类风湿关节炎患者OPG、瘦素表达水平与骨质疏松相关性研究

Correlation between OPG,leptin expression level and occurrence of osteoporosis in patients with rheumatoid arthritis

目的:探讨类风湿关节炎(RA)患者外周血的骨保护素(OPG)、瘦素水平变化及其对RA患者骨质疏松的影响。方法:选择我院收入的类风湿关节炎患者共72例,另外选择60例正常人作为健康对照组,对72例患者给予治疗,评估患者血清OPG、瘦素水平,并对比不同骨质疏松程度下患者的OPG、瘦素水平差异。结果:本组72例类风湿关节炎患者均给予治疗,其中缓解44例,未缓解28例,未缓解的28例患者中16例治疗有效,12例治疗无效。RA组治疗前OPG显著低于对照组及治疗后,瘦素显著高于对照组及治疗后,差异有统计学意义(P<0.05)。缓解组OPG水平显著高于有效组及无效组,瘦素水平显著低于有效组及无效组,差异有统计学意义(P<0.05),有效组OPG水平显著高于无效组,瘦素水平低于无效组,差异有统计学意义(P<0.05)。两组骨质疏松发生情况对比显示,RA组骨质疏松率显著高于对照组,差异有统计学意义(P<0.05),RA组及对照组骨质疏松患者的OPG表达显著低于骨量正常及骨量减少患者(P<0.05),瘦素表达显著高于骨量正常及骨量减少患者(P<0.05)。结论:RA患者外周血OPG水平明显降低,RA患者较易发生骨质疏松,OPG水平越低,患者骨质疏松越严重。RA患者外周血瘦素显著升高,RA水平与患者骨质水平呈负相关。

Objective： To explore the correlation between OPG, leptin expression level and severity of osteoporosis in patients with rheumatoid arthritis. Methods：A total of 72 rheumatoid arthritis patients were enrolled as study group, and 60 healthy volunteers were selected as control group. Correlation be- tween serum OPG, leptin expression level and severity of osteoporosis were investigated. Results： After treatment, 44 out of the 72 cases of patients with rheumatoid arthritis relieved, while for the other 28 ca- ses, symptoms were not relieved, but treatment showed effects in 16 of the 28 cases. Before treatment, OPG of the treatment group was significant lower than that of the control group, and also was lower thanthat after treatment, while leptin level was higher （P^0.05）. For those showed therapeutic effects, OPG levels were significant higher, while leptin level was lower than those who didfft （P^0.05）. Incidence of osteoporosis in the study group was significant higher than that of the control group （P^0.05）. Expres- sion level of OPG of the study group and control subjects with osteoporosis were significant higher than those with normal bone mass or decreased bone mass（P〈0.05）, but expression level of leptin showed the opposite status （P〈0.05）. Conclusions. OPG level decreased in patients with RA, and patients with RA shows higher incidence of osteoporosis the lower OPG level is, the severer of osteoporosis. Leptin level in RA patients is increased showing an negative correlation with the severity of osteoporosis.