老年男性骨质疏松患者外周血T淋巴细胞表面RANKL表达水平的研究

Study on RANKL expression level in peripheral T cells in elderly male patients with osteoporosis

目的探讨T淋巴细胞来源的核因子κB受体活化因子配体(RANKL)是否在老年男性骨质疏松患者骨损伤的发病过程中发挥作用。方法采用前瞻性研究方法,选取2014年1月至2018年1月首都医科大学附属北京友谊医院收治的老年男性骨质疏松患者31例(骨质疏松组),老年男性骨量减低患者35例(骨量减低组),骨密度正常老年男性志愿者36例(对照组),采用流式细胞学方法,检测三组研究对象外周血CD4^+T淋巴细胞及CD8^+T淋巴细胞表面RANKL的表达水平,并分析研究对象CD4^+T淋巴细胞及CD8^+T淋巴细胞表面RANKL的表达水平是否与骨密度水平存在相关性。结果①对照组、骨量减低组及骨质疏松组患者外周血CD4^+T淋巴细胞表面RANKL表达水平依次升高[分别为(1.58±0.95)%、(2.03±1.33)%、(2.34±1.24)%],差异具有统计学意义(P<0.05);对照组、骨量减低组及骨质疏松组患者外周血CD8^+T淋巴细胞表面RANKL表达水平依次升高[分别为(1.11±0.83)%、(1.53±1.11)%、(1.76±0.94)%],差异具有统计学意义(P<0.05)。②CD4^+T细胞表面RANKL表达水平与股骨颈骨密度T值之间呈负相关(P=0.026,r=-0.221);CD8^+T细胞表面RANKL表达水平与股骨颈骨密度T值之间呈负相关(P=0.027,r=-0.219)。结论T淋巴细胞表面RANKL表达的上调对老年男性骨质疏松患者骨密度的下降具有一定影响,可能是引起老年男性骨质疏松患者骨密度下降的机制之一。

Objective To discuss whether the receptor activator of Nuclear Factor-κB Ligand(RANKL)from T cells plays a role in the process of bone damage in elderly male patients with osteoporosis.Methods It is a prospective study.All cases are from Beijing Friendship Hospital during January 2014 to January 2018.A total of 31 elderly male patients with osteoporosis,35 elderly male patients with decreased bone mineral density(BMD),and 36 elderly male patients with normal BMD were enrolled,through flowing cytological method and check the expression level of RANKL on CD4^+and CD8^+T cells in peripheral blood and to discuss if it is related with BMD or not.Results①RANKL expression level on CD4^+T cells was(1.58±0.95)%in control group,(2.03±1.33)%with decreased bone density group and(2.34±1.24)%in group with Osteoporosis,there was significant difference in RANKL expression level of CD4^+T cells in peripheral blood(P<0.05).RANKL expression level on CD8^+T cells was(1.11±0.83)%in control group,(1.53±1.11)%in decreased bone density group and(1.76±0.94)%in osteoporosis group,there was significant difference of RANKL expression level on CD8^+T cells in peripheral blood(P<0.05).②The expression level of RANKL on CD4^+T cells had negative correlation with T value of femoral neck BMD(P=0.026,r=-0.221);and on CD8^+T cells(P=0.027,r=-0.219).Conclusion The increased RANKL on T cells expression level plays a role on decreasing BMD in elderly male patients with osteoporosis,and it may be a mechanism for decreasing BMD in elderly male patients with osteoporosis.