类风湿关节炎合并股骨头坏死的血清25-羟维生素D_(3)、胰岛素样生长因子-1水平与骨代谢标志物的相关性

Correlation of Serum 25-Hydroxyvitamin D_(3) and Insulin-Like Growth Factor-1 Levels and Bone Metabolic Markers in Rheumatoid Arthritis Complicated with Osteonecrosis of the Femoral Head

目的 探讨类风湿关节炎(RA)合并股骨头坏死(ONFH)的血清25-羟维生素D_(3)[25(OH)D_(3)]、胰岛素样生长因子-1(IGF-1)水平与骨保护素(OPG)、C反应蛋白(CRP)、碱性磷酸酶(ALP)的相关性。方法 选取2019年6月至2021年6月郑州市第一人民医院收治的66例RA合并ONFH患者作为研究对象。根据有无ONFH分为合并ONFH组(32例,A组)、未合并ONFH组(34例,B组),选择同期健康体检人员42例为对照组,分析RA合并ONFH相关炎症指标与OPG、CRP、ALP的相关性。结果 A、B组血清25(OH)D_(3)、IGF-1的水平均低于对照组,A组低于B组(P<0.05)。A、B组OPG、ALP水平均低于对照组,A组低于B组(P<0.05);A、B组CRP水平高于对照组,A组高于B组(P<0.05)。血清OPG、ALP水平与血清25(OH)D_(3)、IGF-1水平呈正相关,血清CRP水平与血清25(OH)D_(3)、IGF-1水平呈负相关(P<0.001)。结论 RA合并ONFH患者血清中25(OH)D_(3)、IGF-1的分泌减少,与OPG、ALP水平呈正相关,与CRP水平呈负相关。

Objective To investigate the correlation of serum 25-hydroxyvitamin D_(3) [25(OH)D_(3)],insulin-like growth factor-1(IGF-1) levels and osteoprotegerin(OPG),C-reactive protein(CRP) and alkaline phosphatase(ALP) in rheumatoid arthritis(RA) complicated with osteonecrosis of the femoral head(ONFH).Methods Sixty-six patients with RA and ONFH admitted to Zhengzhou First People’s Hospital from June 2019 to June 2021 were selected as the subjects.According to the presence or absence of ONFH,they were divided into a group with ONFH(32 patients,group A) and a group without ONFH(34 patients,group B),and 42 healthy subjects during the same period were selected as control group.The correlation between inflammatory parameters related to RA with ONFH and OPG,CRP,and ALP was analyzed.Results The levels of serum 25(OH)D_(3) and IGF-1 in group A and group B were lower than those in control group,and those in group A were lower than those in group B(P<0.05).The serum levels of OPG and ALP in group A and group B were lower than those in control group,and those in group A were lower than those in group B(P<0.05).The serum levels of CRP in group A and group B were higher than those in control group,and that in group A was lower than that in group B(P<0.05).Serum OPG and ALP levels were positively correlated with serum 25(OH)D_(3) and IGF-1 levels,and serum CRP levels were negatively correlated with serum 25(OH)D_(3) and IGF-1 levels(P<0.05).Conclusions The secretion of 25(OH)D_(3) and IGF-1 in the serum of RA patients with ONFH is reduced,which is positively correlated with the levels of OPG and ALP,and negatively correlated with the levels of CRP.