Early warning model of osteoporosis in patients with systemic lupus erythematosus based on bone me-tabolism biochemical indexes and pro-inflammatory cytokines

TANG Yan; ZHANG Jing

doi:10.3969/j.issn.1671-8631.2025.11.001

Abstract：Objective:To analyze the risk factors affecting the occurrence of osteoporosis in patients with systemic lupus erythematosus(SLE)based on bone metabolism biochemical indexes and pro-inflammatory cytokines,and to construct an early warning model.Methods:All 182 SLE patients admitted to the Laboratory Department of the Second Affiliated Hospital of Nanchang University from January 2021 to September 2023 were selected to collect their clinical related data,which were divided into occurrence and non-occurrence groups according to whether osteoporosis oc-curred or not,and their bone metabolism biochemical indexes[blood calcium,blood phosphorus,osteocalcin,bone alka-line phosphatase(BALP),and type Ⅰ pre-collagen amino-terminal pre-peptide(PINP)were detected,bone mineral density(BMD),25-hydroxyvitamin D]and pro-inflammatory cytokines[interleukin-6(IL-6),interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)].Univariate analysis and multifactorial logistic regression analysis were used to screen risk factors for osteoporosis in SLE patients.Results:Osteoporosis occurred in 54 patients out of 182 SLE pa-tients,with an incidence rate of 29.67％.The biochemical indexes of bone metabolism,including blood calcium,blood phosphorus,osteocalcin,25-hydroxyvitamin D and BMD in occurrence were lower than those in non-occurrence group,but none of the differences were significant(P＞0.05),while BALP and PINP were higher than those in non-occurrence group,and the differences were statistically significant(P＜0.05).TNF-α levels in occurrence were higher than non-occurrence group,but the difference in comparison of IL-6 and IL-1 levels was not significant(P＞0.05).The results of univariate analysis showed that age,coronary heart disease,history of hormone medication,BALP,PINP,and TNF-α were the single factors affecting the occurrence of osteoporosis in SLE patients.The results of multifactorial a-nalysis showed that age(＞50 years),comorbid coronary heart disease,and history of hormone medication and high-level BALP,PINP,TNF-α were independent risk factors affecting the development of osteoporosis in patients with SLE(P＜0.05).Hosmer～Lemeshow test:x2=8.141,P=0.420＞0.05,goodness of fit.The AUC of the ROC curve was 0.820(95％CI:0.753～0.888),sensitivity was 79.6％,specificity was 70.3％,and maximum Yoden index was 0.499,the model differentiation was good.Conclusion:The early warning model of osteoporosis in SLE patients constructed on the basis of bone metabolism biochemical indexes and pro-inflammatory cytokines in this study has a good clinical ear-ly warning value,which can help healthcare professionals to recognize the risk of osteoporosis in patients with SLE at an early stage.