血清白蛋白、血红蛋白水平对绝经后骨质疏松症患者骨转换指标的影响

Effect of changes in serum levels of albumin and hemoglobin on bone turnover markers in patients with postmenopausal osteoporosis

摘要:

目的 探讨血清白蛋白（ALB）与血红蛋白（Hb）水平对绝经后骨质疏松症患者骨转换指标的影响。方法 选取2019年6月—2021年6月青海省人民医院收治的92例绝经后骨质疏松症患者作为研究组，另取同期来院体检的85例绝经后非骨质疏松症女性作为对照组。比较两组血清ALB、Hb、N端骨钙素（N-MID）、β-胶原降解产物（β-CTX）、抗酒石酸酸性磷酸酶（TRAP-5b）水平，比较不同血清ALB、Hb患者N-MID、β-CTX、TRAP-5b水平，采用Pearson法分析绝经后骨质疏松症患者血清ALB、Hb水平与N-MID、β-CTX、TRAP-5b的相关性，多重线性回归分析绝经后骨质疏松症患者血清ALB、Hb水平对N-MID、β-CTX、TRAP-5b的影响。结果 研究组血清ALB、Hb低于对照组（P <0.05），研究组血清N-MID、β-CTX、TRAP-5b高于对照组（P <0.05）。ALB< 38.37 g/L患者N-MID、β-CTX、TRAP-5b水平高于ALB ≥38.37 g/L患者（P <0.05），Hb< 125.72 g/L患者β-CTX、TRAP-5b水平高于Hb ≥ 125.72 g/L患者（P <0.05）。Pearson相关性分析结果显示，绝经后骨质疏松症患者血清ALB、Hb水平与β-CTX（r =-0.324和-0.387，P =0.011和0.003）、TRAP-5b（r =-0.306和-0.415，P =0.028和0.000）呈负相关。多重线性回归分析显示，绝经后骨质疏松症患者血清β-CTX/TRAP-5b水平受血清ALB、Hb水平影响（P <0.05）。结论 绝经后骨质疏松症患者血清ALB、Hb水平可影响血清β-CTX、TRAP-5b水平，血清ALB、Hb水平可作为监测骨代谢的特异性指标。

Abstract:

Objective To explore the effect of changes in serum levels of albumin (ALB) and hemoglobin (Hb) on bone turnover markers in patients with postmenopausal osteoporosis.Methods A total of 92 patients with postmenopausal osteoporosis admitted to our hospital from June 2019 to June 2021 were selected as the study group, and 85 postmenopausal women without osteoporosis who came to the hospital for health checkup during the same period were selected as the control group. The serum levels of ALB, Hb, N-terminal/mid-fragment osteocalcin (N-MID), β-isomerized C-terminal telopeptide (β-CTX), and tartrate-resistant acid phosphatase 5b (TRAP-5b) were compared between the two groups and among postmenopausal osteoporosis patients with different serum levels of ALB and Hb. Pearson method was used to analyze the relationship between serum levels of ALB and Hb and those of N-MID, β-CTX and TRAP-5b, while multiple linear regression was used to analyze the effects of changes in serum levels of ALB and Hb on those of N-MID, β-CTX, and TRAP-5b in patients with postmenopausal osteoporosis.Results The serum levels of ALB and Hb in the study group were lower than those in the control group (P < 0.05), and serum levels of N-MID, β-CTX, and TRAP-5b in the study group were higher than those in the control group (P < 0.05). The levels of N-MID, β-CTX and TRAP-5b in postmenopausal osteoporosis patients with ALB < 38.37 g/L were higher than those in postmenopausal osteoporosis patients with ALB ≥ 38.37 g/L (P < 0.05), and the levels of β-CTX and TRAP-5b in postmenopausal osteoporosis patients with Hb < 125.72 g/L were higher than those in postmenopausal osteoporosis patients with Hb ≥ 125.72 g/L (P < 0.05). Pearson correlation analysis showed that serum levels of ALB and Hb were negatively correlated with β-CTX (r = -0.324 and -0.387, P = 0.011 and 0.003) and TRAP-5b (r =-0.306 and -0.415, P = 0.028 and 0.000) in postmenopausal osteoporosis patients. Multiple linear regression analysis revealed that the serum levels of β-CTX/TRAP-5b in patients with postmenopausal osteoporosis were affected by the serum levels of ALB and Hb (P < 0.05).Conclusions Changes in serum levels of ALB and Hb can affect the serum levels of β-CTX and TRAP-5b in patients with postmenopausal osteoporosis, and they could thus be established as specific indicators for monitoring the bone metabolism.