes of serum pentraxin 3 (PTX3),annexin A2 (ANXA2) and interleukin-33 (IL-33) in elderly patients with osteoporosis and their predictive value for fracture.Methods：A total of 207 elderly patients with osteoporosis and 207 patients with normal bone mineral density (BMD) were selected as the observation group and control group,respectively.The serum levels of PTX3,ANXA2,IL-33,and BMD were compared between the two groups,and the correlation between serum PTX3,ANXA2,IL-33 and BMD was analyzed.After 2 years of follow-up,the elderly patients with osteoporosis were divided into the occurrence subgroup and the non-occurrence subgroup according to whether they had fractures.The clinical data,BMD,osteoporosis markers (CTX,BALP,iPTH) and serum PTX3,ANXA2,IL-33 levels between the occurrence and non-occurrence subgroups were compared.The relationships of serum PTX3,ANXA2,IL-33 levels with osteoporosis markers and fractures in elderly patients with osteoporosis were analyzed.ROC curve was used to evaluate the predictive value of serum PTX3,ANXA2 and IL-33 for fractures in elderly patients with osteoporosis.Results:The serum levels of PTX3 and ANXA2 in the observation group were higher than those in the control group,while the serum level of IL-33 and BMD were lower than those in the control group (all P<0.05).Serum PTX3,ANXA2 and BMD were negatively correlated in patients with osteoporosis,while serum IL-33 was positively correlated with BMD (all P<0.05).All of 207 elderly patients with osteoporosis were followed up for 2 years,with 7 cases lost to follow-up.Among them,88 cases had fractures (occurrence subgroup) and 112 cases did not have fractures (non-occurrence subgroup).The proportion of females,age and serum levels of CTX,BLAP,iPTH,PTX3 and ANXA2 in the occurrence subgroup were higher than those in the non-occurrence subgroup,while the serum level of IL-33 and BMD were lower than those in the non-occurrence subgroup (all P<0.05).Serum PTX3 and ANXA2 in elderly patients with osteoporosis were positively correlated with CTX,BLAP and iPTH,while IL-33 was negatively correlated with CTX,BLAP and iPTH (all P<0.05).Logistic regression analysis showed that serum PTX3,ANXA2 and IL-33 remained independent factors affecting fractures in elderly patients with osteoporosis after adjusting for other confounding factors (all P<0.05).The combination of serum PTX3,ANXA2 and IL-33 had the largest AUC of 0.918 for predicting fracture in elderly patients with osteoporosis,and the predictive value was significantly better than that of serum PTX3,ANXA2 and IL-33 alone (all P＜0.05).Conclusion:The serum levels of PTX3 and ANXA2 are increased and IL-33 is decreased in elderly patients with osteoporosis,which are related to the risk of fracture.The combination of the three has a higher predictive value for the risk of fracture.

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备注/Memo

备注/Memo:
广东省医学科学技术研究基金资助项目（A2019011048）
更新日期/Last Update: 2025-06-04