Abstract：
BACKGROUND: As a common disease in the elderly, osteoporosis clearly increases the risk of fractures, leading to higher mortality, but the current markers to estimate the risk of fractures are limited. MicroRNA-21 (miR-21) may play an important role in osteoporosis, but the link of this biomarker with fractures was undetermined.
OBJECTIVE: We aimed to investigate the association between miR-21 levels and the presence of fragility fractures.
METHODS: A total of 200 patients were recruited and miR-21 was collected from baseline serum. The correlation between miR-21 and the fracture risk assessment tool (FRAX) score was analyzed. The incidence of fragility fractures was presented by Kaplan-Meier analysis, and Cox regression analysis was utilized to evaluate risk factors. The diagnostic value of miR-21 was conducted by the area under curve (AUC).
RESULTS: The FRAX score was significantly associated with miR-21 level (p<0.001). According to the 50th percentile of miR-21 content in the overall distribution, the cumulative incidence of fragility fractures was significantly higher in patients with higher miR-21 levels than those with lower levels (75.4, 95 % CI: 69.0-81.8 vs. 59.2, 95 % CI: 42.1-76.3, p<0.001). The results of the Cox regression analysis showed that the miR-21 level was an independent risk factor linked to the incidence of fracture (p=0.005). The optimal cut-off value of the miR-21 was 6.08, and the AUC for predicting fracture was 0.718 (95 % CI, 0.645-0.790).
CONCLUSIONS: This study showed that miR-21 has optimal diagnostic performance in the discrimination of fragility fracture, and the circulating miR-21 level in predicting the risk of fragility fracture may have a certain value.
OBJECTIVE: We aimed to investigate the association between miR-21 levels and the presence of fragility fractures.
METHODS: A total of 200 patients were recruited and miR-21 was collected from baseline serum. The correlation between miR-21 and the fracture risk assessment tool (FRAX) score was analyzed. The incidence of fragility fractures was presented by Kaplan-Meier analysis, and Cox regression analysis was utilized to evaluate risk factors. The diagnostic value of miR-21 was conducted by the area under curve (AUC).
RESULTS: The FRAX score was significantly associated with miR-21 level (p<0.001). According to the 50th percentile of miR-21 content in the overall distribution, the cumulative incidence of fragility fractures was significantly higher in patients with higher miR-21 levels than those with lower levels (75.4, 95 % CI: 69.0-81.8 vs. 59.2, 95 % CI: 42.1-76.3, p<0.001). The results of the Cox regression analysis showed that the miR-21 level was an independent risk factor linked to the incidence of fracture (p=0.005). The optimal cut-off value of the miR-21 was 6.08, and the AUC for predicting fracture was 0.718 (95 % CI, 0.645-0.790).
CONCLUSIONS: This study showed that miR-21 has optimal diagnostic performance in the discrimination of fragility fracture, and the circulating miR-21 level in predicting the risk of fragility fracture may have a certain value.
摘要：
背景：作为老年人的常见病，骨质疏松症明显增加骨折的风险，导致更高的死亡率，但是目前评估骨折风险的指标是有限的。微小RNA-21(miR-21)可能在骨质疏松中发挥重要作用,但这种生物标志物与骨折的联系尚未确定。
目的：我们旨在研究miR-21水平与脆性骨折的存在之间的关联。
方法：共招募200名患者，从基线血清中收集miR-21。分析miR-21与骨折风险评估工具(FRAX)评分的相关性。脆性骨折的发生率通过Kaplan-Meier分析，Cox回归分析用于评估危险因素。通过曲线下面积(AUC)检测miR-21的诊断价值。
结果：FRAX评分与miR-21水平显著相关（p<0.001）。根据总分布中miR-21含量的第50百分位数，miR-21水平较高的患者脆性骨折的累积发生率明显高于水平较低的患者（75.4，95％CI：69.0-81.8vs.59.2，95%CI：42.1-76.3，p<0.001）。Cox回归分析结果显示miR-21水平是与骨折发生率相关的独立危险因素(p=0.005)。miR-21的最佳截断值为6.08,预测骨折的AUC为0.718(95%CI,0.645~0.790)。
结论：这项研究表明，miR-21在脆性骨折的鉴别中具有最佳的诊断性能，循环miR-21水平在预测脆性骨折风险方面可能有一定的价值。
目的：我们旨在研究miR-21水平与脆性骨折的存在之间的关联。
方法：共招募200名患者，从基线血清中收集miR-21。分析miR-21与骨折风险评估工具(FRAX)评分的相关性。脆性骨折的发生率通过Kaplan-Meier分析，Cox回归分析用于评估危险因素。通过曲线下面积(AUC)检测miR-21的诊断价值。
结果：FRAX评分与miR-21水平显著相关（p<0.001）。根据总分布中miR-21含量的第50百分位数，miR-21水平较高的患者脆性骨折的累积发生率明显高于水平较低的患者（75.4，95％CI：69.0-81.8vs.59.2，95%CI：42.1-76.3，p<0.001）。Cox回归分析结果显示miR-21水平是与骨折发生率相关的独立危险因素(p=0.005)。miR-21的最佳截断值为6.08,预测骨折的AUC为0.718(95%CI,0.645~0.790)。
结论：这项研究表明，miR-21在脆性骨折的鉴别中具有最佳的诊断性能，循环miR-21水平在预测脆性骨折风险方面可能有一定的价值。
