骨关节炎患者血清1,25(OH)_2D_3、IL-17和IL-10水平的变化及临床意义

Changes of serum 1,25-dihydroxyvitamin D_3,IL-17 and IL-10 in patients with osteoarthritis

目的探讨骨关节炎(OA)患者血清1,25-羟基维生素D3[1,25(OH)_2D_3]、白细胞介素(IL)17及IL-10水平变化及临床意义。方法采用酶联免疫吸附试验(ELISA)检测91例OA患者(OA组)及80名体检健康者(正常对照组)血清1,25(OH)_2D_3、 IL-17和IL-10水平,同时采用电化学发光法检测血清25-羟基维生素D3[25(OH)D3]水平。采用视觉模拟评分法(VAS)对OA患者的疼痛程度进行评分。采用Spearman相关分析评价各指标之间的相关性。结果与正常对照组比较,OA组血清1,25(OH)_2D_3、25(OH)D3、IL-10水平明显降低(P<0.05),IL-17水平明显升高(P<0.05)。按25(OH)D3水平将患者分为维生素D缺乏、不足和充足3组,维生素D缺乏组VAS评分明显高于维生素D不足组和维生素D充足组(P<0.05),而维生素D不足组与维生素D充足组之间VAS评分差异无统计学意义(P>0.05)。按VAS评分将患者分为轻度疼痛组、中度疼痛组和重度疼痛组。重度疼痛组和中度疼痛组血清1,25(OH)_2D_3水平均明显低于轻度疼痛组(P<0.05);而重度疼痛组与中度疼痛组之间差异无统计学意义(P>0.05)。Spearman相关分析显示,1, 2 5 (O H)_2D_3与IL-10呈正相关(r=0.778、P=0.002),与VAS和IL-17呈负相关(r值分别为-0.691、-?0.735,P值分别为0.01、0.007);VAS评分与IL-10呈负相关(r=-0.725,P=0.008),与IL-17呈正相关(r=0.699、P=0.010)。OA患者治疗后血清1,25(OH)_2D_3和IL-10水平明显高于治疗前(P<0.05),但仍低于正常对照组(P<0.05);血清IL-17水平明显低于治疗前(P<0.05),但仍高于正常对照组(P<0.05)。结论 1,25(OH)_2D_3可能与OA的发生及严重程度有一定关系。

Objective To investigate the changes of serum 1,25-dihydroxyvitamin D3[1,25(OH)2D3],interleukin(IL)-17 and IL-10 in patients with osteoarthritis(OA).Methods A total of 91 OA patients and 80 healthy subjects(healthy control group)were enrolled.The levels of 1,25(OH)2D3,IL-17 and IL-10 were determined by enzyme-linked immunosorbent assay(ELISA).The level of 25-hydroxyvitamin D3[25(OH)D3]was determined by electrochemiluminescence.Visual analogue scale(VAS)was used for the scoring of OA patients.The correlations among 1,25(OH)2D3,VAS,IL-17 and IL-10 were analyzed by Spearman correlation analysis.Results Serum levels of 1,25(OH)2D3,25(OH)D3 and IL-10 were lower in OA group than those in healthy control group(P<0.05),and serum level of IL-17 in OA group was higher(P<0.05).According to the levels of 25(OH)D3,the patients were classified into 3 groups,vitamin D deficiency,vitamin D insufficient and vitamin D adequacy groups.The VAS score of vitamin D deficiency group was higher than those of vitamin D insufficient and vitamin D adequacy groups(P<0.05),and there was no statistical significance for the VAS score between vitamin D insufficient and vitamin D adequacy groups(P>0.05).According to VAS scores,the patients were classified into mild pain,moderate pain and severe pain groups.Serum levels of 1,25(OH)2D3 in severe pain and moderate pain groups were lower than that in mild pain group(P<0.05),and there was no statistical significance between severe pain and moderate pain groups(P>0.05).Spearman correlation analysis showed that 1,25(OH)2D3 was positively correlated with IL-10(r=0.778,P=0.002),and it was negatively correlated with VAS and IL-17(r=-0.691 and-0.735,P=0.01 and 0.007).VAS score was negatively correlated with IL-10(r=-0.725,P=0.008)and positively correlated with IL-17(r=0.699,P=0.010).Serum levels of 1,25(OH)2D3 and IL-10 in patients with OA after treatment were higher than those before treatment(P<0.05),but they were lower than those in healthy control group(P<0.05).Serum levels of IL-17 after treatment were lower than those before treatment(P<0.05),but they were higher than those in healthy control group(P<0.05).Conclusions Serum 1,25(OH)2D3 plays a role in the occurrence and severity of OA.