| 膝骨关节炎合并骨质疏松患者的维生素D及骨代谢特点 |
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投稿时间：2024-12-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 王学宗 |
WANG Xue-zong |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203 |
Shi's Center of Orthopaedics and Trauma- tology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China |
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| 路雨 |
LU Yu |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203 |
Shi's Center of Orthopaedics and Trauma- tology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China |
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| 丁道芳 |
DING Dao-fang |
上海中医药大学康复医学研究所, 上海 201203 |
In- stitute of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China |
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| 郑昱新 |
ZHENG Yu-xin |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203 |
Shi's Center of Orthopaedics and Trauma- tology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China |
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| 曹月龙 |
CAO Yue-long |
上海中医药大学附属曙光医院石氏伤科医学中心, 上海 201203
上海市中医药研究院骨伤科研究所, 上海 201203 |
Shi's Center of Orthopaedics and Trauma- tology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Institute of Orthopaedics and Traumatology, Shanghai Institute of Traditional Chinese Medicine, Shanghai 201203, China |
ningtcm@126.com |
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| 期刊信息：《中国骨伤》2025年，第38卷，第4期，第352-357页 |
| DOI：10.12200/j.issn.1003-0034.20240743 |
| 基金项目:国家自然科学基金(编号:82174406;82274553);上海市重中之重临床重点学科建设项目(编号:2017ZZ02024);上海市慢性筋骨病临床医学研究中心项目(编号:20MC1920600) |
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中文摘要:
目的: 探讨膝骨关节炎(knee osteoarthritis,KOA)合并骨质疏松(osteoporosis,OP)患者的维生素D (Vita-min D,VitD)及骨代谢特点。
方法: 回顾性分析2019年3月至2024年3月骨伤科收治的240例患者。依据病种不同分4组。单纯KOA组(KOA组)90例,男13例,女77例,年龄50~91(68.48±8.96)岁。单纯OP组(OP组)90例,男7例,女83例,年龄52~88(69.60±8.94)岁。KOA合并OP组30例,男1例,女29例,年龄51~91(69.03±7.93)岁。体检组30例,男5例,女25例,年龄53~79(64.93±6.51)岁。观察各组一般资料和骨钙素(osteocalcin,OC)、β-骨胶原(β-CrossLaps)、甲状旁腺激素(parathyroid hormone,PTH)、VitD的水平。
结果: VitD水平,KOA合并OP组(19.62±10.38) ng·ml-1和OP组(20.65±10.50) ng·ml-1,低于体检组(27.46±8.00) ng·ml-1及KOA组(24.01±9.11) ng·ml-1,差异有统计学意义(P<0.05)。4组间β-CrossLaps和PTH水平差异有统计学意义(P<0.001,P=0.019),而OC水平差异无统计学意义(P=0.763)。与2个单纯疾病组相比,KOA合并OP组的β-CrossLaps水平(0.81±0.30) ng·ml-1更高,差异有统计学意义(P<0.001)。单纯KOA组β-CrossLaps (0.54±0.22) ng·ml-1和PTH (46.03±18.08) pg·ml-1,与体检组(0.44±0.19) ng·ml-1、(36.65±9.63) pg·ml-1比较,差异有统计学意义(P=0.038,P=0.006)。单纯OP组PTH (43.85±14.30) pg·ml-1与体检组比较,差异有统计学意义(P=0.004)。KOA合并OP组的Kallgren-Lawrence (K-L)分级与KOA组比较,差异有统计学意义(P=0.006);KOA合并OP组,不同K-L分级间β-CrossLaps和VitD水平比较,差异有统计学意义(P=0.016)。不同VitD水平下,KOA合并OP组的OC、β-CrossLaps和PTH水平差异均有统计学意义(P=0.013,P=0.033,P=0.046)。
结论: KOA合并OP患者可存在骨代谢紊乱和VitD下降,其中以β-CrossLaps尤为明显,所以在终末期KOA伴骨质流失的患者当中及时监测和纠正骨代谢和补充VitD可成为缓解病情的有益措施。 |
| 【关键词】膝骨关节炎 骨质疏松 维生素D 骨代谢 |
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| Vitamin D and bone metabolism characteristics in knee osteoarthritis with osteoporosis patients |
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ABSTRACT
Objective To investigate the characteristics of Vitamin D (VitD) and bone metabolism in patients with knee osteoarthritis (KOA) concurrent with osteoporosis (OP).
Methods A retrospective analysis was performed on 240 patients who were admitted to the orthopedics department between March 2019 and March 2024. Patients were stratified into four distinct groups according to their respective disease categories.There were 90 patients in the simple KOA group,comprising 13 males and 77 females,age ranged from 50 to 91 years old with an average of (68.48±8.96) years old. There were 90 patients in the simple OP group,comprising 7 males and 83 females,age ranged from 52 to 88 years old with an average of (69.60±8.94) years old. There were 30 patients in the KOA with OP group,comprising 1 male and 29 females,age ranged from 51 to 91 years old with an average of (69.03±7.93) years old. There were 30 patients in the physical examination group,comprising 5 males and 25 females,age ranged from 53 to 79 years old with an average of (64.93±6.51) years old. The general data and the levels of osteocalcin (OC),β-CrossLaps,parathyroid hormone (PTH) and VitD in each group were observed.
Results The level of VitD in KOA with OP group (19.62±10.38) ng·ml-1 and OP group (20.65±10.50) ng·ml-1 was lower than that in physical examination group (27.46±8.00) ng·ml-1 and KOA group (24.01±9.11) ng·ml-1 (P<0.05). There were significant differences in βCrossLaps and PTH levels among the four groups (P<0.001,P=0.019,respectively),while there was no significant difference in OC levels (P=0.763). Compared with the two simple disease groups,the KOA with OP group had higher levels of β-CrossLaps (0.81±0.30) ng·ml-1 (P<0.001). There were significant differences in β-CrossLaps and PTH between the simple KOA group (0.54±0.22) ng·ml-1,(46.03±18.08) pg·ml-1 and the physical examination group (0.44±0.19) ng·ml-1,(36.65±9.63) pg·mL-1(P=0.038;P=0.006). There was a significant difference in PTH between the OP group(43.85±14.30) ng·ml-1, and the physical examination group,P=0.004. There was a significant difference in Kallgren-Lawrence grading between KOA with OP group and KOA group (P=0.006). Within KOA with OP group,the differences of β-CrossLaps and VitD levels among different K-L grades were statistically significant (P=0.016). The level of OC,β-CrossLaps and PTH within KOA with OP group was significantly different at different VitD levels (P=0.013,P=0.033,P=0.046).
Conclusion Patients with KOA complicated by OP exhibit greater disturbances in bone metabolism and reduced VitD levels,particularly reflected by elevated βCrossLaps. These findings underscore the importance of early monitoring of bone turnover and VitD supplementation in advanced stage KOA with bone loss. |
| KEY WORDS Knee osteoarthritis Osteoporosis Vitamin D Bone metabolism |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王学宗,路雨,丁道芳,郑昱新,曹月龙.膝骨关节炎合并骨质疏松患者的维生素D及骨代谢特点[J].中国骨伤,2025,38(4):352~357 |
| 英文格式: | WANG Xue-zong,LU Yu,DING Dao-fang,ZHENG Yu-xin,CAO Yue-long.Vitamin D and bone metabolism characteristics in knee osteoarthritis with osteoporosis patients[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(4):352~357 |
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