目的 探究骨质疏松症（OP）患者血清Dickkopf-1蛋白（DKK-1）、C1q肿瘤坏死因子相关蛋白3（CTRP3）水平对胸腰椎骨折的预测效能。 方法 将2020年1月至2024年8月在医院治疗的124例OP患者纳入OP组，根据是否发生胸腰椎骨折，将OP患者分为无骨折组（70例）、骨折组（54例），另选取同期体检健康者124例作为对照组。采用酶联免疫吸附法（ELISA）检测血清DKK-1、CTRP3水平；多因素logistic回归分析影响OP患者发生胸腰椎骨折的因素；受试者工作特征曲线（ROC）分析血清DKK-1、CTRP3对OP患者发生胸腰椎骨折的预测价值。 结果 与对照组相比，OP组血清DKK-1水平升高，血清CTRP3水平降低（P < 0.05）；与无骨折组相比，骨折组血清DKK-1水平、年龄、OP病程、OP分级Ⅲ级占比均显著升高，血清CTRP3水平显著降低（P < 0.05）；DKK-1高表达是影响OP患者发生胸腰椎骨折的独立危险因素，CTRP3高表达是影响OP患者发生胸腰椎骨折的独立保护因素（P < 0.05）；血清DKK-1、CTRP3水平单独预测OP患者发生胸腰椎骨折的AUC分别为0.790、0.753，二者联合预测的AUC为0.888，优于二者单独预测（Z_{DKK-1-二者联合}=3.351、Z_{CTRP3-二者联合}=3.172，均P < 0.05）。 结论 OP患者血清中DKK-1表达上调，CTRP3表达下调，二者均是影响OP患者发生胸腰椎骨折的因素，联合对OP患者是否发生胸腰椎骨折有较高的预测价值。

Objective To explore the predictive efficiency of serum Dickkopf-1 protein （DKK-1） and C1q tumor necrosis factor-related protein 3 （CTRP3） levels for thoracolumbar fractures in patients with osteoporosis （OP）. Methods Between January 2020 and August 2024， 124 OP patients treated at the hospital were recruited into the OP group. Based on the occurrence of thoracolumbar fractures， these OP patients were divided into a non-fracture group （n = 70） and a fracture group （n = 54）. Additionally， 124 healthy individuals who underwent physical examinations served as the control group. The enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of serum DKK-1 and CTRP3. Multivariate logistic regression analysis was utilized to analyze the influencing factors of thoracolumbar fractures in OP patients. Receiver operating characteristic （ROC） curves were used to evaluate the predictive value of serum DKK-1 and CTRP3 for thoracolumbar fractures in OP patients. Results In comparison with the control group， the serum level of DKK-1 was significantly higher， while the serum level of CTRP3 was significantly lower in the OP group （P < 0.05）. When compared with the non-fracture group， the fracture group exhibited prominently higher serum DKK-1 levels， age， duration of OP， and proportion of OP grade Ⅲ， whereas the serum CTRP3 level was significantly lower （P < 0.05）. High expression of DKK-1 was identified as an independent risk factor for thoracolumbar fractures in patients with osteoporosis， while high expression of CTRP3 was found to be an independent protective factor for thoracolumbar fractures in such patients （P < 0.05）. The area under the curve （AUC） values of serum DKK-1 and CTRP3 levels for predicting thoracolumbar fractures in OP patients were 0.790 and 0.753， respectively. The AUC of the combined prediction of the two was 0.888， which was superior to the individual predictions of either one （ZDKK-1 - combined = 3.351， ZCTRP3 - combined = 3.172， both P < 0.05）. Conclusions In the serum of OP patients， the expression of DKK-1 is upregulated， while the expression of CTRP3 is downregulated. Both are factors influencing the occurrence of thoracolumbar fractures in OP patients. The combination of the two has a high predictive value for the occurrence of thoracolumbar fractures in OP patients.