膝骨关节炎严重程度与抵抗素水平的相关性

Correlation between resistin level and severity of knee osteoarthritis

背景:研究显示抵抗素表达水平与骨关节炎的发病机制密切相关。目的:旨在探讨膝骨关节炎患者的血清和关节液中抵抗素水平与膝关节病变程度的相关性。方法:选取74例膝骨关节炎患者和79例健康对照者,通过关节镜进行软骨损伤程度评分;WOMAC评分来评估患者的症状严重程度;X射线K-L分级系统评估膝关节影像学分级;ELISA检测血清和关节液中抵抗素及Ⅱ型胶原基端端肽水平。结果与结论:(1)关节液中抵抗素水平与膝放射学病变程度X射线K-L分级呈正相关,与WOMAC评分中疼痛、肢体功能及总评分成正相关,与WOMAC僵硬评分无显著的相关性;(2)骨关节炎组血清抵抗素水平与WOMAC总分、各分项评分及X射线K-L分级评分差异均无显著的相关性;(3)多元回归分析在去除混合因素后,显示关节液中抵抗素水平与WOMAC评分差异有显著性意义,关节液中抵抗素水平与Noyes评分及CTX-II水平成正相关;(4)结果说明,关节液中抵抗素水平在反映膝骨关节炎患者的病变严重程度及关节软骨退变程度上可能作为一个潜在的生物标志物。

BACKGROUND： Resistin has been shown to play an important role in the pathogenesis and progression of osteoarthritis. OBJECTIVE： To investigate the correlation between resistin level in serum and synovial fluid and the severity of knee osteoarthritis. METHODS： Seventy-four patients with knee osteoarthritis and 79 healthy individuals were recruited. The Noyes score method was used to assess articular cartilage damage arthroscopically. The severity of knee osteoarthritis was evaluated according to the Western Ontario McMaster University Osteoarthritis （WOMAC） score. The radiographic severity of knee osteoarthritis was assessed by the Kellgren-Lawrence （K-L） grading system. The levels of resistin and cross linked C-telopeptide of type Ⅱ collagen （CTX-Ⅱ） in serum and synovial fluid were determined by ELISA. RESULTS AND CONCLUSION： The resistin level in the synovial fluid was positively correlated with the radiographic severity of knee osteoarthritis, WOMAC pain, WOMAC function, and WOMAC total scores, but showed no correlation with the WOMAC stiffness score. There were no significant correlations between the serum level of resistin and WOMAC total scores, subscale or K-L Grading system in the the osteoarthritis patients. Multiple regression analysis showed that the correlation between the synovial fluid level of resistin and WOMAC scores was of significance after removal of other confounding factors, and the resistin level in the synovial fluid was positively correlated with Noyes scores and CTX-Ⅱ level. These results suggest that the resistin level in the synovial fluid can serve as a potential biomarker reflecting the severity of knee osteoarthritis and cartilage degenerative degree in patients with osteoarthritis.