Combined detection of vitamin D, CRP and TNF-α has high predictive value for osteoporosis in elderly men

Ziyu Dong; Min Li; Yonghai Zhang; Hui Liu; Yuhan Cui

Combined detection of vitamin D, CRP and TNF-α has high predictive value for osteoporosis in elderly men

Am J Transl Res. 2023 Aug 15;15(8):5536-5542. eCollection 2023.

Authors

Ziyu Dong¹, Min Li², Yonghai Zhang¹, Hui Liu¹, Yuhan Cui¹

Affiliations

¹ Inspection Technology School, Xinyang Vocational and Technical College No. 48, 24th Street, Yangshan New District, Xinyang 464000, Henan, China.
² Medical School, Xinyang Vocational and Technical College No. 48, 24th Street, Yangshan New District, Xinyang 464000, Henan, China.

PMID: 37692933
PMCID: PMC10492047

Abstract

Objective: To observe the predictive value of 25-hydroxyvitamin D3 (25(OH)D3), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) levels for osteoporosis in elderly men.

Methods: A retrospective analysis was conducted in 122 elderly male patients that were tested in The Affiliated Hospital of Xinyang Vocational and Technical College between January 2020 and May 2022. The patients were divided into an osteoporosis group (OG, n = 77) and a control group (CG, n = 45) according to the results of bone mineral density. The formula N = Z^2*(P*(1-P))/E^2 was used to calculate the required sample size (N) for a given confidence interval (Z), total error (E), and proportion (P) of the target population. The proportion (P) is often assumed to be 0.5 and not randomly distributed across the population. The levels of cross-linked C-terminal telopeptide of type I collagen (CTX-I), procollagen type I N-terminal propeptide (PINP), intact parathyroid hormone (iPTH), osteocalcin (OC), and serum levels of 25(OH)D3, CRP, and TNF-α were measured and compared between the two groups. Pearson correlation was used to analyze the relationship between the parameters. The predictive value of 25(OH)D3, CRP and TNF-α for osteoporosis was also analyzed using receiver operating characteristic (ROC) curves. Logistic multivariate analysis was performed to analyze the risk factors for osteoporosis in elderly men.

Results: Compared with the CG, the OG exhibited evidently lower serum 25(OH)D3, but significantly higher CRP and TNF-α (P < 0.05). Pearson correlation demonstrated that the bone mineral density was negatively correlated with CTX-I, PINP, serum CRP and TNF-α, whereas it was positively correlated with OC and 25(OH)D3 in elderly men. The areas under the ROC curve (AUCs) of serum 25(OH)D3, CRP and TNF-α were identified as 0.931, 0.878 and 0.846, respectively, and the AUC of the combined detection of the three was 0.991. Furthermore, age, CTX-I, PINP, OC, 25(OH)D3, as well as serum CRP and TNF-α were identified as risk factors for osteoporosis among elderly men.

Conclusion: Serum 25(OH)D3, CRP, and TNF-α are associated with osteoporosis in elderly men, and can serve as predictors for osteoporosis.

Keywords: 25-hydroxyvitamin D3; CRP; TNF-α; osteoporosis; prediction.