绝经后妇女同型半胱氨酸代谢与脊柱骨关节炎病情严重程度的关系

Relationship between homocysteine metabolism and severity of spinal osteoarthritis in postmenopausal women

目的 探讨绝经后妇女同型半胱氨酸(homocysteine, Hcy)代谢与脊柱骨关节炎(osteoarthritis, OA)病情严重程度的关系。方法 选择2019年1月~2020年12月在本院就诊的绝经后脊柱OA患者97例作为研究组,按1∶1的比例抽取同期在本院接受体检的绝经后非脊柱OA受试者97例作为对照组。观察两组患者血清Hcy、叶酸水平及亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase, MTHFR)基因C677T多态性差异,采用多因素Logistic回归分析探讨Hcy和MTHFR基因C677T多态性与脊柱OA分级(KL分级)的关系。结果 研究组Hcy水平高于对照组,叶酸水平低于对照组,差异均有统计学意义(P<0.05)。不同KL分级脊柱OA患者的Hcy和叶酸水平差异存在统计学意义(P<0.05)。两组受试者MTHF基因C677T单核苷酸多态性分布存在统计学差异(P<0.05)。不同KL分级脊柱OA患者之间存在MTHFR基因C677T单核苷酸多态性差异,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,平衡混杂因素后,Hcy和MTFFR基因C677T单核苷酸多态性是KL分级增加的风险因素(P<0.05)。结论 血清Hcy水平及Hcy代谢相关基因变异MTHFR基因C677T多态性与脊柱OA及病情严重程度存在相关性。

Objective To investigate the relationship between homocysteine(Hcy) metabolism and the severity of spinal osteoarthritis(OA) in postmenopausal women. Methods From January 2019 to December 2020, 97 postmenopausal patients with spinal OA treated in our hospital were selected as the study group, and 97 postmenopausal non-spinal OA subjects who underwent physical examination in our hospital in the same period were selected as the control group according to the ratio of 1:1.The differences of serum Hcy, folate levels and C677 T polymorphism of methylenetetrahydrofolate reductase(MTHFR) gene between the two groups were observed. The relationship between C677 T polymorphism of Hcy and MTHFR gene and spinal OA grade(KL grade) after balancing confounding factors was observed by multivariate logistic analysis. Results The level of Hcy in the study group was higher than that in the control group, and the level of folic acid was lower than that in the control group(P<0.05). There were significant differences in Hcy and folate levels in patients with spinal OA of different KL grades(P<0.05).There was significant difference in the distribution of C677 T single nucleotide polymorphism of MTHFR gene between the two groups(P<0.05).There was significant difference in MTHFR gene C677 T single nucleotide polymorphism between patients with spinal OA of different KL grades(P<0.05). Multivariate logistic analysis showed that the C677 T single nucleotide polymorphisms of Hcy and MTFFR genes were risk factors for the increase of KL grade after balancing confounding factors(P<0.05).Conclusion Serum Hcy level and Hcy metabolism related gene variation, MTHFR gene C677 T polymorphism are correlated with spinal OA and disease severity.