不同类型老年女性髋部骨折血清IGF-1及IGFBP-3,4,5表达相关性研究

目的研究不同类型老年女性髋部骨折中外周血清中血清胰岛素样生长因子1（IGF-1）及血清胰岛素样生长因子结合蛋白3,4,5（IGFBP-3,4,5）表达差异及同骨密度的相关性。方法选取年龄大于65岁老年女性髋部骨折患者,检测并比较外周血清中IGF-1及IGFBP-3,4,5表达差异及同骨密度的相关性。结果转子间骨折组转子区骨矿物质密度（BMD）较股骨颈骨折组低（P〈0.001）,股骨颈组血清中IGFBP-4含量较转子间骨折组低（P〈0.001）,而IGFBP-5含量高于转子间骨折组（P〈0.001）。在血清指标相关性表达中,血清IGF-1表达与股骨颈区BMD成正相关（R=0.46,P=0.002）,血清IGFBP-4同转子区BMD成负相关（R=-0.634,P〈0.001）,血清IGFBP-5同股骨颈区BMD成正相关（R=0.235,P〈0.001）。结论外周血清中IGF-1及其结合蛋白表达的差异可能是导致不同类型老年髋部骨折的病理机制之一,但由于IGF-1及其结合蛋白调节机制相当复杂,对于IGF-1及IGFBPs表达机制同骨折类型的关系尚需大量的实验研究进一步证实。

Research of correlation between expressions of insulin-like growth factor system and senile hip fracture of various types

Objective To study disparities of insulin-like growth factor-1（IGF-1 ） and insulin-like growth factor binding protein-3,4,5（IGFBP-3,4,5） expressions in peripheral serum of female senile hip fracture of different kinds and their correlation with bone mineral density（BMD）.Methods IGF-1 and IGFBP-3,4,5 expressions in peripheral serum were examined,and their correlation with bone mineral density（BMD） in selected female suffered from senile hip fracture aged over 65 were compared.Results BMD of the intertrochanteric fracture group was lower than that of the femoral neck fracture group（P0.001 ）,that IGFBP-4 level in serum of the femoral neck fracture group was lower than that of the intertrochanteric fracture group（P0.001 ）,and that IGFBP-5 level in serum of the femoral neck fracture group was higher than that of the intertrochanteric fracture group（P0.001 ）.As for the correlation expressed by serum markers,IGF-1 expression in serum had a positive correlation with BMD in femoral neck fracture（R =0.46,P=0.002）,the IGFBP-4 expression in serum had a negative correlation with BMD in intertrochanteric fracture （R=-0.634,P0.001 ）,and the IGFBP-5 expression in serum had a positive correlation with BMD in femoral neck fracture（R=0.235,P0.001 ）.Conclusion IGF-1 in peripheral serum and different expressions of IGFBPs may be a pathologic mechanism that leads to different types of senile hip fracture.Owing to the complexity of IGF-1 and of IG-FBP regulatory mechanism,further researches and experiments are needed to verify the correlation of IGF-1 and IGFBP expressions with the types of fracture.