目的 测定帕金森病(PD)伴骨质疏松症患者血清钙结合蛋白(S100)A6、S100A12水平并分析其临床意义。方法 选取2021-04至2024-03就诊于武警山东总队医院的PD患者134例,根据是否发生骨质疏松症将患者分为骨质疏松组(n=53)和非骨质疏松组(n=81),以Pearson相关性分析血清S100A6、S100A12与骨代谢标志物之间的关系,并通过多因素Logistic回归分析影响PD患者骨质疏松症的危险因素,绘制受试者工作特征(ROC)曲线分析两指标对PD发生骨质疏松症的预测价值。结果 134例PD患者中,53例发生骨质疏松症,发生率为39.55%。与非骨质疏松组相比,骨质疏松组血清S100A6、S100A12水平升高 (P＜0.05)。骨质疏松组Ⅰ型前胶原氨基端前肽(PⅠNP)和25-羟基维生素D[25(OH)D]水平低于非骨质疏松组,而Ⅰ型胶原C末端肽(S-CTX)和β-胶原特殊序列(β-CTX)水平高于非骨质疏松组(P＜0.05)。Pearson相关性分析显示,血清S100A6、S100A12与PⅠNP和25(OH)D呈负相关(P＜0.05),而与S-CTX、β-CTX呈正相关(P＜0.05)。多因素Logistic回归分析模型结果显示,高龄、女性、病情为晚期及血清S100A6、S100A12升高是PD患者发生骨质疏松症的独立危险因素(P＜0.05)。ROC曲线显示,血清S100A6和S100A12单独预测PD患者发生骨质疏松症的AUC分别为0.665、0.746,联合预测AUC为0.913(0.872~0.945),联合预测效能高于单一指标(P＜0.05)。结论 血清S100A6、S100A12在PD伴骨质疏松症患者中异常升高,两者与骨代谢存在相关性,有助于筛查PD伴骨质疏松症的患者。
Abstract
Objective To determine the levels of serum calcium-binding protein (S100) A6 and S100A12 in patients with Parkinson's disease (PD) and osteoporosis and analyze their clinical significance. Methods A total of 134 PD patients admitted to Shandong Provincial Corps Hospital of Chinese People's Armed Police Force from April 2021 to March 2024 were selected and divided into an osteoporosis group (n=53) and a non-osteoporosis group (n=81) according to the occurrence of osteoporosis. Pearson correlation analysis was used to analyze the relationship between serum S100A6, S100A12 and bone metabolism markers. Multivariate Logistic regression analysis was used to analyze the risk factors affecting osteoporosis in PD patients, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the two indicators for osteoporosis in PD patients. Results Among 134 PD patients, 53 cases developed osteoporosis(39.55%). Compared with non-osteoporosis group, serum levels of S100A6 and S100A12 in osteoporosis group increased (P<0.05). The type I procollagen amino-terminal propeptide (PINP) and 25-hydroxyvitamin D [25(OH)D] levels in osteoporosis group were lower than those in non-osteoporosis group, while the type I collagen C-terminal peptide (S-CTX) and β-collagen specific sequence (β-CTX) levels were higher than those in non-osteoporosis group (P<0.05). Pearson correlation analysis showed that serum S100A6 and S100A12 were negatively correlated with PINP and 25 (OH) D (P<0.05), but positively correlated with S-CTX and β-CTX (P<0.05). Multivariate Logistic regression analysis showed that old age, female, advanced disease and elevated serum S100A6 and S100A12 were independent risk factors for osteoporosis in PD patients (P<0.05). ROC curve showed that serum S100A6 and S100A12 alone predicted the AUC of osteoporosis in PD patients were 0.665 and 0.746 respectively, the combined predicted AUC was 0.913 (0.872-0.945), and the combined prediction efficiency was higher than that of single index (P<0.05). Conclusions Serum S100A6 and S100A12 are abnormally elevated in PD patients with osteoporosis and they are correlated with bone metabolism, which is helpful for screening PD patients with osteoporosis.
关键词
帕金森病 /
骨质疏松症 /
钙结合蛋白A6 /
钙结合蛋白A12 /
骨代谢
Key words
Parkinson's disease /
osteoporosis /
calcium-binding protein A6 /
calcium-binding protein A12 /
bone metabolism
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基金
2022年度山东省医药科技项目(202205031076)
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