原发性骨质疏松症患者血清中sFRP4 DKK1表达及临床意义

doi:10.3969/j.issn.1006-6233.2023.06.08

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摘要 目的: 分析原发性骨质疏松症患者血清中sFRP4、DKK1表达及临床意义。方法: 选取本院2019年1月至2021年1月期间收治的82例原发性骨质疏松症患者作为研究组,另选取同期健康体检者75例作为对照组,采用酶联免疫吸附法(ELISA)检测血清sFRP4、DKK1水平,采用电化学发光法检测血清β胶原降解产物(β-CTX)、Ⅰ型胶原氨基端延长肽(P1NP)、骨桥蛋白(OPN)以及N端骨钙素(N-MID)水平,使用骨密度仪检测股骨BMD值以及腰椎L_1~4BMD值。采用Pearson法分析血清sFRP4、DKK1水平与骨代谢指标以及骨密度之间的相关性;采用Logistics回归分析原发性骨质疏松症的影响因素;受试者工作特征曲线(ROC)分析血清sFRP4、DKK1水平对原发性骨质疏松症的诊断价值。结果: 研究组血清sFRP4(62.98±10.79)μg/L和DKK1(14.28±3.97)μg/mL表达水平显著高于对照组(46.87±8.88)μg/L和(11.43±3.04)μg/mL(P<0.05),研究组β-CTX(4.52±1.02)ng/mL、P1NP(47.28±4.26)ng/mL、OPN(26.64±5.11)ng/mL以及N-MID(89.87±8.02)ng/mL显著高于对照组(3.55±0.92)ng/mL、(30.84±4.53)ng/mL、(19.01±4.12)ng/mL和(81.95±9.50)ng/mL(P<0.05),研究组股骨BMD(0.58±0.16)g/cm³和腰椎L_1~4BMD(0.64±0.18g/cm³)显著低于对照组(0.82±0.19)g/cm³和(0.83±0.23)g/cm³(P<0.05)。根据pearson相关性分析得知,sFRP4和DKK1的表达水平呈正相关性(P<0.05),sFRP4和DKK1表达水平与股骨BMD和腰椎L_1~4BMD呈负相关(P<0.05),与β-CTX、P1NP、OPN和N-MID呈正相关(P<0.05)。根据Logistic回归分析得知,sFRP4、DKK1高表达是影响原发性骨质疏松症发生的危险因素(P<0.05)。血清sFRP4诊断原发性骨质疏松症的AUC为0.874,DKK1诊断原发性骨质疏松症的AUC为0.809,二者联合诊断原发性骨质疏松症的AUC为0.921,优于血清sFRP4和DKK1各自单独诊断(Z联合vs sFRP4=2.851、Z联合vsDKK1=4.365,P均<0.05)。结论: 血清sFRP4和DKK1在原发性骨质疏松症患者中显著升高,与患者的骨代谢和BMD密切相关,二者联合可更好的诊断原发性骨质疏松症。

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关键词 ：原发性骨质疏松症, 分泌型卷曲相关蛋白4, DKK1

Abstract：Objective: To analyze the expression and clinical significance of sFRP4 and DKK1 in serum of patients with primary osteoporosis. Methods: Eighty-two patients with primary osteoporosis admitted to our hospital from January 2019 to January 2021 were selected as the study group, in addition, 75 cases from the same period of healthy physical examination were selected as the control group. Serum sFRP4 and DKK1 levels were detected by enzyme-linked immunosorbent assay (ELISA), serum β collagen degradation products (β-CTX), type I collagen amino-terminal elongation peptide (P1NP), osteopontin (OPN) and N-terminal osteocalcin (N-MID) levels were detected by electrochemiluminescence. The BMD value of femur and L_1~4BMD value of lumbar spine were measured with bone densitometer. Pearson method was used to analyze the correlation between serum sFRP4, DKK1 levels, bone metabolism indexes, and bone mineral density; the influencing factors of primary osteoporosis were analyzed by logistic regression; the diagnostic value of serum sFRP4 and DKK1 levels in primary osteoporosis was analyzed by ROC curve. Results: The expression levels of serum sFRP4 (62.98±10.79) μg/L and DKK1 (14.28±3.97) μg/mL in the study group were significantly higher than those in the control group (46.87±8.88) μg/L and (11.43±3.04) μg/mL (P<0.05), and the β-CTX (4.52±1.02) ng/mL, P1NP (47.28±4.26) ng/mL and OPN (26.64±5.11) ng/mL in the study group and N-MID (89.87±8.02) ng/mL were significantly higher than those in the control group (3.55±0.92) ng/mL, (30.84±4.53) ng/mL, (19.01±4.12) ng/mL and (81.95±9.50) ng/mL (P<0.05), and the femur BMD (0.58±0.16) g/cm³ and lumbar L_1~4BMD (0.64±0.18 g) in the study group. cm³) was significantly lower than that of the control group (0.82±0.19) g/cm³ and (0.83±0.23) g/cm³ (P<0.05). Pearson correlation analysis showed that the expression levels of sFRP 4 and DKK1 were positively correlated (r=0.479, P<0.05), and the expression levels of sFRP 4 and DKK1 were negatively correlated with femoral BMD and lumbar L_1~4BMD (P<0.05), and positively correlated with β-CTX, P1NP, OPN and N-MID (P<0.05). Logistic regression analysis showed that the overexpression of sFRP4 and DKK1 was a risk factor for primary osteoporosis (P<0.05). The AUC of serum sFRP4 in diagnosis of primary osteoporosis was 0.874, and that of DKK1 in diagnosis of primary osteoporosis was 0.809, the AUC of the combination of the two methods in the diagnosis of primary osteoporosis was 0.921, which was superior to the diagnosis of serum sFRP4 and DKK1 separately (Z combination vs sFRP4=2.851, Z combination vs DKK1=4.365, P<0.05). Conclusion: Serum sFRP4 and DKK1 are significantly elevated in patients with primary osteoporosis, which is closely related to bone metabolism and BMD, and the combination of the two can better diagnose primary osteoporosis.

Key words： Primary osteoporosis Secretory crimp related protein 4 DKK1

基金资助:四川省自然科学基金项目,(编号:2022NSFSC1463)

引用本文:

古红, 王静, 邓晓琴. 原发性骨质疏松症患者血清中sFRP4 DKK1表达及临床意义[J]. 河北医学, 2023, 29(6): 922-927.
GU Hong, et al. Expression of sFRP4 and DKK1 in Serum and Clinical Significance in Patients with Primary Osteoporosis. HeBei Med, 2023, 29(6): 922-927.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.06.08 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I6/922

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