The Quantify Evaluation Study On The Risk Of Hip Fracture In The Elder Persons By The Bone Biochemical Markers Of BALP, TRAP-5b, And Singh Index

Objective: In this study, comparing and analyzing the changes of the bone metabolicmarkers including BALP, TRAP-5b, and singh index in elderly hip fracture group andthe control group，the correlations between the three predictors of BALP, TRAP-5b,and singh index were derived, and the sensitivity and specificity of predicting hipfracture were calculated. It is the most important to provide a useful reference forclinical preventive elderly hip fracture occurred by investigating the clinicalsignificance of those biochemical markers of bone metabolism.Methods:1.43patients of hip fracture over60named as fracture group, and43normal controls aged over60named as control group were chosen. All of the patientswere offered from inpatient department of Zhuhai City People’s Hospital of JinanUniversity Third Affiliated Hospital.2. Determination of the Singh index: with thehelp of an experienced radiology technician and three senior orthopedic surgeons, thepelvic plain film X-ray by the Siemens Aristos Vx Plus Model X-ray machine(fracture group and the control group) were analyzed, and then the Singh index ofthese pelvic X-ray grading were record and the mean of Singh index was judged.3.Determination of markers of bone metabolism: fasting venous blood3-5ml in themorning were prepared after all subjects were fasting than12h. Then Blood sampleswere sent to our hospital clinical laboratory, and were stored in-76°C lowtemperature refrigerator after separation of the serum specimens. The bone metabolicmarkers in serum BALP, TRAP-5b were measured by enzyme-linked immunosorbentassay (ELLSA) after specimen collection before uniform. SPSS13.0statisticalsoftware was used to analyze all of experimental data.Result:1There are significantly differences of the bone metabolic markers TBALP, TRAP-5b, and Singh index between the fracture group and the control group (P <0.05).2There exists a significant positive correlation between Bone metabolic markersBALP, and TRAP-5b (P <0.01), and there is a significant negatively correlationbetween singh index and bone metabolic markers BALP, and TRAP-5b (P <0.01).3The singh index of the fracture group is lower than the control group. This resultindicates the bone metabolism elevated after fracture incidence.4ROC graphs for diagnosis and hip fracture show that the area under curve of wasTRAP-5b0.76, and the area under curve of BALP was0.519.5The sensitivity of Bone metabolic markers BALP, TRAP-5b, and Singh index were71.9%，57.1%,60.5%respectively, and the experimental sensitivity of those jointdiagnosis of hip fracture is95.1%.Conclusion: By comparing the levels of BALP, TRAP-5b and singh index changes infracture group with the control group, the bone metabolic markers including BALP,TRAP-5b, and singh index in fracture group were found to be abnormal. Bonemetabolic markers BALP, TRAP-5b can be used to reflect the level of bonemetabolism, and the singh Index reaction monitoring indicators can be used to reflectthe bone strength. It is showed from our experimental results that the above bonemetabolic markers can be used as the elderly hip fracture prediction. Furthermore,combination consideration of the bone metabolic markers BALP, TRAP-5b and singhindex to predict is of more meaningful than the single bone metabolism indicators ofBALP, or TRAP-5b singh index in elderly hip fracture. So BALP, TRAP-5b, andSingh index combination can significantly improve the sensitivity of the prediction ofhip fracture in elderly.