The diagnostic value of the combined application of blood lipid metabolism markers and interleukin-6 in osteoporosis and osteopenia.

IF 3.9 2区 医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Liping Fan, Jiahao Chen, Chong Chen, Yongwei Zhang, Yeqing Yang, Zhe Chen
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引用次数: 0

Abstract

Background: This study aimed to analyse the relationship of the blood lipid profile and interleukin-6 (IL-6) with osteoporosis and osteopenia and to explore the predictive value of the combined application of these biomarkers in osteoporosis and osteopenia.

Methods: Data from 276 patients treated in the orthopaedics department were retrospectively analysed. Their general information was collected, and the relationships among the blood lipid profile, IL-6 with bone turnover markers, and bone mineral density (BMD) were analysed. Patients were categorized based on their T scores for intergroup comparisons. Finally, the diagnostic efficiency of lipid metabolism markers and IL-6 for osteoporosis and osteopenia was assessed using receiver operating characteristic (ROC) curves.

Results: (1) In both males and females, a negative relationship was observed between BMD and several biomarkers, including total cholesterol (TC), apolipoprotein B (ApoB), low-density lipoprotein cholesterol (LDL-C), free fatty acids (FFAs), and IL-6. Additionally, apolipoprotein A1 (ApoA1) was negatively correlated with BMD only in females, and the ApoA1/ApoB ratio was positively correlated with BMD only in males. (2) FFAs and IL-6 were positively correlated with β-CrossLaps peptide in males. However, for females, TC, ApoB, LDL-C, and IL-6 were negatively correlated with 25-hydroxyvitamin D. FFAs, IL-6, and age were negatively correlated with osteocalcin in males and females. (3) According to the T scores for the lumbar spine, the TC, ApoA1, ApoB, HDL-C, LDL-C, FFA, and IL-6 levels in the osteoporosis group and the TC, ApoB, LDL-C, and FFA levels in the osteopenia group were significantly greater than those in the normal bone mass group. Additionally, the osteoporosis group presented substantially higher levels of ApoA1, FFAs, and IL-6 than the osteopenia group. (4) IL-6 was positively correlated with FFAs, while a negative correlation was observed with TC, ApoA1, ApoB, HDL-C, and LDL-C. (5) The ROC curve revealed that the areas under the curve (AUCs) of TC, FFAs, IL-6, ApoA1, and the ApoA1/ApoB ratio for predicting osteoporosis or osteopenia were 0.634, 0.713, 0.670, 0.628, and 0.516, respectively, whereas the AUC of the combination of TC, FFAs, IL-6, and ApoA1 was 0.846, and the AUC of the combination of TC, FFAs, IL-6, and the ApoA1/ApoB ratio was 0.842. In the sex stratification analysis, in males, the AUCs of TC, FFAs, IL-6, and the ApoA1/ApoB ratio for the prediction of osteoporosis or osteopenia were 0.596, 0.688, 0.739, and 0.539, respectively. In contrast, the AUC of the combination of TC, FFAs, IL-6, and the ApoA1/ApoB ratio was 0.838. In females, the AUCs of TC, FFAs, IL-6, ApoA1, and the ApoA1/ApoB ratio for predicting osteoporosis or osteopenia were 0.620, 0.728, 0.653, 0.611, and 0.502, respectively, whereas the AUC of the combination of TC, FFAs, IL-6, and ApoA1 was 0.841, and the AUC of the combination of TC, FFAs, IL-6, and the ApoA1/ApoB ratio was 0.828.

Conclusion: The levels of TC, FFAs, IL-6, ApoA1, and ApoB could contribute to changes in bone metabolism, moreover, FFAs could induce an increase in IL-6 further aggravating bone mass loss and leading to osteoporosis. Based on the comparison of the AUC results, the combination of TC, FFAs, and IL-6 with ApoA1 or the ApoA1/ApoB ratio can better predict osteoporosis or osteopenia in patients, and the diagnostic efficiency is significantly better than that of any individual indicator. The regulation of blood lipid levels should become a new target for clinicians to treat osteoporosis and osteopenia.

血脂代谢指标与白细胞介素-6联合应用在骨质疏松症和骨质减少症中的诊断价值。
背景:本研究旨在分析血脂和白细胞介素-6 (IL-6)与骨质疏松症和骨质减少症的关系,探讨这些生物标志物联合应用在骨质疏松症和骨质减少症中的预测价值。方法:回顾性分析骨科收治的276例患者的资料。收集他们的一般信息,分析血脂、IL-6与骨转换标志物和骨密度(BMD)的关系。根据患者的T评分进行组间比较。最后,使用受试者工作特征(ROC)曲线评估脂质代谢标志物和IL-6对骨质疏松症和骨质减少症的诊断效率。结果:(1)无论男性还是女性,骨密度与总胆固醇(TC)、载脂蛋白B (ApoB)、低密度脂蛋白胆固醇(LDL-C)、游离脂肪酸(FFAs)和白细胞介素6 (IL-6)等生物标志物呈负相关。此外,载脂蛋白A1 (ApoA1)仅在女性中与BMD呈负相关,ApoA1/ApoB比值仅在男性中与BMD呈正相关。(2)男性FFAs和IL-6与β-CrossLaps肽呈正相关。然而,对于女性,TC、ApoB、LDL-C和IL-6与25-羟基维生素d呈负相关,男性和女性的FFAs、IL-6和年龄与骨钙素呈负相关。(3)腰椎T评分显示,骨质疏松组TC、ApoA1、ApoB、HDL-C、LDL-C、FFA、IL-6水平显著高于正常骨量组,骨质减少组TC、ApoB、LDL-C、FFA水平显著高于正常骨量组。此外,骨质疏松组ApoA1、FFAs和IL-6的水平明显高于骨质减少组。(4) IL-6与FFAs呈正相关,与TC、ApoA1、ApoB、HDL-C、LDL-C呈负相关。(5) ROC曲线显示,TC、FFAs、IL-6、ApoA1和ApoA1/ApoB比值预测骨质疏松或骨质减少的曲线下面积(AUC)分别为0.634、0.713、0.670、0.628和0.516,而TC、FFAs、IL-6和ApoA1联合预测骨质疏松或骨质减少的AUC为0.846,TC、FFAs、IL-6和ApoA1/ApoB联合预测骨质疏松或骨质减少的AUC为0.842。在性别分层分析中,男性TC、FFAs、IL-6和ApoA1/ApoB比值预测骨质疏松或骨质减少的auc分别为0.596、0.688、0.739和0.539。TC、FFAs、IL-6和ApoA1/ApoB比值联合使用的AUC为0.838。在女性中,TC、FFAs、IL-6、ApoA1和ApoA1/ApoB比值预测骨质疏松或骨质减少的AUC分别为0.620、0.728、0.653、0.611和0.502,而TC、FFAs、IL-6和ApoA1联合预测骨质疏松或骨质减少的AUC为0.841,TC、FFAs、IL-6和ApoA1/ApoB联合预测骨质疏松或骨质减少的AUC为0.828。结论:TC、FFAs、IL-6、ApoA1、ApoB水平可参与骨代谢的改变,且FFAs可诱导IL-6升高,进一步加重骨量丢失,导致骨质疏松。结合AUC结果对比,TC、FFAs、IL-6联合ApoA1或ApoA1/ApoB比值能更好地预测患者骨质疏松或骨质减少,诊断效率明显优于任何单项指标。调节血脂水平应成为临床医生治疗骨质疏松和骨质减少的新目标。
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来源期刊
Lipids in Health and Disease
Lipids in Health and Disease 生物-生化与分子生物学
CiteScore
7.70
自引率
2.20%
发文量
122
审稿时长
3-8 weeks
期刊介绍: Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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