Correlation of serum pentraxin 3 expression with disease severity and its prognostic value in postmenopausal osteoporosis.

Objective: Pentraxin 3 (PTX3) is an acute-phase protein of the pentraxin family, primarily secreted by immune cells and endothelial cells. This study analyzed its correlation with the severity of postmenopausal osteoporosis (PMOP) and its prognostic value.

Methods: Postmenopausal women (n = 405) were retrospectively selected and arranged into normal bone mineral density (BMD), osteopenia, and PMOP groups. Baseline data and follow-up records were analyzed. Serum PTX3 were quantified, and its correlations with Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) score, BMD, and bone turnover markers (BTMs) were analyzed. The independent risk factors for fractures in PMOP patients were screened. The prediction of PTX3 for fractures was evaluated, and its effects, together with BMD, on fracture risk were assessed.

Results: PMOP patients showed reduced BMD and serum 25-hydroxyvitamin D levels and increased BTM and PTX3 levels. Serum PTX3 showed positive correlations with ODI, VAS scores, and BTM levels, but negative correlations with BMD. PMOP patients experiencing fractures exhibited markedly higher PTX3 levels than non-fracture patients. Multivariate analysis identified PTX3 as an independent risk factors for fractures in PMOP patients, while elevated BMD (lumbar spine, femur neck, and hip joint) as protective factors. PTX3 demonstrated superior predictive accuracy for fracture risk in PMOP patients (area-under-the-curve [AUC]: 0.874) over β-CTX (AUC = 0.689), PINP (AUC = 0.811), OC (AUC = 0.831), lumbar spine BMD (AUC = 0.791), femoral neck BMD (AUC = 0.793), and hip joint BMD (AUC = 0.799), with no statistically significant differences (all p > 0.05). Low BMD and high PTX3 levels elevated fracture risk in PMOP patients.

Conclusion: Serum PTX3 levels are correlated with BMD, BTMs, and symptom severity, and can assist in predicting fractures in PMOP patients.