伴绝经后骨质疏松症的股骨颈骨折患者外周血Treg细胞频率、Treg细胞相关因子表达水平的变化及其临床意义

Treg and Treg-related Cytokines in Patients with Femoral Neck Fracture and PMOP

【目的】分析伴绝经后骨质疏松症(PMOP)的股骨颈骨折患者外周血Treg细胞频率、Treg细胞相关因子表达水平的变化及其临床意义。【方法】选择2016年10月至2020年9月长沙市中心医院收治的30例伴PMOP的股骨颈骨折患者(伴PMOP骨折组)和30例无PMOP的股骨颈骨折女性患者(无PMOP骨折组),并选择同期健康体检的30例无骨折的健康绝经后女性志愿者(对照组)。采用化学发光法检测血清骨钙素(BGP)、Ⅰ型胶原羧基端肽(b-CTX)、Ⅰ型胶原N-端前肽(PINP)水平,采用流式细胞学技术检测各组Treg细胞频率,采用ELISA检测白细胞介素10(IL-10)、转化生长因子β(TGF-β)水平。比较三组研究对象Treg细胞频率、IL-10、TGF-b、BGP、b-CTX、PINP水平。【结果】伴PMOP骨折组患者Treg细胞频率及血清IL-10、TGF-β水平低于无PMOP骨折组患者及对照组(P<0.05),对照组与无PMOP骨折组患者组间比较,差异无统计学意义(P>0.05)。伴PMOP骨折组患者血清b-CTX、PINP水平高于无PMOP骨折组患者及对照组,BGP水平低于无PMOP骨折组患者及对照组,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,血清b-CTX、PINP水平与Treg细胞频率均呈负相关(r分别为-0.262、-0.255,均P<0.05)。【结论】伴PMOP的股骨颈骨折患者Treg细胞频率降低,Treg细胞相关因子表达水平偏低,Treg细胞数目减少可能与PMOP发病有关。

【Objective】To investigate the frequency of Treg and levels of Treg-related cytokines(IL-10 and TGF-b)in patients with femoral neck fracture and post-menopausal osteoporosis(PMOP).【Methods】From October 2016 to September 2020,30 patients with femoral neck fracture and PMOP(the PMOP fracture group),30 patients with femoral neck fracture and normal BMD(in the non-PMOP fracture group,PMOP fracture group),and 30 healthy control subjects(the control group)were enrolled for the study.Chemiluminescence method was used to detect serum osteocalcin(BGP),typeⅠcollagen carboxy-terminal peptide(b-CTX)and typeⅠcollagen N-terminal propeptide(PINP).Flow cytometry was used to detect the frequency of Treg cells in each group.The levels of interleukin 10(IL-10)and transforming growth factor beta(TGF-β)were detected by ELISA.Venous blood was drawn to separate PBMCs and serum,then the frequency of Treg and level of IL-10 and TGF-βwas examined and compared among the three groups.The serum level of BGP,PINP and b-CTX were tested and compared as well.【Results】The frequency of Treg cells and the levels of serum IL-10 and TGF-βin the patients with PMOP fracture were lower than those in the non-PMOP fracture group and the control group(P<0.05).There was no statistical difference between the control group and the non-PMOP fracture group.The serum levels of b-CTX and PINP in the PMOP fracture group were higher than those in the non-PMOP fracture group and the control group,and the BGP level was lower than that in the non-PMOP fracture group and the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum b-CTX and PINP levels were negatively correlated with Treg cell frequency(r=-0.262 and r=-0.255,respectively,both P<0.05).【Conclusion】The frequency of Treg and Treg-related cytokine levels were decreased in patients with femoral neck fracture and PMOP,which might participate in the pathogenesis of osteoporosis.