Expressions Of Leptin,insulin-like Growth Factor-1 And Insulin-like Growth Factor-binding Protein-3 In Serum Of Senile Patients With Osteoporosis And Its Clinical Significance

Objective:To observe the expressions of leptin,insulin-like growth factor-1(IGF-1)and insulin-like growth factor-binding protein-3(IGFBP-3)in serun of elderly patients with osteoporosis and its clinical significance.Methods:60 elderly patients with abnormal bone mass admitted to the First Affiliated Hospital of Bengbu medical college were selected as the case group.According to the classification criteria of bone density by the world health organization(WHO),the case group was divided into two subgroups,30 cases of osteoporosis group,30 cases of bone loss,and 30 cases of elderly patients with normal bone mass who underwent physical examination during the same period were selected in the control group.The expression levels of leptin,IGF-1 and IGFBP-3 in serum of each group were used to detect by ELISA,and the relationship among leptin,IGF-1 and IGFBP-3 in osteoporosis group was analyzed by linear correlation analysis.The diagnostic value of individual and combined tests for osteoporosis in the elderly was evaluated by receiver operating characteristic curve(ROC curve),and the sensitivity of the diagnostic threshold was determined according to the maximum Youden index?Results:1.There was no significant difference in age,gender,height,weight and body mass index among the three groups(P > 0.05).2.Through anova,the mean levels of leptin among the three groups were(7.80�1.11),(9.0�1.28),(11.41�2.05),the mean levels of IGF-1 were(85.61�5.98),(93.43�6.44),(121.29�8.25),and the mean levels of IGFBP-3 were(3.35�0.50),(3.59�0.63),and(4.44�0.34)were not identical(P < 0.05).After LSD multiplecomparisons,leptin and IGF-1 in osteoporosis group were significantly lower than those in the other two groups,and IGFBP-3 in osteoporosis group was significantly lower than that in the control group,with statistically significant differences(P < 0.05).Leptin,IGF-1 and IGFBP-3 in bone loss group were significantly lower than those in the control group,with statistically significant differences(P < 0.05).In osteoporosis group,serum leptin was positively correlated with IGF-1(P < 0.05),IGF-1 was positively correlated with IGFBP-3(P < 0.05),and partial correlation analysis after correction of IGF-1 showed no correlation between leptin and IGFBP-3(P > 0.05)?3.The area under the ROC curve(AUC value)of early osteoporosis was: leptin +IGF-1(0.906)> IGF-1(0.904)> IGF-1 + IGFBP-3(0.903)> leptin(0.866)> leptin +IGFBP-3(0.865)> IGFBP-3(0.822).The AUC value of leptin + IGF-1 has the highest diagnostic value,and it has a high sensitivity(100%)and specificity(70.0%)at the optimal threshold value.4.When the optimal diagnostic thresholds of each indicator were reached,the sensitivity of leptin,IGF-1,IGFBP-3,leptin + IGF-1,leptin + IGFBP-3,and IGFBP-3to the diagnosis of early osteoporosis was 83.3%,96.7%,96.7%,100%,83.3%,and96.7%,respectively,which showed that the combined detection of leptin and IGF-1 was superior to the independent detection of each indicator in the early diagnosis of osteoporosis.Conclusion:1.Serum leptin,IGF-1 and IGFBP-3 are involved in the occurrence and development of osteoporosis and have a coordinating effect.Regular detection may be help early diagnosis of the disease.2.The combined detection of leptin and IGF-1 is superior to the independent detection of all indicators,with high sensitivity and specificity,which may have a high clinical value for the early diagnosis of osteoporosis.