血清CTRP3及PGC-1α表达与创伤性骨折愈合的相关性分析
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作者Author单位AddressE-Mail
廖宏伟 LIAO Hong-wei 郑州市骨科医院创伤外科, 河南 郑州 450000 Department of Trauma Surgery, Zhengzhou Orthopedic Hospital, Zhengzhou 450000, Henan, China lhj_evol@163.com 
李学栋 LI Xue-dong 郑州市骨科医院足踝外科, 河南 郑州 450000  
马金锋 MA Jin-feng 河南省洛阳正骨医院骨伤科, 河南 洛阳 471000  
期刊信息:《中国骨伤》2022年,第35卷,第11期,第1059-1064页
DOI:10.12200/j.issn.1003-0034.2022.11.010
基金项目:河南省中医药科学研究专项课题(编号:2018ZY2111)
中文摘要:

目的: 探讨创伤性骨折患者血清C1q/TNF相关蛋白3(C1q/tumor necrosis factor-related protein-3,CTRP3),过氧化物酶体增殖物激活受体γ共激活因子-1α(peroxisome proliferator-activated receptor γ coactivator-1α,PGC-1α)表达水平对骨折愈合的预测价值。

方法: 2019年1月至2020年1月收治80例创伤性胫骨平台骨折患者,采用膝关节后侧入路支撑钢板内固定手术治疗,术后随访12个月,根据骨折延迟愈合判定标准将患者分为两组:骨折愈合组54例,男24例,女30例,年龄29~75(52.36±13.17)岁;延迟愈合组26例,男13例,女13例,年龄29~75(53.82±13.52)岁。采用酶联免疫吸附(enzyme linked immunosorbent assay,ELISA)法检测创伤性骨折患者血清CTRP3、PGC-1α及25-羟维生素D3[25(OH)D3]水平;采用全自动生化分析仪检测血磷、血钙水平,计算钙磷乘积;采用Pearson法分析延迟愈合患者术后1周血清CTRP3、PGC-1α与骨生化相关指标的相关性;采用受试者工作特征曲线(receiver operator characteristic curve,ROC)分析血清CTRP3、PGC-1α水平对创伤性骨折愈合的预测价值。

结果: 骨折愈合组术后1、4周血清CTRP3、PGC-1α、钙磷乘积、25(OH)D3水平高于延迟愈合组(P<0.05)。延迟愈合患者术后1周血清CTRP3与PGC-1α呈正相关(r=0.637,P<0.05),且二者与钙磷乘积、25(OH)D3均呈正相关(P<0.05)。血清CTRP3、PGC-1α水平预测创伤性骨折愈合的曲线下面积(area under curve,AUC)分别为0.845、0.855,截断值分别为188.678、2.697 ng/ml,特异性分别为96.2%、80.8%,敏感度分别为53.7%、77.8%;二者联合预测的AUC为0.904,特异性为88.5%,敏感度为81.5%。

结论: 创伤性骨折延迟愈合患者术后1、4周血清CTRP3、PGC-1α水平均低于正常愈合患者,其表达水平对预测患者骨折愈合状况有一定的参考价值。
【关键词】骨折  骨折,不愈合  C1q/TNF相关蛋白3  过氧化物酶体增生物激活受体γ共激活因子1α
 
Correlation analysis of serum CTRP3 and PGC-1α expression with traumatic fracture healing
ABSTRACT  

Objective: To investigate the relationship between serum C1q/tumor necrosis factor-related protein-3(CTRP3) and peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α) on predictive value of expression level on fracture healing.

Methods: From January 2019 to January 2020,80 patients with traumatic tibial plateau fractures were treated by internal fixation with support plates through the posterior approach of the knee joint. The patients were followed up for 12 months. According to the criteria for delayed fracture healing,the patients were divided into two groups:54 patients in fracture healing group included 24 males and 30 females,aged 29 to 75 years old with an average of (52.36±13.17) years;In the delayed healing group,there were 26 cases,13 males and 13 females,aged from 29 to 75 with an average od (53.82±13.52) years. The serum levels of CTRP3,PGC-1αand 25 hydroxyvitamin D3[25(OH)D3] in patients with traumatic fracture were detected by enzyme-linked immunosorbent assay(ELISA);Blood phosphorus and calcium levels were measured by automatic biochemical analyzer,and the product of calcium and phosphorus was calculated;Pearson's method was used to analyze the correlation between serum CTRP3,PGC-1αand bone biochemical indexes in patients with delayed union one week after operation;The predictive value of serum levels of CTRP3 and PGC-1αon traumatic fracture healing was analyzed by receiver operating characteristic curve(ROC curve).

Results: PGC-1α,calcium phosphorus product and 25(OH)D3 in the fracture healing group were higher than those in the delayed healing group at 1 and 4 weeks after operation(P<0.05). Serum CTRP3 was positively correlated with PGC-1α(r=0.637,P<0.05) and positively correlated with calcium phosphorus product and 25(OH)D3(P<0.05). The areas under the curve(AUC) of serum ctrp3 and PGC-1α levels in predicting traumatic fracture healing were 0.845 and 0.855,respectively. The cutoff values were 188.678 pg/ml and 2.697 ng/ml,respectively. The specificity was 96.2% and 80.8%,and the sensitivity was 53.7% and 77.8%;The predicted AUC was 0.904,the specificity was 88.5%,and the sensitivity was 81.5%.

Conclusion: The serum levels of CTRP3 and PGC-1 in patients with delayed union of traumatic fracture at 1 and 4 weeks after operation α The expression level is of certain reference value to predict the fracture healing status of patients.
KEY WORDS  Fractures  Fractures,ununited  C1q/tumor necrosis factor-related protein-3,CTRP3  Peroxisome proliferator-activated receptor γ coactivator-1α,PGC-1α
 
引用本文,请按以下格式著录参考文献:
中文格式:廖宏伟,李学栋,马金锋.血清CTRP3及PGC-1α表达与创伤性骨折愈合的相关性分析[J].中国骨伤,2022,35(11):1059~1064
英文格式:LIAO Hong-wei,LI Xue-dong,MA Jin-feng.Correlation analysis of serum CTRP3 and PGC-1α expression with traumatic fracture healing[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(11):1059~1064
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