血清胃饥饿素、脂肪因子与膝骨关节炎患者骨密度的相关性研究

Study on the correlation between serum ghrelin and adipokines,bone mineral density in patients with knee osteoarthritis

目的探讨血清胃饥饿素、脂肪因子水平与膝骨关节炎(knee osteoarthritis)患者骨密度(bone mineral density,BMD)之间的相关性。方法本研究选取了164例有症状的膝骨关节炎患者和100位健康人群(对照组)。使用酶联免疫吸附试验(ELISA)测量受试者血清胃饥饿素、脂联素和抵抗素水平。通过双能X线吸收测定法(DXA)测量受试者全身、腰椎、髋部和股骨的BMD。结果膝骨关节炎受试者的全身、腰椎、髋关节、股骨的BMD水平低于对照组(P均<0.05);但脂联素及胃饥饿素水平明显高于对照组(P均<0.05);在单因素分析中,血清胃饥饿素水平与所测量各个部位的骨密度之间有显著的负相关性(P<0.05);脂联素与股骨干骨密度和总股骨骨密度呈显著负相关(P<0.05)。进一步调整年龄、性别、体质量指数(body mass index,BMI)和骨关节炎(osteoarthritis,OA)后,胃饥饿素水平与各个部位的骨密度之间仍然存在显著负相关(P<0.05);脂联素与股骨干、股骨的骨密度之间有显著的相关性(P<0.05)。而血清抵抗素与各部位骨密度在混杂因素调整前后未发现显著相关性。结论血清胃饥饿素和脂联素水平与BMD呈显著负相关,提示胃饥饿素和脂联素对膝骨关节炎患者BMD有潜在的不利影响。

Objective To investigate the cross-sectional associations between serum levels of ghrelin and adipokines and bone mineral density(BMD)in patients with knee osteoarthritis(OA).Methods This study included 164 symptomatic ROA patients and 100 healthy people(control group).Serum levels of ghrelin,adiponectin,and resistin were measured using enzyme-linked immunosorbent assay(ELISA).The BMD of the subjects'whole body,lumbar spine,hip,and femur were measured by dual-energy X-ray absorptiometry(DXA).Results The bone mineral density of the whole body,lumbar spine,hip joint and femur of ROA subjects were lower than that of the control group(all P<0.05);but the levels of adiponectin and gastrin were significantly higher than that of the control group(P<0.05);In univariate analysis,the result showed a significant negative correlation between serum ghrelin levels and bone mineral density measured at various sites(P<0.05).Serum adiponectin was significantly negatively correlated with femoral shaft and total femur BMD(P<0.05).After further adjustment of age,gender,BMI and OA,there was still a significant negative correlation between the level of ghrelin and BMD in various parts(P<0.05);there was a significant correlation between adiponectin and BMD of femoral shaft and total femur(P<0.05).No significant correlation was found between serum resistin and bone mineral density at various sites before and after adjustment of confounding factors.Conclusion The serum levels of ghrelin and adiponectin were significantly and negatively associated with BMD,suggesting potentially detrimental effects of ghrelin and adiponectin on BMD in knee OA patients.