Correlation Of Bone Metabolic Markers In Patients With Osteoporotic Vertebral Compression Fracture

Objective:This study investigated the correlation between bone metabolic markers and metabolic indicators such as inflammation,blood lipids,liver and kidney function,and blood calcium in patients with osteoporotic vertebral compression fracture（OVCF）in southwestern Shandong Province.The purpose of this study was to find suitable predictors of bone metabolic markers and provide evidence for avoiding the adverse consequences of exacerbating osteoporosis and even re fracture in patients with OVCF in clinical practice.Methods:This study selected 443 patients who were diagnosed as OVCF and admitted to the hospital for percutaneous vertebroplasty（PVP）from July 1,2020 to July 31,2022 in the Spinal Surgery Department of the Affiliated Hospital of Jining Medical University,and collected their clinical data,anthropometric indicators（height,weight,blood pressure）,bone metabolism markers（25-hydroxyvitamin D,β-Collagen special sequence,total type I collagen amino terminal extender peptide,osteocalcin）,blood lipid index（triglyceride,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,very low-density lipoprotein cholesterol）,inflammation index（white blood cells,percentage of neutrophils,C-reactive protein）,liver and kidney function index（combined bilirubin,unconjugated bilirubin,total bilirubin,plasma albumin,uric acid）and blood calcium,SPSS statistical software was used to describe the baseline data of the subjects,analyze the correlation between various bone metabolic markers and metabolic indicators,draw the correlation scatter chart,and conduct multiple linear regression analysis to determine the independent predictors of various bone metabolic markers.Results:1.Pearson correlation analysis of various bone metabolic markers and metabolic indicators:25（OH）D is positively correlated with Ca²⁺,TC,LDL-C;β-CTX was negatively correlated with BMI and WBC,and positively correlated with Ca²⁺.P1NP was negatively correlated with WBC,NE%,ALB,HDL-C;OC was negatively correlated with BMI,WBC,NE%,CRP,DBIL,TBIL,VLDL-C,and positively correlated with Ca²⁺（P<0.05）.There was no statistically significant correlation between other metabolic indicators of bone metabolism markers（P>0.05）.2.Scatter plot and multiple linear regression analysis of various bone metabolic markers and metabolic indicators:（1）After adjusting for confounding factors,25（OH）D and TC（β=0.135,P=0.006）,TC is an independent predictor of 25（OH）D;（2）After adjusting for confounding factors,β-CTX and Ca²⁺（β=0.145,P=0.006）is linear and positively correlated with WBC（β=-0.113,P=0.036）showed linear negative correlation,and Ca²⁺and WBC are independent predictor ofβ-CTX;（3）After adjusting for confounding factors,P1NP and WBC（β=-0.151,P=0.003）、HDL-C（β=-0.115,P=0.016）、NE%（β=-0.174,P=0.001）showed a linear negative correlation,and WBC,HDL-C,NE%are independent predictors of P1NP;（4）After adjusting for confounding factors,OC and WBC（β=-0.238,P<0.001）、NE%（β=-0.122,P=0.030）、VLDL-C（β=-0.164,P=0.002）、DBIL（β=-0.119,P=0.025）is negatively correlated with Ca²⁺（β=0.145,P=0.006）,WBC,NE%,VLDL-C,DBIL,Ca²⁺are independent predictors of OC.Conclusion:Serum WBC and Ca²⁺are both influencing factors of OVCF,and have a certain relationship with markers of bone resorption and bone formation.By measuring the serum WBC and Ca²⁺levels in OVCF patients,it is possible to preliminarily determine the overall bone metabolism status of such patients,and avoid the adverse consequences of neglecting their predictive role in the changes of bone metabolism markers,which may worsen osteoporosis and even lead to vertebral re fracture.NE%,DBIL,and blood lipid indicators can also reflect changes in bone metabolism in OVCF patients to a certain extent.