摘要目的:探讨FOS基因甲基化与妊娠期糖尿病（GDM）患者发生骨质疏松症（OP）的关联性。方法:2017年8月至2022年8月在济宁医学院附属医院产科收集120例GDM患者作为研究对象，根据骨密度值将研究对象分为OP组（15例）和无OP组（105例）。检测两组FOS基因甲基化情况，测量血钙（Ca）、磷（P）、 β-胶原特殊序列（ β-CTX）、Ⅰ型前胶原氨基端原肽（PINP）、骨钙素（OC）和骨碱性磷酸酶（AKP）水平，分析FOS基因甲基化与OP的相关性。 结果:OP组FOS甲基化频率为66.67%（10/15），显著高于无OP组的28.57%（30/105）（ χ2=8.57， P=0.003）。与无OP组相比，OP组AKP、OC水平显著降低（AKP：19.05±3.65比12.98±3.09， t=6.13， P<0.001）（OC：12.76±1.74比9.12±1.49， t=7.70， P<0.001），两组间Ca、P、 β-CTX、PINP差异无统计学意义（ P>0.05）。OP组患者中，与FOS甲基化阴性患者相比，阳性患者骨密度、AKP、OC水平显著降低（骨密度：0.38±0.05比0.31±0.06， t=2.24， P=0.043）（AKP：16.20±1.68比11.47±2.34， t=4.00， P=0.001）（OC：10.27±1.55比8.58±1.14， t=2.41， P=0.032）。Logistic多因素分析显示，FOS甲基化是GDM孕妇患OP的风险性因素（ OR=1.17，95% CI=0.04~4.26， P=0.027），骨密度（ OR=0.71，95% CI=0.42~2.10， P=0.012）、AKP（ OR=0.53，95% CI=0.24~1.90， P=0.008）、OC（ OR=0.90，95% CI=0.17~5.18， P=0.021）则是GDM患者患OP的保护性因素。 结论:FOS基因甲基化与GDM孕妇患OP具有显著关联，可增加GDM孕妇患OP的风险。

abstractsObjective:To explore the correlation between the methylation of the FOS gene and the occurrence of osteoporosis (OP) in patients with gestational diabetes mellitus (GDM) .Methods:From Aug. 2017 to Aug. 2022, 120 patients with gestational diabetes mellitus (GDM) were collected in Affiliated Hospital of Jining Medical College as the research subjects. According to the bone density values, the research subjects were divided into the OP group (15 cases) and the non-OP group (105 cases) . The methylation status of the FOS gene was detected in the two groups of patients, and levels of blood calcium (Ca) , phosphorus (P) , β-collagen special sequence ( β-CTX) , procollagen I n-terminal propeptide (PINP) , osteocalcin (OC) , and bone alkaline phosphatase (AKP) were measured to analyze the correlation between FOS gene methylation and osteoporosis (OP) . Results:The frequency of FOS methylation in the OP group patients [66.67% (10/15) ] was significantly higher than that in the non-OP group patients [28.57% (30/105) ] ( χ2=8.57, P=0.003) . Compared to the non-OP group, patients in the OP group showed significant decreases in AKP and OC levels (AKP: 19.05±3.65 vs. 12.98±3.09, t=6.13, P<0.001) (OC: 12.76±1.74 vs. 9.12±1.49, t=7.70, P<0.001) , with no statistically significant differences in Ca, P, β-CTX, or PINP between the two groups ( P>0.05) . Among OP group patients, those who were FOS methylation positive showed significantly lower bone density, AKP, and OC levels compared to FOS methylation negative patients (bone density: 0.38±0.05 vs. 0.31±0.06, t=2.24, P=0.043) (AKP: 16.20±1.68 vs. 11.47±2.34, t=4.00, P=0.001) (OC: 10.27±1.55 vs. 8.58±1.14, t=2.41, P=0.032) . In Logistic multivariate analysis, FOS methylation was found to be a risk factor for osteoporosis in GDM pregnant women ( OR=1.17, 95% CI=0.04-4.26, P=0.027) , while bone density ( OR=0.71, 95% CI=0.42-2.10, P=0.012) , AKP ( OR=0.53, 95% CI=0.24-1.90, P=0.008) , and OC ( OR=0.90, 95% CI=0.17-5.18, P=0.021) were identified as protective factors for GDM patients against osteoporosis. Conclusion:The methylation of the FOS gene is significantly associated with the occurrence of OP in pregnant women with GDM, and it can increase the risk of OP in pregnant women with GDM.