慢性痛风性关节炎患者血清骨保护素及瘦素水平与骨质疏松的相关性

目的检测慢性痛风性关节炎患者血清骨保护素（OPG）及瘦素（LEP）水平，探讨与骨质疏松（OP）的关系。方法采用双能X线吸收法（DXA）测定慢性痛风性关节炎患者51例（观察组）及健康者50例（对照组）的骨密度，根据骨密度情况将痛风患者分为合并OP组和非OP组，采用ELISA方法测定所有受试者血清0PG及LEP水平，并测定超敏C反应蛋白（hs-CRP）等其它临床指标，分析OPG与LEP的变化及其与骨质疏松的关系。结果慢性痛风性关节炎患者OPG水平较对照组显著降低（P〈0．05），而LEP水平则显著增高（P〈0．05）；合并OP组患者CRP、LEP水平显著高于非0P组患者（P〈0．05），而OPG水平则显著下降（P〈0．05）。相关性研究表明慢性痛风性关节炎患者OP严重程度与hs-CRP（r=-0．240，P〈0．01）、LEP（r=-0．351，P〈0．05）水平呈显著负相关性。结论慢性痛风性关节炎患者易出现骨质疏松，患者血清OPG和LEP水平的变化可能与痛风患者骨质疏松的发生密切相关。

Objective To analysis the relationship between serum levels of osteoprotegerin （ OPG ） , leptin （ LEP ） and occurrence of osteoporosis （ OP ） in patients with chronic gouty arthritis. Methods Bone mineral density （ BMD ） of 51 patients with chronic gouty arthritis （ Patient Group ） and 50 healthy volunteers （ Control Group ） were measured through dual-energy X-ray absorptiometry （ DXA ） , 51 patients were divided into OP group and non-OP group according to BMD, serum levels OPG and LEP were examined by ELISA in all subjects, high sensitivity C-raactive protein （ hs-CRP ） and other clinical parameters was collected at the same time. The relationships between OPG, LEP and BMD were also explored. Results The serum level of OPG were significantly decreased in Patient Group compared to Control Group （ P〈0.05 ） , along with a significantly increased level of LEP （ P〈0.01 ） . The patients in OP group had higher levels of serum CRP and LEP but lower levels of OPG compared with non-OP group.Correlation analysis indicated that the levels of CRP （ r=--0.240, P〈0.01 ） and LEP （ r=-0.240, P〈0.01 ） were negative correlated with severity of osteoprorosis in patients with chronic gouty arthritis. Conclusion Patitents with chronic gouty arthritis shows higher incidence of osteoprorosis, the increased level of LEP and decreased level of OPG were correlated with osteoprorosis in gout.