老年骨质疏松症患者血清caveolin-1、ANXA2、OPG/PYR对脆性骨折的辅助诊断价值OA

Objective To investigate the adjunctive diagnostic value of serum caveolin-1,annexin A2(ANXA2)and the osteoprotegerin/pyridinoline ratio(OPG/PYR)for fragility fractures in elderly patients with osteoporosis(OP).Methods A total of 206 elderly patients with OP admitted to Yunnan Provincial Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were enrolled.According to the presence of fragility fractures at admission,the patients were assigned to a fracture group(100 cases)and a non-fracture group(106 cases).Baseline characteristics,traditional bone turnover markers[procollagen typeⅠ N-terminal propeptide(PⅠNP),β-carboxy-terminal crosslinked telopeptide of type Ⅰ collagen(β-CTX),tartrateresistant acid phosphatase 5b(TRACP5b)],serum levels of caveolin1 and ANXA2,and the OPG/PYR were recorded and compared between the two groups.Pearson correlation analysis was used to examine the as-sociations of serum caveolin1 and ANXA2 levels and the OPG/PYR with bone mineral density(BMD)and traditional bone turnover markers in patients with fragility fractures.Multivariate Logistic regression analysis was performed to identify factors associated with fragility fractures in elderly patients with OP.Receiver oper-ating characteristic(ROC)curve analysis was conducted to evaluate the adjunctive diagnostic value of serum caveolin1,ANXA2 and OPG/PYR for fragility fractures.Results Lumbar spine BMD,femoral neck BMD,OPG/PYR and serum PⅠNP and caveolin-1 levels were significantly lower in the fracture group than those in the non-fracture group,whereas β-CTX,TRACP-5b and ANXA2 levels were significantly higher,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that in patients with fragility fractures,serum caveolin-1 level and OPG/PYR were positively correlated with lumbar spine BMD,femoral neck BMD and PⅠNP(P<0.05)and negatively correlated with β-CTX and TRACP-5b(P<0.05);conversely,ANXA2 level was negatively correlated with lumbar spine BMD,femoral neck BMD and PⅠNP(P<0.05),and positively correlated with β-CTX and TRACP-5b(P<0.05).Multivariate Logistic regression analysis indicated that caveolin-1,ANXA2,OPG/PYR,PⅠNP,β-CTX and TRACP-5b were significant factors influencing fragility fractures(P<0.05).ROC curve analysis showed that the combined adjunctive diagnosis using caveolin-1,ANXA2 and OPG/PYR yielded an area of under the curve(AUC)of 0.943(95%CI:0.900-0.971),with no statistically significant difference compared with the AUC of the combined traditional markers(Z=1.243,P>0.05).Conclusion Serum ANXA2,caveolin-1 and the OPG/PYR were established as independent factors for fragility fractures in elderly OP patients.Their combination could yield an adjunc-tive diagnostic tool to inform clinical decision-making.