女性膝骨性关节炎与雌二醇及其代谢产物的关系

Estradiol and its metabolites and their association with knee osteoarthritis of women

目的 探讨血浆中雌二醇及其代谢产物与女性骨关节炎（OA）发病的关系.方法 64例女性膝OA（绝经前后各32例）作为实验组,48例健康女性（绝经前后各24例）作为对照组.应用高效液相色谱-电喷雾离子源-串联四极杆质谱联用技术对血浆内6种雌激素及其代谢产物定量测定.结果 实验组与对照组比较,绝经前卵泡期女性OA游离雌二醇水平[（65.0±9.2）比（72.3 ±10.4） ng/L;P ＜0.05]、绝经前卵泡期[（264.2±40.4）比（296.5 ±31.1） ng/L;P＜0.05]及黄体期[（262.7±45.4）比（304.1±51.5） ng/L;P ＜0.05]女性OA总2-羟基雌酮水平均降低.绝经后女性OA游离雌二醇[（13.7±3.1）比（18.2±5.6） ng/L;P＜0.05]及总雌二醇水平[（40.1±8.0）比（51.4±12.1）ng/L;P＜ 0.05]均降低;而总2-羟基雌二醇水平[（16.9±4.9）比（11.6±4.0） ng/L;P ＜0.01]升高.在调整体质量指数后,黄体期女性OA总2-羟基雌酮水平与总雌二醇水平明显相关（r =0.683,P＜0.01）;绝经后女性OA总2-羟基雌二醇水平与游离（r=0.373,P＜0.05）及总雌二醇（r =0.416,P＜0.05）水平明显相关.结论 除雌二醇缺乏外,绝经前低水平的总2-羟基雌酮及绝经后高水平的总2-羟基雌二醇与女性OA发病明显相关.

Objective To investigate whether serum levels of selected endogenous estrogens and their metabolites are involved in the pathogenesis of osteoarthritis in pre-and post-menopausal women with osteoarthritis.Methods Sixty-four women patients with osteoarthritis of the knee as experimental groups and 48 healthy women as control groups were included in this study.Serum concentrations of estrogens and its metabolites were measured by high performance liquid chromatography-mass spectrometry.Results Our results show that the serum concentrations of free estradiol （P ＜ 0.05） and total 2-hydroxyestrone （P ＜ 0.05） were significantly lower in premenopausal women with osteoarthritis compared to the levels detected in the control groups （healthy women）.While serum concentrations of free （P ＜ 0.05） and total estradiol （P ＜ 0.05） in postmenopausal women with osteoarthritis was significantly decreased compared to those of the control groups,the level of total 2-hydroxyestradiol （P ＜ 0.01） significantly increased in postmenopausal women.Furthermore,the total 2-hydroxyestrone concentration positively correlated with the total estradiol level in premenopausal luteal phase women with osteoarthritis （r =0.683,P ＜ 0.01）.In addition,the total 2-hydroxyestradiol level positively correlated with free （r =0.373,P ＜ 0.05） and total estradiol （r =0.416,P ＜ 0.05） levels in postmenopausal women with osteoarthritis.Conclusion Except for free and total estradiol deficiency,a decreased serum level of total 2-hydroxyestrone in premenopausal women and an increased total 2-hydroxyestradiol level in postmenopausal women with osteoarthritis may also correlate with the pathogenesis of female osteoarthritis.