Correlation and Predictive Value of Serum Chemerin，SDF-1α，and MiR-21 with Adjacent Vertebral Re-fracture after Thoracolumbar Fracture Surgery in Elderly Patients

Yongzhan ZHANG; Haoyang LI; Liqiang YIN

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Yongzhan ZHANG, Haoyang LI, Liqiang YIN. Correlation and Predictive Value of Serum Chemerin，SDF-1α，and MiR-21 with Adjacent Vertebral Re-fracture after Thoracolumbar Fracture Surgery in Elderly Patients[J]. Journal of Kunming Medical University.

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Correlation and Predictive Value of Serum Chemerin，SDF-1α，and MiR-21 with Adjacent Vertebral Re-fracture after Thoracolumbar Fracture Surgery in Elderly Patients

Department of Orthopedics，Third Ward，Jincheng People’s Hospital，Jincheng Shanxi 048000

Received Date: 2026-01-05
Available Online: 2026-04-28

Abstract

Abstract

Objective To investigate the correlation between serum chemokines, stromal cell-derived factor 1α （SDF-1α） and micro ribonucleic acid-21 （miR-21） and adjacent vertebral re-fracture after thoracolumbar fracture surgery in the elderly, and to explore the predictive value of the three. Methods A total of 285 elderly patients with thoracolumbar fractures in Jincheng People's Hospital from September 2021 to September 2024 were selected as the study subjects. All patients underwent percutaneous vertebroplasty （PVP） or percutaneous kyphoplasty （PKP）, and they were followed up for 12 months. According to the occurrence of adjacent vertebral re-fracture, they were divided into re-fracture group and non-re-fracture group. The clinical data, serum chemerins, SDF-1α and miR-21 levels were compared between the two groups, and the predictive value of serum chemerins, SDF-1α and miR-21 for postoperative adjacent vertebral re-fracture was evaluated. Results In this study, 281 elderly patients with thoracolumbar fractures were followed up for 12 months, and 4 patients were lost to follow-up. The incidence of adjacent vertebral re-fracture was 26.69 % （75/281）. The levels of serum chemokine and SDF-1α in the re-fracture group were higher than those in the non-re-fracture group, and the level of miR-21 was lower than that in the non-re-fracture group （P < 0.05）. According to Lasso-Logistic regression analysis, bone mineral density, bone cement extravasation, postoperative vertebral height recovery rate, postoperative Cobb angle, serum chemokine, SDF-1α and miR-21 were independent influencing factors of adjacent vertebral refracture after thoracolumbar fracture in the elderly （P < 0.05）. Receiver operating characteristic （ROC） curve analysis showed that the area under the curve （AUC） of serum chemerin, SDF-1α and miR-21 in predicting adjacent vertebral re-fracture was 0.761 （95%CI: 0.706-0.809）, 0.736 （95%CI: 0.681-0.787） and 0.773 （95%CI: 0.719-0.820）. The AUC of serum chemerin, SDF-1α, miR-21 combined with clinical indicators in predicting adjacent vertebral re-fracture was 0.934 （95%CI: 0.898-0.960）. The 10-fold cross-validation showed that the average AUC was 0.926 （95%CI: 0.892-0.955）, and the AUC range of each fold was 0.911-0.942. The calibration curve showed that the calibration of the prediction model was good （Hosmer-Lemeshow test P > 0.05）. Conclusion Serum chemerin, SDF-1α and miR-21 are independently associated with adjacent vertebral re-fracture after thoracolumbar fracture surgery in the elderly. Combined detection can effectively predict the risk of adjacent vertebral re-fracture.
- Thoracolumbar fracture,
- Adjacent vertebral re-fracture,
- chemerin,
- Stromal cell-derived factor 1α,
- MicroRNA-21,
- Correlation,
- Predictive value

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