The predictive value of bone turnover markers PINP and β ⁃ CTX in osteoporosis in patients with Parkinson’s disease
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摘要:
目的：研究骨转换标志物Ⅰ型胶原氨基端前肽（procollagen type Ⅰ N-terminal propeptide，PINP）、Ⅰ型胶原羧基端前肽（β-cross-linked ctelopeptide of type I collagen，β-CTX）在帕金森病（Parkinson’s disease，PD）并发骨质疏松中的预测价值。方法：纳入PD患者105例，根据是否合并骨质疏松分为骨质疏松组和非骨质疏松组，对所有患者检测25（OH）D、甲状旁腺激素、骨钙素、β-CTX、PINP等骨代谢指标，分析各指标与骨质疏松发生之间的关系。结果：①骨质疏松组少动强直型比例、女性比例、PINP、骨钙素、β-CTX水平均高于非骨质疏松组，骨质疏松组25（OH）D水平低于非骨质疏松组，差异均具有统计学意义； ②相关分析结果显示PD患者骨质疏松发生与骨钙素（r=0.28，P=0.005）、β-CTX（r=0.36，P=0.001）、PINP（r=0.40，P＜0.001）均呈正相关，与25（OH）D（r=-0.30，P=0.002）、PINP/β-CTX（r=-0.56，P＜0.001）均呈负相关，差异具有统计学意义；③多因素二元Lo- gistic 回归分析显示，25（OH）D（OR=0.95，95%CI：0.84~0.98，P=0.041）、PINP/β-CTX（OR=0.90，95%CI：0.83~0.98，P=0.017）是 PD病合并骨质疏松的独立危险因素；④ROC曲线分析示25（OH）D联合PINP/β-CTX时ROC曲线下面积最大，AUC=0.82，灵敏性=0.80，特异性=0.84，P＜0.001。结论：血清25（OH）D水平及PINP/β-CTX比值与PD患者骨质疏松发生密切相关，在PD患者骨质疏松的发生中具有重要的预测价值，二者联合检测时诊断价值更高。
Abstract:
Objective：To investigate the predictive value of bone turnover markers，such as（procollagen type Ⅰ N-terminal propeptide，PINP）and（β-cross-linked ctelopeptide of type I collagen，β-CTX）in Parkinson’s disease（PD）complicated with osteoporosis. Methods：Total 105 patients with PD were enrolled and divided into osteoporosis group and non-osteoporosis group according to whether they were complicated with osteoporosis. Bone metabolism indexes，such as 25（OH）D，parathyroid hormone， osteocalcin，β-CTX，and PINP，were detected in all patients，and the relationship between these indexes and the occurrence of osteoporosis was analyzed. Results：① The proportion of oligotonic type，female proportion，PINP，osteocalcin and β-CTX were higher in osteoporosis group than in non-osteoporosis group，while the level of 25（OH）D was lower in osteoporosis group than in non-osteoporosis group，and the differences were statistically significant；② Correlation analysis showed that the incidence of osteoporosis in PD patients was significantly positively correlated with osteocalcin（r=0.28，P=0.005），β-CTX（r=0.36，P=0.001），PINP（r=0.40，P < 0.001），and 25（OH）D（r=-0.30，P=0.002），PINP/β-CTX（r=-0.56，P < 0.001）were negatively correlated；③ Multivariate binary logistic regression analysis showed that 25（OH）D，（OR=0.95，95%CI：0.84~0.98，P=0.041），PINP/β-CTX（OR=0.90，95%CI 0.83~0.98，P=0.017）were risk factors for PD complicated with osteoporosis；④Receiver Operating Characteristic showed that 25（OH）D combined with PINP/β- CTX had the largest area under ROC curve，with AUC=0.82，sensitivity=0.80，specificity=0.84，P < 0.001. Conclusion：Serum25（OH）D level and PINP/β-CTX ratio are closely related to the occurrence of osteoporosis in PD patients. They may have an important predictive value in the occurrence of osteoporosis in PD patients，and the diagnostic value is higher when they are combined.
