标题：绝经后骨质疏松症患者血清SOST、OPN、Semaphorin3A水平与骨密度及骨代谢指标的关系

      作者：赵鹏飞 1，许平安 2    1.安康市人民医院骨科，陕西 安康 725000；2.西安兵器工业卫生研究所521医院骨科，陕西 西安 710065

      卷次： 2021年32卷9期

      【摘要】 目的 探讨绝经后骨质疏松症(PMOP)患者血清骨硬化蛋白(SOST)、骨桥蛋白(OPN)、Semaphorin3A(Sema3A)水平与骨密度、骨代谢指标的相关性。方法 选取安康市人民医院2017年5月至2020年5月收治的106例PMOP患者作为PMOP组，选取同期于我院体检的单纯绝经妇女 89例作为对照组。比较两组妇女血清SOST、OPN、Sema3A水平及骨密度(L1~4、股骨颈和全髋部位骨密度)和骨代谢指标[Ⅰ型前胶原氨基末端前肽(PINP)、β-联降解产物(β-CTX)、骨钙素(OC)、骨碱性磷酸酶(BALP)]。经 Pearson线性相关分析 PMOP患者血清 SOST、OPN、Sema3A水平与骨密度、骨代谢指标的相关性。结果 PMOP组妇女的血清SOST、OPN、PINP、β-CTX、OC、BALP水平分别为 (15.39±1.47) pg/mL、(13.54±3.79) ng/mL、(53.25±12.48) ng/mL、(0.55±0.19) μg/L、(3.58±1.02) μg/L、(22.18±5.52) μg/L，明显高于对照组的(10.95±1.21) pg/mL、(8.29±2.58) ng/mL、(41.39±9.34) ng/mL、(0.32±0.10) μg/L、(2.79±0.18) μg/L、(18.43±4.23) μg/L，差异均有统计学意义(P<0.05)；PMOP组妇女L1~4、股骨颈、全髋部骨密度及血清Sema3A水平分别为(0.82±0.11) g/cm2、(0.77±0.10) g/cm2、(0.72±0.07) g/cm2、(4.19±0.38) ng/mL，明显低于对照组的(0.95±0.08) g/cm2、(0.91±0.13) g/cm2、(0.89±0.09) g/cm2、(6.73±1.41) ng/mL，差异均有统计学意义(P<0.05)；血清SOST、OPN水平与L1~4、股骨颈、全髋部骨密度呈负相关(P<0.05)，与血清PINP、β-CTX、OC、BALP水平呈正相关(P<0.05)；血清Sema3A水平与L1~4、股骨颈、全髋部骨密度呈正相关(P<0.05)，与血清PINP、β-CTX、OC、BALP水平呈负相关(P<0.05)。结论 PMOP患者血清SOST、OPN水平上调，而血清Sema3A下调，且三者与骨密度、骨代谢指标有相关性，具有作为PMOP治疗靶点的潜力。
      【关键词】 绝经后骨质疏松症；骨硬化蛋白；骨桥蛋白；Semaphorin3A；骨密度；骨代谢
      【中图分类号】 R68 【文献标识码】 A 【文章编号】 1003—6350（2021）09—1136—04

Relationship between levels of serum sclerostin, osteopontin, Semaphorin3A and bone mineral density and bonemetabolism in postmenopausal osteoporosis patients.
ZHAO Peng-fei 1, XU Ping-an 2. 1. Department of Orthopedics,Ankang People's Hospital, Ankang 725000, Shaanxi, CHINA; 2. Department of Orthopedics, 521 Hospital of Xi'an OrdnanceIndustry Health Research Institute, Xi'an 710065, Shaanxi, CHINA
【Abstract】 Objective To explore the correlation between serum sclerostin (SOST), osteopontin (OPN), Sema-phorin3A (Sema3A) levels and bone mineral density and bone metabolism indexes in postmenopausal osteoporosis(PMOP) patients. Methods A total of 106 PMOP patients, who admitted to Ankang People's Hospital from May 2017to May 2020, were included as the PMOP group, and 89 simple menopausal women who were undergoing physical ex-amination in the same hospital during the same period were selected as the control group. The serum SOST, OPN, Se-ma3A levels and bone density (bone density of lumbar spine 1 to 4, femoral neck and total hip) and bone metabolism in-dexes (Ⅰ procollagen N-terminal propeptide [PINP], β-C-terminal telopeptide region of collagen type 1 [β-CTX], osteo-calcin [OC], bone alkaline phosphatase [BALP]) in the two groups of women were compared. Pearson linear correlationanalysis was conducted to analyze the correlation between serum SOST, OPN and Sema3A levels and bone mineral densi-ty and bone metabolism indexes in PMOP patients. Results The serum SOST, OPN, PINP, β-CTX, OC, and BALP lev-els in the PMOP group were (15.39±1.47) pg/mL, (13.54±3.79) ng/mL, (53.25±12.48) ng/mL, (0.55±0.19) μg/L, (3.58±1.02) μg/L, (22.18 ± 5.52) μg/L, respectively, which were significantly higher than corresponding (10.95 ± 1.21) pg/mL,(8.29±2.58) ng/mL, (41.39±9.34) ng/mL, (0.32±0.10) μg/L, (2.79±0.18) μg/L, (18.43±4.23) μg/L in the control group (allP<0.05); the bone mineral density of lumbar spine 1 to 4, femoral neck, total hip and serum Sema3A levels in PMOPgroup were (0.82±0.11) g/cm2, (0.77±0.10) g/cm2, (0.72±0.07) g/cm2, (4.19±0.38) ng/mL, respectively, which were signifi-cantly lower than corresponding (0.95±0.08) g/cm2, (0.91±0.13) g/cm2, (0.89±0.09) g/cm2, (6.73±1.41) ng/mL in the con-trol group (all P<0.05); the levels of serum SOST and OPN were negatively correlated with BMD of lumbar 1 to 4, femo-