Clinical significance and diagnostic value of mitochondria-related proteins insulin-like growth factor-1，matrix metalloproteinase-9， and pyruvate kinase M in patients with osteoporosis

Wang Siwei; Yao Xiaosheng; Qi Xiaonan; Wang Yu; Cui Haijian; Cao Qi; Zhao Jiaxuan

doi:10.13406/j.cnki.cyxb.003764

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Clinical significance and diagnostic value of mitochondria-related proteins insulin-like growth factor-1，matrix metalloproteinase-9， and pyruvate kinase M in patients with osteoporosis

Clinical research | 更新时间：2025-12-31

- Clinical significance and diagnostic value of mitochondria-related proteins insulin-like growth factor-1，matrix metalloproteinase-9， and pyruvate kinase M in patients with osteoporosis
- Journal of Chongqing Medical University Vol. 50, Issue 12, Pages: 1723-1728(2025)
- 作者机构：
  
  1.辽宁中医药大学第一临床学院，沈阳 110032
  2.辽宁中医药大学附属医院骨一科，沈阳 110032
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003764
  CLC： R580
- Received：04 September 2024，
  
  Revised：2024-12-11，
  
  Accepted：20 December 2024，
  
  Published：28 December 2025
- 稿件说明：
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王思微,姚啸生,戚晓楠等.线粒体相关蛋白IGF-1、MMP-9、PKM在骨质疏松症患者中的临床意义及诊断价值[J].重庆医科大学学报,2025,50(12):1723-1728.

Wang Siwei,Yao Xiaosheng,Qi Xiaonan,et al.Clinical significance and diagnostic value of mitochondria-related proteins insulin-like growth factor-1，matrix metalloproteinase-9， and pyruvate kinase M in patients with osteoporosis[J].Journal of Chongqing Medical University,2025,50(12):1723-1728.
王思微,姚啸生,戚晓楠等.线粒体相关蛋白IGF-1、MMP-9、PKM在骨质疏松症患者中的临床意义及诊断价值[J].重庆医科大学学报,2025,50(12):1723-1728. DOI： 10.13406/j.cnki.cyxb.003764.

Wang Siwei,Yao Xiaosheng,Qi Xiaonan,et al.Clinical significance and diagnostic value of mitochondria-related proteins insulin-like growth factor-1，matrix metalloproteinase-9， and pyruvate kinase M in patients with osteoporosis[J].Journal of Chongqing Medical University,2025,50(12):1723-1728. DOI： 10.13406/j.cnki.cyxb.003764.

摘要

目的

研究骨质疏松症患者及合并肌少症的骨质疏松症患者临床指标和线粒体相关蛋白的情况，并分析线粒体蛋白在疾病的临床意义。

方法

选取骨质疏松症患者32例，分为单纯骨质疏松症患者21例，肌少-骨质疏松症患者11例，选取同期对照者16例。检测第1~4腰椎、全腰椎、股骨颈骨及髋部骨密度T值、握力测试、骨骼肌指数（skeletal muscle index，SMI）、步行速度、简易体能状况量表（short physical performance battery，SPPB），酶联免疫吸附实验检测骨钙素（osteocalcin，OC）、Ⅰ型前胶原羧基端前肽（carboxyterrninal propeptide of type Ⅰ pmcollagen，PICP）、鸢尾素（Irisin）含量，蛋白质组学方法检测胰岛素样生长因子1（insulin-like growth factors 1，IGF-1）、基质金属蛋白酶9（matrix metalloproteinase 9，MMP-9）、丙酮酸激酶M（pyruvate kinase M，PKM），将上述指标进行相关性分析，受试者工作特征（receiver operating characteristic，ROC）曲线分析指标对骨质疏松症的诊断效能。

结果

第1~4腰椎、全腰椎、股骨颈骨、大粗隆、粗隆间骨密度T值，骨质疏松症组、肌少-骨质疏松症组较对照组减低（

=13.585、15.899、5.027、8.918、13.685、7.101、19.293、17.542，

0.001、

0.001、0.011、0.001、

0.001、0.002、

0.001、

0.001）；骨质疏松症组、肌少骨质疏松症组SMI值、SPPB积分、OC较对照组减低，肌少-骨质疏松症组较骨质疏松症组减低（

=11.746、16.439、29.645，均

0.001）；骨质疏松症组、肌少-骨质疏松症组PICP较对照组增高（

=15.542、

=0.000）；肌少-骨质疏松症组Irisin较对照组及骨质疏松症组减低（

=8.912，

=0.001）；握力测试阳性率在分别为0.00%、54.55%、14.29%（

=13.219，

=0.001）。骨质疏松组MMP-9、PKM蛋白较对照组增高（Ratio=1.612、1.443；

=3.257、3.278；

=0.003、0.002）；肌少-骨质疏松组MMP-9、PKM蛋白较对照组增高（Ratio=1.347、1.235；

=2.511、2.074；

=0.019、0.049），IGF-1蛋白较对照组降低（Ratio=0.670；

=-2.618；

0.001）；肌少-骨质疏松组IGF-1蛋白较骨质疏松症组减低（Ratio=0.804；

=-5.471；

=0.014）。IGF-1与股骨颈骨密度、OC呈正相关（

=0.342、0.331，

=0.017、0.022），与SMI、握力呈正相关（

=0.405、0.546，

=0.004、

0.001），与PICP呈负相关（

=-0.405，

=0.004）；MMP-9与全腰椎骨密度、OC呈负相关（

=-0.4395、-0.398，

=0.005、0.005）；PKM与握力呈负相关（

=-0.339，

=0.018）。线粒体蛋白联合OC、PICP、Irisin指标联合检测诊断骨质疏松症曲线下面积（area under the curve，AUC）为0.966，诊断效能高于单一指标。

结论

骨质疏松症患者不同组别存在IGF-1、MMP-9、PKM的差异变化，且与骨质疏松症及肌少-骨质疏松症其他指标呈一定相关性，多指标联合检测诊断效能较高。

Abstract

Objective

To investigate the clinical indices and mitochondria-related proteins in patients with osteoporosis alone or comorbid with sarcopenia，as well as the clinical significance of mitochondrial proteins in diseases.

Methods

A total of 32 patients with osteoporosis were enrolled，among whom there were 21 patients with simple osteoporosis and 11 patients with osteosarcopenia，and 16 individuals during the same period of time were enrolled as controls. The bone mineral density（BMD） of lumbar vertebrae L1-L4，all lumbar vertebrae，femoral neck，and hip was measured，as well as grip strength，skeletal muscle index（SMI），walking speed，and Short Physical Performance Battery（SPPB） score； ELISA was used to measure the content of osteocalcin（OC），procollagen I C-terminal propeptide（PICP），and irisin，and the proteomics methods were used to measure the levels of insulin-like growth factor-1 （IGF-1），matrix metalloproteinase-9（MMP-9），and pyruvate kinase M（PKM）. A correlation analysis was performed for the above indicators，and the receiver operating characteristic（ROC） curve was used to investigate their performance in the diagnosis of osteoporosis.

Results

Compared with the control group，the osteoporosis group and osteosarcopenia group had significant reductions in the BMD of lumbar vertebrae L1-L4，all lumbar vertebrae，femoral neck，greater trochanter，and intertrochanteric bone（

=13.585，15.899，5.027，8.918，13.685，7.101，19.293，and 17.542，

0.001，

0.001，0.011，0.0

01，

0.001，0.002，

0.001，and

0.001）. The osteoporosis group and osteosarcopenia group had significant reductions in SMI，SPPB score，and OC compared with the control group，and the osteosarcopenia group had significant reductions in these values compared with the osteoporosis group（

=11.746，16.439，and 29.645，all

0.001）. Compared with the control group，the osteoporosis group and osteosarcopenia group had a significant reduction in PICP（

=15.542，

0.001），and the osteosarcopenia had a significant reduction in irisin compared with the other two groups（

=8.912，

=0.001）. The positive rate of grip strength test was 0.00% in the control group，54.55% in the osteoporosis group，and 14.29% in the osteosarcopenia group（

=13.219，

=0.001）. Compared with the control group，the osteoporosis group had significant increases in MMP-9 and PKM（ratio=1.612 and 1.443，

=3.257 and 3.278，

=0.003 and 0.002），and the osteosarcopenia group had significant increases in MMP-9 and PKM（ratio=1.347 and 1.235，

=2.511 and 2.074，

=0.019 and 0.049） and a significant reduction in IGF-1（ratio=0.670，

=-2.618，

0.001），while compared with the osteoporosis group，the osteosarcopenia group had a significant reduction in IGF-1（ratio=0.804，

=-5.471，

=0.014）. IGF-1 was positively correlated with BMD and OC（

=0.342 and 0.331，

=0.017 and 0.022） and was positively correlated with SMI and grip strength（

=0.405 and 0.546，

=0.004 and

0.001），and it was negatively correlated with PICP（

=-0.405，

=0.004）. MMP-9 was negatively correlated with the BMD of all lumbar vertebrae and OC（

=-0.4395 and -0.398，

=0.005 and 0.005），and PKM was negatively

correlated with grip strength（

=-0.339，

=0.018）. Mitochondrial proteins combined with OC，PICP，and irisin had an area under the ROC curve of 0.966 in the diagnosis of osteoporosis，with a higher diagnostic efficiency than each index alone.

Conclusion

There are differences in IGF-1，MMP-9，and PKM between different groups of osteoporosis patients，which are correlated with other indicators of osteoporosis and osteosarcopenia，and combined measurement of multiple indicators has a relatively high diagnostic efficiency.

关键词

Keywords

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