| 张琦,孙莹,宋昕,等.老年骨质疏松症患者血清CXC类趋化因子配体12和血管内皮生长因子A蛋白表达与肌少症的相关性[J].中国临床保健杂志,2024,27(2):201-205. |
| 老年骨质疏松症患者血清CXC类趋化因子配体12和血管内皮生长因子A蛋白表达与肌少症的相关性 |
| The correlation between serum CXCL12,VEGF-A protein expression and sarcopenia in elderly patients with osteoporosis |
| 投稿时间：2023-08-10 |
| DOI：10.3969/J.issn.1672-6790.2024.02.013 |
| 中文关键词: 骨质疏松 肌减少症 趋化因子CXCL12 血管内皮生长因子A 老年人 |
| 英文关键词: Osteoporosis Sarcopenia Chemokine CXCL12 Vascular endothelial growth factor A Aged 〖FL |
| 基金项目:应急总医院医学发展科研基金项目(K201917) |
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| 中文摘要: |
| 目的 探究老年骨质疏松症(OP)患者血清CXC类趋化因子配体12(CXCL12)和血管内皮生长因子-A(VEGF-A)蛋白表达及其与肌少症的相关性。方法 选取2021年6月至2023年1月在应急总医院就诊的192例老年OP患者为研究对象,并按照其是否并发肌少症分为肌少症组与非肌少症组。采用酶联免疫吸附(ELISA)法检测血清CXCL12、VEGF-A蛋白表达水平；采用Pearson法分析患者血清CXCL12、VEGF-A水平与四肢骨骼肌指数(SMI)之间的相关性。通过logistic回归分析老年OP患者肌少症的影响因素,用受试者工作特征(ROC)曲线分析血清CXCL12、VEGF-A蛋白水平对老年OP患者合并肌少症的诊断效能。结果 192例老年OP患者肌少症发生率为36.98%(71/192)。肌少症组患者血清CXCL12、VEGF-A水平均低于非肌少症组患者(P＜0.05)。老年OP并肌少症患者血清CXCL12、VEGF-A水平均与SMI呈正相关(r=0.583,P<0.001；r=0.643,P<0.001)。肌少症组患者年龄≥70岁、体重指数(BMI)＜24 kg/m2、有糖尿病史、合并慢性肾病患者占比及收缩压(SBP)、舒张压(DBP)均高于非肌少症组(P＜0.05),上肢脂肪含量、血清25羟基维生素D3[25(OH)D3]水平、钙含量、L1-4平均骨密度、股骨颈骨密度均低于非肌少症组(P＜0.05)。且多因素logistic回归分析结果显示,年龄≥70岁、有糖尿病史、高SBP、高DBP均为老年OP患者合并肌少症的危险因素(P＜0.05),高上肢脂肪含量、血清25(OH)D3、CXCL12、VEGF-A水平、钙含量、L1-4平均骨密度、股骨颈骨密度均是保护因素(P＜0.05)。血清CXCL12、VEGF-A水平联合诊断老年OP患者合并肌少症的ROC曲线下面积大于两者单独诊断(Z=2.554,P=0.011；Z=2.466,P=0.014)。结论 血清CXCL12与VEGF-A水平可作为老年OP患者合并肌少症的辅助诊断指标,两者联合检测的诊断效果更好。 |
| 英文摘要: |
| Objective To investigate the expression levels of serum CXC chemokine ligand 12 (CXCL12) and vascular endothelial growth factor A (VEGF-A) proteins in the serum of elderly patients with osteoporosis (OP) and their correlation with sarcopenia.Methods A total of 192 elderly OP patients who visited Emergency General Hospital from June 2021 to January 2023 were collected as the study subjects,and according to whether they were complicated with sarcopenia,they were divided into sarcopenia group and non sarcopenia group.Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of serum CXCL12 and VEGF-A proteins;Pearson method was applied to analyze the correlation between serum CXCL12,VEGF-A levels and limb skeletal muscle index (SMI) in patients.Logistic regression was applied to analyze the influencing factors of sarcopenia in elderly OP patients,receiver operating characteristic (ROC) curve was applied to analyze the diagnostic efficacy of serum CXCL12 and VEGF-A protein levels in elderly OP patients with sarcopenia.Results The incidence of sarcopenia in 192 elderly OP patients was 36.98% (71/192).The serum levels of CXCL12 and VEGF-A in the sarcopenia group were lower than those in the non sarcopenia group (P<0.05).Pearson analysis showed that serum CXCL12 and VEGF-A levels were positively correlated with SMI in elderly OP patients with sarcopenia (r=0.583,P<0.001;r=0.643,P<0.001).The percentage of patients with age ≥ 70 years old,body mass index (BMI)<24 kg/m2,history of diabetes,and chronic kidney disease,systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the myopenia group were higher than those in the non myopenia group (P<0.05),the upper limb fat content,serum 25 hydroxyvitamin D3[25(OH)D3] level,calcium content,average bone mineral density of L1-4,and bone mineral density of neck of femur were lower than those in the non myopenia group (P<0.05).The results of multivariate logistic regression analysis showed that age ≥ 70 years old,history of diabetes,high SBP and DBP were all risk factors for elderly OP patients with myopenia (P<0.05),high upper limb fat content,serum 25(OH)D3,CXCL12,VEGF-A levels,calcium content,L1-4 average bone density,and neck of femur bone density were protective factors (P<0.05).The combined diagnosis of serum CXCL12 and VEGF-A levels in elderly OP patients with sarcopenia had a higher AUC than their individual diagnosis (Z=2.554,P=0.011;Z=2.466,P=0.014).Conclusions The serum levels of CXCL12 and VEGF-A in elderly patients both can serve as diagnostic indicators for elderly OP patients with sarcopenia,and the combination of the two has better diagnostic efficacy. |
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