标题：绝经后骨质疏松症患者血清鸢尾素、4D同型二聚体、骨形成蛋白6的表达及临床意义

      作者：周涛，张兵，朱鹏    西安医学院第二附属医院骨科，陕西 西安 710038

      卷次： 2022年33卷17期

      【摘要】 目的 探讨绝经后骨质疏松症患者血清鸢尾素(Irisin)、4D同型二聚体(SM4D)、骨形成蛋白6 (BMP6)的表达水平及临床意义。方法 选取2019年1月至2021年1月期间西安医学院第二附属医院骨科收治的90例绝经后骨质疏松症患者为观察组，另选同期在我院进行健康检查的50例健康人群为对照组。检测并比较两组受试者的血清 Irisin、SM4D、BMP6水平及骨密度(BMD)、骨代谢指标，并采用Pearson相关系数分析血清 Irisin、SM4D、BMP6与BMD及各项骨代谢指标的相关性。结果 观察组患者的血清 Irisin、BMP6水平分别为(14.37±4.38) ng/mL、(59.34±6.46) ng/mL，明显低于对照组的(31.92±6.02) ng/mL、(88.38±8.02) ng/mL，而SM4D水平为(1.87±0.46) μg/L，明显高于对照组的(0.58±0.16) μg/L，差异均有统计学意义(P<0.05)；观察组患者的股骨颈、腰椎L1~4 BMD分别为(0.56±0.15) g/cm3、(0.62±0.12) g/cm3，明显低于对照组的(0.87±0.21) g/cm3、(0.78±0.19) g/cm3，差异均有统计学意义(P<0.05)。观察组患者的Ⅰ型胶原氨基端前肽(PINP)、骨桥蛋白(OPN)、β胶原降解产物(β-CTX)、N-端骨钙素(N-MID)水平分别为(46.92±5.87) ng/mL、(24.56±4.15) ng/mL、(4.62±1.12) ng/mL、(89.23±9.92) ng/mL，明显高于对照组的(31.22±4.18) ng/mL、(18.87±3.21) ng/mL、(3.78±0.89) ng/mL、(80.34±8.93) ng/mL，差异均有统计学意义(P<0.05)；经Pearson相关性分析结果显示：绝经后骨质疏松症患者的血清 Irisin、BMP6水平与股骨颈、腰椎L1~4 BMD呈正相关(P<0.05)，与 PINP、OPN、β-CTX、N-MID呈负相关(P<0.05)；而 SM4D水平与股骨颈、腰椎L1~4 BMD呈负相关(P<0.05)，与PINP、OPN、β-CTX、N-MID呈正相关(P<0.05)。结论 绝经后骨质疏松症患者的血清 Irisin、BMP6呈现低表达，SM4D呈现高表达，并与患者的BMD和骨代谢指标有明显的相关性。检测血清 Irisin、BMP6、SM4D水平对绝经后骨质疏松症患者的诊治有一定的指导意义。
      【关键词】 绝经后骨质疏松症；血清鸢尾素；4D同型二聚体；骨形成蛋白6；骨密度；骨代谢
      【中图分类号】 R711.51 【文献标识码】 A 【文章编号】 1003—6350（2022）17—2215—04

Expression and clinical significance of serum Irisin, 4D homodimer, and bone morphogenetic protein 6 in patientswith postmenopausal osteoporosis.
ZHOU Tao, ZHANG Bing, ZHU Peng. Department of Orthopaedics, the SecondAffiliated Hospital of Xi'an Medical College, Xi'an 710038, Shaanxi, CHINA
【Abstract】 Objective To investigate the expression and clinical significance of serum Irisin, 4D homodimer(SM4D), and bone morphogenetic protein 6 (BMP6) in patients with postmenopausal osteoporosis. Methods Ninetypatients with postmenopausal osteoporosis who were treated in Department of Orthopaedics, the Second Affiliated Hos-pital of Xi'an Medical College from January 2019 to January 2021 were selected as the observation group, and 50healthy people who underwent health examination in the hospital during the same period were selected as the controlgroup. The levels of serum Irisin, SM4D, BMP6, bone mineral density (BMD), and bone metabolism indexes betweenthe two groups were detected and compared. Pearson correlation coefficient was used to analyze the correlation betweenserum Irisin, SM4D, BMP6 and BMD, various bone metabolism indexes. Results The levels of serum Irisin andBMP6 in the observation group were (14.37±4.38) ng/mL and (59.34±6.46) ng/mL, which were significantly lower than(31.92±6.02) ng/mL and (88.38±8.02) ng/mL in the control group, and the level of SM4D was (1.87±0.46) μg/L, whichwas significantly higher than (0.58±0.16) μg/L in the control group, with statistically significant differences (P<0.05).The femoral neck and lumbar L1~4 BMD in the observation group were (0.56±0.15) g/cm3 and (0.62±0.12) g/cm3, whichwere significantly lower than (0.87±0.21) g/cm3 and (0.78±0.19) g/cm3 in the control group (P<0.05). The levels of ami-no-terminal propeptide (PINP), osteopontin (OPN), β Collagen degradation products (β-CTX), N-terminal osteocalcin(N-MID) in the observation group were (46.92±5.87) ng/mL, (24.56±4.15) ng/mL, (4.62±1.12) ng/mL, and (89.23±9.92) ng/mL, which were significantly higher than (31.22±4.18) ng/mL, (18.87±3.21) ng/mL, (3.78±0.89) ng/mL, and(80.34±8.93) ng/mL in the control group (P<0.05). Pearson correlation analysis showed that the levels of serum Irisinand BMP6 in patients with postmenopausal osteoporosis were positively correlated with femoral neck and lumbar L1~4BMD (P<0.05), and negatively correlated with PINP, OPN, β-CTX, and N-MID (P<0.05). The level of SM4D was nega-