| Background:At present,osteoporosis has become a potential disease threatening the middle-aged and elderly at home and abroad,with the characteristics of high prevalence and complications.As a serious complication of osteoporosis,osteoporotic fractures occur frequently in the proximal humerus,distal radius,spine and hip,especially in elderly and postmenopausal women.Most patients with osteoporotic fracture need surgical treatment,which has a huge impact on medical burden,physical and mental health,and surgical plan.Therefore,reasonable and effective fracture prediction and evaluation tools are of great significance for early anti-osteoporosis treatment and prevention of osteoporotic fractures.Currently except bone mineral density,bone turnover markers,FRAX~?tool,QCT,TBS the Garvan nomogram evaluation method,QUS technology,bone quality related hip bone geometric parameters and finite element modeling analysis on osteoporotic fractures have prediction function,but the other tools beyond bone mineral density measurement has been verified in not validly,and they are the lack of uniform international guidelines for recommended.As an important parameter reflecting bone quality,bone turnover markers are recommended for fracture prediction tool by IOF,IFCC and the European guidelines for diagnosis and treatment of postmenopausal women,but there are a lack of comparison,big data and multicenter studies.In addition,some studies have found that bone mineral density as a conventional prediction and assessment tool tends to underestimate the incidence of fractures in some patients with clinical high-risk factors.Therefore,it is recommended that more effective assessment tools and comparative studies should be carried out,and prospective clinical study can be carried out by qualified clinical trial institutions.Objective:To investigate the clinical signifificance of the detection of bone mineral density(BMD)and bone turnover markers(BTMs)in the elder women with osteoporosis,and to compare their predictive power for osteoporotic fractures(OF)Methods:From October 2017 to February 2019,96 patients with OF and 107 patients with osteoporosis who were hospitalized in the Department of Orthopaedics at the First Affiliated Hospital of Chengdu Medical College were examined,they were divided into fracture group and non-fracture group.BMD was measured using dual-energy X-ray absorptiometry(DXA).BTMs including type I procollagen amino terminal eptide(PINP),β-cross-linked C-telopeptide of type I collagen(β-CTX)and molecular fragment of osteocalcin N terminal(N-MID)were detected with lectrochemiluminescence.Bone metabolism related indicators including alkaline phosphatase(ALP),calcium(Ca)and phosphorus(P)were detected at the same time.The measurement data between the two groups were compared using independent-samples t test,One-way ANOVA was conducted to compare the gap between groups,the correlation between BMD and BTMs and OF was analyzed using binary logistic regression.Results:BMD in the fracture group was lower than that in the non-fracture group(P<0.05);PINP andβ-CTX in the fracture group were higher than in the non-fracture group,N-MID in the fracture group was lower than that in the non-fracture group at 71 to 80and 81 to 90 years old patients,and the difference was statistically significant(P<0.05).There was no significant difference in ALP,P and Ca between two groups(P>0.05).Binary logistic regression analysis showed that BMD in the lumbar spine and hip andβ-CTX were significantly correlatd with OF(respectively OR=-4.182,-6.929,7.572),and the difference were statistically significant(P<0.05).PINP and N-MID were positively correlation with OF(respectively OR=4.213,2.510),but the difference was not statistically significant(P>0.05).Conclusion:Osteoporotic elder women with the lower BMD and higherβ-CTX are more likely to develop OF,β-CTX may be more capable than BMD to predict OF.It can help timely manage and take related interventions for high-risk population. |
PDF Full Text Request