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| 维生素D、鸢尾素与冠心病骨质疏松关系研究 |
| Research on the relationship between vitamin D, irisin and osteoporosis in coronary heart disease |
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| DOI：10.3969/j.issn.1006-7108.2026.07.008 |
| 中文关键词: 冠心病 骨质疏松 25-羟基维生素D 鸢尾素 骨折 |
| 英文关键词:coronary artery disease osteoporosis 25-hydroxyvitamin D irisin fracture |
| 基金项目:国家重点研发计划子课题（2019YFF0216501-L48） |
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| 摘要点击次数: 12 |
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| 中文摘要: |
| 目的 探讨冠心病合并骨质疏松症（CAD/OP）老年患者血清25-羟基维生素D[25(OH)D]和鸢尾素水平与髋部骨折风险的相关性，并评估其预测价值。方法 纳入2021年10月至2023年12月在我院就诊的316例 CAD/OP老年患者，按是否发生髋部骨折分为非骨折组（n=285）和骨折组（n=31）。收集患者基线资料、血清25(OH)D、鸢尾素等血清指标，检测骨密度并评估髋部骨折情况。采用相关分析、Logistic回归及ROC曲线评估各指标与骨密度及髋部骨折风险的关系。结果 与非骨折组比较，骨折组患者25(OH)D、鸢尾素、腰椎及髋部T值、血清钙及骨钙素水平均显著降低（均P<0.05），而碱性磷酸酶（ALP）和甲状旁腺激素（PTH）水平均显著升高（均P<0.05）。25(OH)D与腰椎T值（r=0.169，P=0.003）和髋部T值（r=0.178，P=0.001）呈正相关，鸢尾素与腰椎T值（r=0.196，P<0.001）和髋部T值（r=0.325，P<0.001）亦呈正相关。两者均与髋部骨折风险呈负相关（25(OH)D：r=?0.340，鸢尾素：r=?0.181，均P<0.001）。Logistic回归显示，25(OH)D（OR=0.865，95 %CI：0.814~0.919，P<0.001）和鸢尾素（OR=0.386，95 %CI：0.172~0.865，P=0.021）均是骨折风险的独立保护因子。两者联合预测髋部骨折风险的AUC为0.847（P<0.001），高于单独预测。结论 血清25(OH)D和鸢尾素水平显著影响CAD/OP老年患者的髋部骨折风险，二者联合检测在预测髋部骨折中具有较高的临床价值。强化25(OH)D补充及鸢尾素相关治疗可能成为降低CAD/OP老年患者发生骨折风险的有效策略。 |
| 英文摘要: |
| Objective To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] and irisin levels and the risk of hip fractures in elderly patients with coronary artery disease and osteoporosis (CAD/OP), to evaluate their predictive value. Methods A total of 316 elderly CAD/OP patients who visited our hospital from October 2021 to December 2023 were enrolled and stratified into non-fracture (n=285) and fracture (n=31) groups based on the presence of hip fractures. Baseline demographic and clinical data were collected, along with serum levels of 25(OH)D, irisin, and other biochemical markers. Bone mineral density (BMD) was measured, and hip fracture status was assessed. Correlation analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis were employed to evaluate the relationships between biomarkers, BMD, and hip fracture risk. Results Compared with the non-fracture group, the fracture group exhibited significantly lower levels of levels of 25(OH)D, irisin, lumbar spine and hip T-scores, serum calcium and osteocalcin(all P<0.05), while the level of alkaline phosphatase (ALP) and parathyroid hormone (PTH) was significantly higher (all P<0.05). Serum 25(OH)D was positively correlated with lumbar spine T-score (r=0.169, P=0.003) and hip T-score (r=0.178, P=0.001), while serum irisin showed positive correlations with lumbar spine T-score (r=0.196, P<0.001) and hip T-score (r=0.325, P<0.001). Both biomarkers showed a negative correlation with the risk of hip fractures (25(OH)D: r=?0.340, irisin: r=?0.181, both P<0.001). Logistic regression revealed that 25(OH)D (OR=0.865, 95% CI: 0.814-0.919, P<0.001) and irisin (OR=0.386, 95% CI: 0.172-0.865, P=0.021) were independent protective factors for fracture risk. The combined predictive value of 25(OH)D and irisin for hip fracture risk yielded an area under the ROC curve (AUC) of 0.847 (P<0.001), which was superior to either marker alone. Conclusion Serum 25(OH)D and irisin levels significantly influence the risk of hip fractures in elderly CAD/OP patients. Their combined assessment offers high clinical value in predicting fracture risk. Enhancing 25(OH)D supplementation and targeting irisin pathways may represent effective strategies to mitigate fracture risk in this patient population. |
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