中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (2): 165-170.doi: 10.12307/2022.1013

• 骨组织构建 bone tissue construction •    下一篇

外周血干扰素γ、单核细胞趋化蛋白1对绝经后骨质疏松症的预测价值

林  适1，袁嘉尧1，林贤灿1，杨彬彬1，吴建军1，东智卓玛1，唐子佳1，杨志杰1，万  雷2，黄宏兴2   

  1. 1广州中医药大学第三临床医学院，广东省广州市  510000；2广州中医药大学第三附属医院，广东省广州市  510378
  • 收稿日期:2022-01-19 接受日期:2022-03-07 出版日期:2023-01-18 发布日期:2022-06-18
  • 通讯作者: 黄宏兴，博士，主任中医师，教授，广州中医药大学第三附属医院，广东省广州市 510378
  • 作者简介:林适，男，1991年生，广东省阳春市人，汉族，2019年广州中医药大学毕业，硕士，医师，主要从事中医药治疗骨质疏松症及中医药治疗骨伤科疾病的研究。
  • 基金资助:
    国家自然科学基金(81973886)，项目负责人：黄宏兴；国家自然科学基金(82174395)，项目负责人：万雷；广州中医药大学“双一流”与高水平大学学科协同创新团队重点项目(2021XK21)，项目负责人：黄宏兴；2021年广州中医药大学研究生科研创新项目(博士研究生)，项目负责人：林适

Diagnostic value of peripheral blood interferon-gamma and monocyte chemoattractant protein-1 in postmenopausal osteoporosis

Lin Shi1, Yuan Jiayao1, Lin Xiancan1, Yang Binbin1, Wu Jianjun1, Dongzhi Zhuoma1, Tang Zijia1, Yang Zhijie1, Wan Lei2, Huang Hongxing2   

  1. 1The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China; 2The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, Guangdong Province, China
  • Received:2022-01-19 Accepted:2022-03-07 Online:2023-01-18 Published:2022-06-18
  • Contact: Huang Hongxing, MD, Chief physician, Professor, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, Guangdong Province, China
  • About author:Lin Shi, Master, Physician, The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
  • Supported by:
    the National Natural Science Foundation of China, Nos. 81973886 (to HHX) and 82174395 (to WL); “Double First-Class” and High-level University Discipline Collaborative Innovation Team Key Project of Guangzhou University of Chinese Medicine, No. 2021XK21 (to HHX); 2021 Graduate Research and Innovation Project (MD candidate) OF Guangzhou University of Chinese Medicine (to LS)

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摘要：

文题释义：
ROC曲线：接受者操作特性曲线(receiver operating characteristic curve，简称ROC曲线)，又称为感受性曲线(sensitivity curve)。接受者操作特性曲线就是以虚惊概率为横轴，击中概率为纵轴所组成的坐标图，和被试在特定刺激条件下由于采用不同的判断标准得出的不同结果画出的曲线。
骨矿含量：即骨矿物质含量，是评价骨健康状况的指标之一，指骨骼矿物质含量密度疏松的矿物质元素的含有量，即骨中钙、磷、镁等矿物质含量，反映钙储留状况。

背景：干扰素γ、单核细胞趋化蛋白1在骨免疫过程中发挥重要作用，与骨质疏松症的发生具有密切关系，但鲜有研究报道干扰素γ和单核细胞趋化蛋白1在骨质疏松中的诊断价值及相互关系。
目的：探讨外周血干扰素γ、单核细胞趋化蛋白1水平对绝经后骨质疏松症的预测价值。
方法：按照前瞻性病例-对照原则选取广州中医药大学第三附属医院2019年12月至2021年1月门诊收集的71名受试者作为研究对象。根据骨质疏松症的诊断标准分为骨质疏松组(35名)和非骨质疏松组(36名)。比较两组受试者基线资料及外周血干扰素γ、单核细胞趋化蛋白1水平。二元logistics回归进行危险因素分析，研究外周血干扰素γ、单核细胞趋化蛋白1水平和骨密度、骨矿含量间的相关性。受试者工作特征曲线(ROC)评价干扰素γ、单核细胞趋化蛋白1对绝经后骨质疏松症的预测效能。
结果与结论：①两组受试者在年龄、身高、体质量、体质量指数、绝经时间等比较，差异无显著性意义(P > 0.05)；两组受试者T值、腰椎骨密度、腰椎骨矿含量、整体骨密度、整体骨矿含量比较，差异有显著性意义(P < 0.05)；②骨质疏松组干扰素γ水平显著低于非骨质疏松组(P < 0.05)、单核细胞趋化蛋白1水平显著高于非骨质疏松组(P < 0.05)；③单因素和多因素logistics回归分析显示，干扰素γ、单核细胞趋化蛋白1是绝经后骨质疏松症的独立危险因素。ROC曲线进一步肯定了干扰素γ、单核细胞趋化蛋白1对绝经后骨质疏松症具有较好的预测价值[干扰素γ曲线下面积(AUC)=0.799 2，单核细胞趋化蛋白1 AUC=0.800 1]，并确定了预测临界值(干扰素γ值< 1 456 ng/L、灵敏度100%、特异度50%，单核细胞趋化蛋白1值> 365.9 ng/L、灵敏度85.29%、特异度67.57%)；④结果提示，如绝经后女性血清干扰素γ值< 1 456 ng/L、单核细胞趋化蛋白1值> 365.9 ng/L，可能存在骨量丢失的情况。
缩略语：单核细胞趋化蛋白1：monocyte chemoattractant protein-1，MCP-1

https://orcid.org/0000-0001-6388-071X(林适) 

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 绝经后骨质疏松症, 干扰素γ, MCP-1, ROC曲线, 单核细胞趋化蛋白1

Abstract: BACKGROUND: Interferon-γ (IFN-γ) and monocyte chemoattractant protein-1 (MCP-1) play an important role in bone immunity and are closely related to the occurrence of osteoporosis. However, few studies have reported the diagnostic value of IFN-γ and MCP-1 in osteoporosis.
OBJECTIVE: To explore the predictive value of peripheral blood IFN-γ and McP-1 in postmenopausal osteoporosis. 
METHODS: A total of 71 subjects were collected from the Outpatient department of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from December 2019 to January 2021 according to the prospective case-control principle, who were divided into osteoporosis group (n=35) and control group (n=36). Baseline data and levels of IFN-γ and MCP-1 were compared between the two groups. Risk factors were analyzed by binary logistics regression analysis. The correlation between the levels of IFN-γ and MCP-1 and bone mineral density and bone mineral content were analyzed. Receiver operating characteristic curve (ROC) was used to evaluate the predictive efficacy of IFN-γ and MCP-1 in postmenopausal osteoporosis. 
RESULTS AND CONCLUSION: There were no significant differences in age, height, body mass, body mass index and menopause time between the two groups (P > 0.05), but significant differences existed in T value, lumbar bone mineral density, lumbar bone mineral content, overall bone mineral density and overall bone mineral content between the two groups (P < 0.05). The level of IFN-γ in the osteoporosis group was significantly lower than that in the control group (P < 0.05), while the level of MCP-1 was significantly higher than that in the control group (P < 0.05). Univariate and multivariate logistic regression analyses showed that IFN-γ and MCP-1 were independent risk factors for postmenopausal osteoporosis. Receiver operating characteristic curve further confirmed that IFN-γ and MCP-1 had good predictive value for postmenopausal osteoporosis (IFN-γ AUC=0.7992, MCP-1 AUC=0.8001). The critical predictive values (IFN-γ < 1 456 ng/L, sensitivity 100%, specificity 50%; MCP-1 > 365.9 ng/L, sensitivity 85.29%, specificity 67.57%) were determined. Indeed, IFN-γ value < 1456 ng/L and MCP-1 value > 365.9 ng/L suggest that there may be bone loss in postmenopausal women.

Key words: postmenopausal osteoporosis, interferon-γ, MCP-1, receiver operating characteristic curve, monocyte chemoattractant protein-1

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