摘要
目的探讨骨吸收标志物β-I型胶原C-末端肽交联(β-CTX)与Graves病(GD)患者并发高钙血症的相关性。方法纳入2021年1月至12月期间于阜阳市人民医院内分泌科住院治疗的287例GD患者,按照校正血钙水平分为对照组(n=251)及高钙组(n=36),比较两组临床资料及血清β-CTX水平,logistic回归模型分析GD患者发生高钙血症的危险因素。采用Pearson相关分析血清β-CTX水平与其他指标的相关性。结果287例GD患者中共确诊高钙血症36例,高钙血症发生率为12.54%。高钙组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、血磷(P)及β-CTX高于对照组,全段甲状旁腺激素(iPTH)低于对照组(均P<0.05)。多因素logistic回归分析显示,FT3(OR=1.283,95%CI:1.049~1.570,P<0.05)及iPTH(OR=0.924,95%CI:0.863~0.989,P<0.05)、β-CTX(OR=2.488,95%CI:1.193~5.189,P<0.05)均为GD患者发生高钙血症的影响因素。Pearson相关分析结果显示,β-CTX与FT3、FT4、血钙、P、碱性磷酸酶(ALP)、总Ⅰ型胶原氨基端延长肽(PINP)、N端骨钙素(N-MID)及25(OH)D呈正相关,与iPTH呈负相关(均P<0.05)。结论β-CTX在GD并发高钙血症患者血清中呈高水平,是GD患者发生高钙血症的危险因素。
Objective To explore the association of bone resorption markerβcarboxyterminal peptide of collagen Ⅰ(β-CTX)with hypercalcemia in patients with Graves'disease(GD).Methods 287 patients with GD who were hospitalized in the endocrinology department of Fuyang People's Hospital from January 2021 to December 2021 were divided into control group(n=251)and hypercalcemia group(n=36)according to the corrected blood calcium level.The clinical data and serum β-CTX level of the two groups were compared.Logistic regression model was used to analyze the risk factors of hypercalcemia in GD patients.Pearson correlation was used to analyze the correlation between serum β-CTX level and other indexes.Results Of the 287 GD patients,36 were diagnosed as hypercalcemia,and the incidence of hypercalcemia was 12.54%.The levels of free triiodothyronine(FT3),free thyroxine(FT4),blood phosphorus(P)and β-CTX in hypercalcemia group were higher than those in control group,and the total parathyroid hormone(iPTH)in hypercalcemia group were lower than those in control group(all P<0.05).Multivariate Logistic regression analysis showed that FT3(OR=1.283,95%CI:1.049-1.570,P<0.05),iPTH(OR=0.924,95%CI:0.863-0.989,P<0.05),β-CTX(OR=2.488,95%CI:1.193-5.189,P<0.05)were the influencing factors for hypercalcemia in GD patients.Pearson correlation analysis showed that β-CTX was positively correlated with FT3,FT4,blood calcium,P,alkaline phosphatase(ALP),total procollagen type I amino end terminal peptide(PINP),N-bone-gamma-carboxyglutamic-acid-containing proteins(N-MID)and 25(OH)D,and negatively correlated with iPTH(all P<0.05).Conclusionsβ-CTX is highly expressed in the serum of GD patients with hypercalcemia,which is a risk factor for the occurrence of hypercalcemia in GD patients.
作者
蒋瑞妹
王卓群
牛敏
申金付
秦瑶
李娟
Jiang Ruimei;Wang Zhuoqun;Niu Min;Shen Jinfu;Qin Yao;Li Juan(Department of Endocrinology,Fuyang People's Hospital,Fuyang 236000,China;Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210006,China)
出处
《中国医师杂志》
CAS
2023年第4期528-531,536,共5页
Journal of Chinese Physician
基金
国家自然科学基金(82000747)
阜阳市自筹经费科技计划项目(FK202081005)。
