The levels of bone turnover markers in patients with osteoporotic fractures and their correlation with postoperative skeletal muscle status
Han Juan
Zhao Peipei
Wei Le
Ji Junmin
Shi Xinchun
Abstract：Objective To investigate the levels of bone turnover markers in patients with osteoporotic fractures and their correlation with postoperative skeletal muscle status.Methods A total of 98 patients with osteoporotic femoral neck fractures who were treated at the Orthopedic Center of Xinjiang Uygur Autonomous Region People's Hospital from January 2023 to January 2025 were selected as the research subjects.According to the skeletal muscle status of the patients one month after the operation,they were divided into a sarcopenia group(54 cases)and a non-sarcopenia group(44 cases).Pearson corre-lation analysis was used to investigate the correlation between bone turnover marker levels and postoperative skeletal muscle status.Multiple logistic regression analysis was applied to investigate the influencing factors of postoperative skeletal muscle status in patients with osteoporotic fractures.Receiver operating characteristic(ROC)curve analysis was applied to evaluate the predictive value of bone turnover marker levels for the postoperative skeletal muscle status of patients with osteoporotic femo-ral neck fractures.Results The grip strength of both hands,6-meter walking speed,and postoperative skeletal muscle index(SMI)level in the sarcopenia group were lower than those in the non-sarcopenia group(t/P=6.138/＜0.001,8.584/＜0.001,7.610/＜0.001).The levels of parathyroid hormone(PTH),type Ⅰ procollagen amino-terminal peptide(P ⅠNP),and type Ⅰ collagen carboxyl-terminal peptide β special sequence(β-CTX)in the sarcopenia group were higher than those in the non-sar-copenia group(t/P=4.425/＜0.001,3.924/＜0.001,4.982/＜0.001).Osteocalcin(OC),blood phosphorus,blood calcium,and 25-hydroxyvitamin D were lower than those in the non-sarcopenia group(t/P=7.788/＜0.001,6.899/＜0.001,6.400/＜0.001,3.568/＜0.001).Pearson correlation analysis showed that the levels of OC,blood phosphorus,blood calcium,and 25-hydroxyvitamin D in patients with osteoporotic femoral neck fractures were positively correlated with postoperative SMI(r/P=0.574/＜0.001,0.523/＜0.001,0.659/＜0.001,0.653/＜0.001).The levels of PTH,P ⅠNP and β-CTX were negatively correlated with postopera-tive SMI(r/P=-0.786/＜0.001,-0.670/＜0.001,-0.637/＜0.001).High P ⅠNP and high β-CTX were independent risk factors affecting the postoperative skeletal muscle status of patients with osteoporotic femoral neck fractures[OR(95％CI)=1.152(1.001-1.325),17.282(2.333-128.011)].High OC and high 25-hydroxyvitamin D were independent protective factors[OR(95％CI)=0.196(0.062-0.622),0.314(0.099-0.997)].The AUCs of OC,25-hydroxyvitamin D,P ⅠNP,and β-CTX levels alone and in combination for predicting the postoperative skeletal muscle status of patients with osteoporotic femoral neck fractures were 0.844,0.689,0.716,0.822,and 0.956,respectively.The combined prediction of the four was superior to the in-dividual predictive values of OC,25-hydroxyvitamin D,P ⅠNP,and β-CTX(Z/P=2.362/0.018,4.637/＜0.001,2.721/0.006,4.381/＜O.001).Conclusion The levels of OC,25-hydroxyvitamin D,P ⅠNP,and β-CTX are closely related to the postopera-tive skeletal muscle status of patients with osteoporotic femoral neck fractures.The combined prediction of the four has a rela-tively high value in predicting postoperative skeletal muscle reduction in patients.
Keywords：Osteoporotic fractureBone turnover markersSkeletal muscle statusCorrelationInfluencing factors
Publication Date：2026-02-18
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：6( 196-201 )