Prognostic value of serum osteosin combined with procollagen typeⅠN-terminal propeptide in predicting hip dysfunction in elderly patients with intertrochanteric fracture of femur after proximal femoral nail antirotation
ZHAI Jiangbo1 HENG Dezhong1▲ YAO Peng2
1.Department of Orthopedics, Yellow River Sanmenxia Hospital, Henan Province, Sanmenxia 472000, China;
2.Clinical Laboratory, Yellow River Sanmenxia Hospital, Henan Province, Sanmenxia 472000, China
Abstract：Objective To investigate the prognostic value of serum osteosin (OSTN) combined with procollagen typeⅠN-terminal propeptide (PⅠNP) in predicting hip dysfunction after proximal femoral nail antirotation (PFNA) in elderly pa- tients with intertrochanteric fracture of femur (IFF). Methods A total of 200 elderly IFF patients who underwent PFNA surgery in the Department of Orthopedics of Yellow River Sanmenxia Hospital, Henan Province from February 2019 to December 2021 were selected and divided into adverse group (51 cases) and excellent group (149 cases) according to the Harris hip function score at one year after surgery. The clinical data and serum OSTN, PⅠNP levels were compared between the two groups, and the influencing factors of hip dysfunction in elderly IFF patients after PFNA surgery were analyzed. The predictive value of serum OSTN and PⅠNP levels in elderly IFF patients after PFNA surgery was analyzed by receiver operating characteristics (ROC) curve. Results Age, proportion of complications before surgery, proportion of American Society of Anesthesiologists rating ≥Ⅲ before surgery, proportion of Evans-Jensen classification ≥Ⅲ before surgery, proportion of severe osteoporosis, and serum OSTN, PⅠNP levels in the adverse group were higher than those in the excellent group, and the differences were statistically significant (P＜0.05). The results of multivariate analysis showed that age, preoperative comorbidities, American Society of Anesthesiologists rating before surgery, Evans-Jensen classification before surgery, osteoporosis, and serum OSTN, PⅠNP levels were independent influencing factors for hip dysfunction in elderly IFF patients after PFNA surgery (P＜0.05). ROC curve analysis results showed that the area under the curve of the combined prediction of serum OSTN and PⅠNP levels of hip dysfunction in elderly IFF patients after PFNA was larger than that of the two alone (P＜0.05). Conclusion The elevated serum OSTN and PⅠNP levels in elderly IFF patients are associated with hip dysfunction after PFNA surgery, and may be auxiliary predictors of IFF.
翟江波1 衡德忠1▲ 姚鹏2. 血清骨织素联合Ⅰ型前胶原氨基端前肽检测对老年股骨粗隆间骨折股骨近端防旋髓内钉术后髋关节功能不良的预测价值[J]. 中国医药导报, 2023, 20(27): 90-94.
ZHAI Jiangbo1 HENG Dezhong1▲ YAO Peng2. Prognostic value of serum osteosin combined with procollagen typeⅠN-terminal propeptide in predicting hip dysfunction in elderly patients with intertrochanteric fracture of femur after proximal femoral nail antirotation. 中国医药导报, 2023, 20(27): 90-94.
[1] 李兴国，邓叶龙，刘朝晖，等.中国老年髋部骨折流行性病学特征分析[J].实用骨科杂志，2021，27（7）：601-606.
[2] Gong XF，Li XP，Zhang LX，et al. Current status and distribution of hip fractures among older adults in China [J]. Osteoporos Int，2021，32（9）：1785-1793.
[3] 中国医师协会急救复苏专业委员会创伤骨科与多发伤学组，中国医药教育学会骨质疾病专业委员会修复重建学组，中国老年学和老年医学学会老年病分会骨科专家委员会，等.中国老年髋部骨折病人行微创手术治疗专家共识[J].临床外科杂志，2022，30（4）：394-400.
[4] Ng JPH，Tan TL，Pillai A，et al. Outcomes of ultra-old vs old patients after hip fracture surgery：a matched cohort analysis of 1524 patients [J]. Arch Orthop Trauma Surg，2022，7（21）：3145-3154.
[5] 任明诗，丁羽，李子涵，等.成骨细胞与破骨细胞相互调节作用的研究进展[J].中国药理学通报，2022，38（6）：822-827.
[6] Thomas G，Moffatt P，Salois P，et al. Osteocrin，a novel bone- specific secreted protein that modulates the osteoblast phenotype [J]. J Biol Chem，2003，278（50）：50563-50571.
[7] 中华医学会骨质疏松和骨矿盐疾病分会.骨转换生化标志物临床应用指南[J].中华骨质疏松和骨矿盐疾病杂志，2021，14（4）：321-336.
[8] Kanai Y，Yasoda A，Mori KP，et al. Circulating osteocrin stimulates bone growth by limiting C-type natriuretic peptide clearance [J]. J Clin Invest，2017，127（11）：4136-4147.
[9] 张萌萌，张秀珍，邓伟民，等.骨代谢生化指标临床应用专家共识（2020）[J].中国骨质疏松杂志，2020，26（6）：781-796.
[10] Jensen JS，Michaelsen M. Trochanteric femoral fractures tre- ated with McLaughlin osteosynthesis [J]. Acta Orthop Scand，1975，46（5）：795-803.
[11] Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures：treatment by mold arthroplasty. An end-result study using a new method of result evaluation [J]. J Bone Joint Surg Am，1969，51（4）：737-755.
[12] 中华医学会骨质疏松和骨矿盐疾病分会，中华医学会内分泌学分会，中华医学会糖尿病学分会，等.糖尿病患者骨折风险管理的中国专家共识[J].中华内分泌代谢杂志，2019，35（7）：535-547.
[13] 李宁，李新萍，杨明辉，等.老年髋部骨折的骨质疏松症诊疗专家共识[J].中华骨与关节外科杂志，2021，14（8）：657-663.
[14] 白黎明，罗军，易观俊，等.InterTan与PFNA内固定联合个体化康复训练治疗老年骨质疏松性股骨粗隆间骨折的疗效比较[J].中国骨与关节损伤杂志，2022，37（6）：609-612.
[15] 王海虎，邓杰林，倪进荣，等.LPFP与PFNA内固定术治疗不同类型老年股骨粗隆间骨折的疗效及生物力学性能对比分析[J].老年医学与保健，2022，28（2）：375-380.
[16] Gu J，He S，Wang L. Analysis of one-year postoperative mortality and risk factors of elderly patients with intertroch- anteric fractures after PFNA [J]. Niger J Clin Pract，2022， 25（9）：1557-1562.
[17] Bord S，Ireland DC，Moffatt P，et al. Characterization of osteocrin expression in human bone’ [J]. J Histochem Cytochem，2005，53（10）：1181-1187.
[18] Watanabe-Takano H，Ochi H，Chiba A，et al. Mechanical load regulates bone growth via periosteal Osteocrin [J]. Cell Rep，2021，36（2）：109380.
[19] 田琳琳，冯正平.骨转换生化标志物的研究进展[J].中国骨质疏松杂志，2022，28（5）：755-759.
[20] Stevenson NL，Bergen DJM，Lu Y，et al. Giantin is required for intracellular N-terminal processing of type Ⅰ procollagen [J]. J Cell Biol，2021，220（6）：e202005166.
[21] 王湛，王毅，冯凯强，等.骨转换标志物CTX-1和PINP预测骨质疏松骨折的研究进展[J].中国骨质疏松杂志，2021，27（7）：1084-1087.
[22] 王峰，潘浩，刘国强，等.血清PⅠNP/β-CTX比值、OPN与老年骨质疏松患者髋部骨折的关系[J].国际检验医学杂志，2022，43（11）：1338-1341.
[23] 戴文昊，刘亦冰，解强，等.老年骨质疏松症合并髋部骨折患者外周T淋巴细胞亚群、炎性细胞因子水平与骨代谢生化指标的关系[J].广东医学，2022，43（6）：740-744.
[24] Gillett MJ，Vasikaran SD，Inderjeeth CA. The Role of PINP in Diagnosis and Management of Metabolic Bone Disease [J]. Clin Biochem Rev，2021，42（1）：3-10.
[25] Panteli M，Vun JSH，Pountos I，et al. Biological and molecular profile of fracture non-union tissue：A systematic review and an update on current insights [J]. J Cell Mol Med，2022，26（3）：601-623.
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