围绝经期妇女血清雌激素水平对骨质疏松疾病的预测价值

目的探讨围绝经期妇女血清雌激素水平在骨质疏松疾病预测中的应用效果。方法选取该院2018年1月-2020年1月接诊的96例围绝经期妇女作为研究对象,根据年龄及是否发生骨质疏松症进行分组,对所有受试者进行血清雌激素、骨代谢指标、骨密度(BMD)检测。分析血清雌激素与骨代谢指标、BMD的关系及血清雌激素对骨质疏松症的预测效能。结果41~50岁妇女组血清雌二醇(E2)、腰椎BMD、股骨近端BMD值均显著高于51~60岁组,N端骨钙素(N-MID)、Ⅰ型胶原氨基端前肽(PINP)、Ⅰ型羧基末端肽(CTX)水平均显著低于51~60岁组,差异有统计学意义(P<0.05)。骨质疏松组血清E2、腰椎BMD、股骨近端BMD值均明显低于对照组,N-MID、PINP、CTX水平均明显高于对照组(P<0.05)。血清E2与N-MID、CTX均呈低度负相关,与PINP呈中度负相关。ROC曲线显示,血清E2≤20.45 pg/ml对围绝经期妇女骨质疏松症发生的灵敏度、特异度分别为73.65%、48.27%。结论围绝经期妇女血清雌激素水平明显下降,雌激素水平不足可引起骨代谢异常、BMD下降,增加骨质疏松疾病发生风险。监测围绝经期血清雌激素水平变化,可为临床预测骨质疏松疾病的发生提供参考依据。

The predictive value of serum estrogen level on osteoporosis in perimenopausal women

Objective To explore the application effect of serum estrogen level in the prediction of osteoporosis.Methods 96 perimenopausal women who were admitted to our hospital from January 2018 to January 2020 were selected as the research objects,and were divided into groups according to age and osteoporosis.Serum estrogen,bone metabolism index and bone mineral density(BMD)were measured in all subjects.The relationship between serum estrogen and bone metabolism index,BMD,and the prediction effect of serum estrogen on osteoporosis were analyzed.Results The serum E2,BMD of lumbar vertebrae and BMD of proximal femur in 41-50 years group were significantly higher than those in 51-60 years group,and the levels of N-MID,PINP and CTX were significantly lower than those in 51-60 years group(P<0.05).The serum E2,BMD of lumbar vertebrae and BMD of proximal femur in osteoporosis group were significantly lower than those in control group,and the levels of N-MID,PINP and CTX were significantly higher than those in control group(P<0.05).Serum E2 was negatively correlated with N-MID and CTX,and moderately negatively correlated with PINP.ROC curve showed that the sensitivity and specificity of serum E2≤20.45 pg/ml were 73.65%and 48.27%respectively,P<0.05.Conclusion The level of serum estrogen in perimenopausal women decreased significantly.The deficiency of estrogen level can lead to abnormal bone metabolism,decreased bone density and increased the risk of osteoporosis.Monitoring the changes of serum estrogen level in perimenopause can provide reference for clinical prediction of osteoporosis.