Predictive value of PⅠNP,β-CTX and bone formation indexes on secondary osteoporosis in elderly patients with diabetic nephropathy

Chen Hongfei; Liu Ying; Wei Quan

doi:10.3969/j.issn.1674-7151.2025.02.007

Abstract：Objective To explore the predictive value of serum type Ⅰ procollagen amino terminal propeptide(PⅠNP),β-collagen specific sequence(β-CTX)and bone formation indicators on secondary osteoporosis in elderly patients with diabetic nephropathy.Methods Using retrospective research method,82 elderly patients with diabetic nephropathy admitted in Longyan People's Hospital from January to June 2024 were selected as research subjects.According to whether osteoporosis was secondary,they were divided into osteoporosis group(43 cases)and non osteoporosis group(39 cases).The serum bone formation indicators,including osteocalcin and 25 hydroxyvitamin D3[25(OH)D3],as well as PⅠNP and β-CTX of patients upon admission were detected using fully automated chemiluminescence immunoassay analyzer and enzyme linked immunosorbent assay,and the levels of above indicators were compared between two groups.The receiver operator characteristic curve(ROC curve)was drawn,area under ROC curve(AUC)was calculated,and the predictive efficacies of above indicators on secondary osteoporosis in elderly patients with diabetic nephropathy were analyzed.According to bone density T value,the patients with osteoporosis were divided into mild to moderate group(23 cases;-2.5<T<-1.0)and severe group(20 cases;T≤-2.5).The differences in serum osteocalcin,25(OH)D3,PⅠNP and β-CTX levels were compared among patients with different degrees of osteoporosis at enrollment.Results The serum levels of PⅠNP and β-CTX in osteoporosis group were significantly higher than those in non osteoporosis group,while the levels of osteocalcin and 25(OH)D3 were significantly lower than those in non osteoporosis group[PⅠNP(μg/L):57.35±7.85 vs.45.66±7.70;β-CTX(μg/L):0.75±0.10 vs.0.55±0.07;osteocalcin(μg/L):16.45±3.36 vs.22.15±2.46;25(OH)D3(μg/L):25.06±4.62 vs.36.12±4.24;all P<0.05].ROC curve analysis showed that the AUC of serum bone formation indexes,PⅠNP and β-CTX for predicting secondary osteoporosis with diabetic nephropathy were 0.907,0.924,0.856 and 0.905,respectively.The serum levels of osteocalcin and 25(OH)D3 in mild to moderate group of osteoporosis were significantly higher than those in severe group,while the levels of PⅠNP and β-CTX were significantly lower than those in severe group[osteocalcin(μg/L):23.26±3.17 vs.20.89±2.53;25(OH)D3(μg/L):27.58±3.36 vs.22.16±2.39;PⅠNP(μg/L):55.29±5.88 vs.59.72±6.10;β-CTX(μg/L):0.72±0.07 vs.0.79±0.08;all P<0.05].Conclusion The detection of PⅠNP,β-CTX and bone formation indicators could effectively predict the occurrence of secondary osteoporosis in elderly patients with diabetic nephropathy,and has high clinical application value.