老年膝关节骨性关节炎患者血清脂联素和白细胞介素-17及转化生长因子-β_1水平变化及临床意义
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摘要
目的探讨血清脂联素(adiponectin, APN)、白细胞介素-17(interleukin-17, IL-17)及转化生长因子-β_1(transforming growth factor-β_1, TGF-β_1)水平与老年膝关节骨性关节炎(knee osteoarthritis, KOA)严重程度的相关性,评估其对老年KOA的诊断价值。方法 170例老年KOA患者为KOA组,70例体检健康者为对照组,采用ELISA法检测血清APN、IL-17及TGF-β_1水平,并进行2组及不同K-L分级患者间比较;绘制ROC曲线,分析APN、IL-17及TGF-β_1对老年KOA的诊断价值;采用Pearson相关性分析血清APN、IL-17、TGF-β_1水平与K-L分级等临床指标的相关性。结果 KOA组血清APN[(3 162.40±418.25)μg/L]、IL-17[(32.75±16.38)ng/L]及TGF-β_1[(54.87±13.16)μg/L]水平均高于对照组[(684.72±205.63)μg/L、(15.84±8.20)ng/L、(10.42±2.63)μg/L](P<0.05),K-L分级Ⅳ级、Ⅲ级、Ⅱ患者血清APN、IL-17及TGF-β_1水平依次降低(P<0.05);当血清APN、IL-17及TGF-β_1最佳截断值分别为2 483.50μg/L、27.42 ng/L、40.35μg/L时,三项联合诊断老年KOA的AUC(0.960)大于APN、IL-17、TGF-β_1单独检测的AUC(0.825、0.796、0.863),其敏感度为90.7%,特异度为83.5%;老年KOA患者血清APN、IL-17、TGF-β_1水平与K-L分级呈正相关(r=0.316,P=0.004;r=0.241,P=0.026;r=0.289,P=0.015),与年龄、性别、体质量指数无明显相关性(P>0.05)。结论血清APN、IL-17及TGF-β_1水平升高与老年KOA严重程度密切相关,三项联合检测对老年KOA诊断有参考价值。
Objective To investigate the correlations of the serum levels of adiponectin(APN), interleukin-17(IL-17) and transforming growth factor-β_1(TGF-β_1) with the severity of knee osteoarthritis(KOA) in elderly patients, and to evaluate their diagnostic values. Methods The serum levels of APN, IL-17 and TGF-β_1 were detected by ELISA and compared between 170 elderly patients with KOA(KOA group) and 70 healthy volunteers(control group) as well as among patients in different Kellgren-Lawrence(K-L) grades. The diagnostic values of APN, IL-17 and TGF-β_1 were analyzed by ROC curve. Pearson correlation was used to analyze the correlations of serum APN, IL-17 and TGF-β_1 levels with K-L grades. Results The levels of APN((3 162.40±418.25) μg/L), IL-17((32.75±16.38) ng/L) and TGF-β_1((54.87±13.16) μg/L) in KOA group were significantly higher than those in control group((684.72±205.63) μg/L,(15.84±8.20) ng/L,(10.42±2.63)μg/L)(P<0.05). The levels of APN, IL-17 and TGF-β_1 reduced gradually in patients in K-L grade Ⅳ, Ⅲ and Ⅱ in turn(P<0.05). When the optimal cut-off values of APN, IL-17 and TGF-β_1 were 2483.50 μg/L, 27.42 ng/L and 40.35 μg/L, the AUC of joint detection of them three was 0.960, significantly higher than that of any single detection of APN, IL-17 and TGF-β_1(0.825, 0.796, 0.863), and the sensitivity and specificity were 90.7% and 83.5%. The levels of APN, IL-17 and TGF-β_1 were positively correlated with K-L grades(r=0.316, P=0.004, r=0.241, P=0.026, r=0.289, P=0.015), and were not significantly correlated with age, gender and body mass index(P>0.05). Conclusion The elevated serum levels of APN, IL-17 and TGF-β_1 are closely correlated with the severity of KOA in the elderly, and the joint detection of them three has reference value to the diagnosis.
Objective To investigate the correlations of the serum levels of adiponectin(APN), interleukin-17(IL-17) and transforming growth factor-β_1(TGF-β_1) with the severity of knee osteoarthritis(KOA) in elderly patients, and to evaluate their diagnostic values. Methods The serum levels of APN, IL-17 and TGF-β_1 were detected by ELISA and compared between 170 elderly patients with KOA(KOA group) and 70 healthy volunteers(control group) as well as among patients in different Kellgren-Lawrence(K-L) grades. The diagnostic values of APN, IL-17 and TGF-β_1 were analyzed by ROC curve. Pearson correlation was used to analyze the correlations of serum APN, IL-17 and TGF-β_1 levels with K-L grades. Results The levels of APN((3 162.40±418.25) μg/L), IL-17((32.75±16.38) ng/L) and TGF-β_1((54.87±13.16) μg/L) in KOA group were significantly higher than those in control group((684.72±205.63) μg/L,(15.84±8.20) ng/L,(10.42±2.63)μg/L)(P<0.05). The levels of APN, IL-17 and TGF-β_1 reduced gradually in patients in K-L grade Ⅳ, Ⅲ and Ⅱ in turn(P<0.05). When the optimal cut-off values of APN, IL-17 and TGF-β_1 were 2483.50 μg/L, 27.42 ng/L and 40.35 μg/L, the AUC of joint detection of them three was 0.960, significantly higher than that of any single detection of APN, IL-17 and TGF-β_1(0.825, 0.796, 0.863), and the sensitivity and specificity were 90.7% and 83.5%. The levels of APN, IL-17 and TGF-β_1 were positively correlated with K-L grades(r=0.316, P=0.004, r=0.241, P=0.026, r=0.289, P=0.015), and were not significantly correlated with age, gender and body mass index(P>0.05). Conclusion The elevated serum levels of APN, IL-17 and TGF-β_1 are closely correlated with the severity of KOA in the elderly, and the joint detection of them three has reference value to the diagnosis.
引文
[1] ZHAN D,THUMTECHO S,TANAVALEE A,et al.Association of adiponectin gene polymorphisms with knee osteoarthritis[J].World J Orthop,2017,8(9):719-725.
[2] DUAN L,ZHANG W,ZHANG F,et al.Myrtol improves post-traumatic knee osteoarthritis by regulation of reactive oxygen species,transforming growth factor-β1 and apoptosis in a mouse model[J].Exp Ther Med,2018,15(1):393-399.
[3] VRGOC G,VRBANEC J,EFTEDAL R K,et al.Interleukin-17 and Toll-like receptor 10 genetic polymorphisms and susceptibility to large joint osteoarthritis[J].J Orthop Res,2018,36(6):1684-1693.
[4] 王强,苟海昕,曹月龙,等.膝骨关节炎X线分级与疼痛程度的相关性分析[J].中国中医骨伤科杂志,2015,23(6):18-21.
[5] 中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[6] 陈亮,刘玉杰,魏民.脂联素在膝骨关节炎患者软骨中的表达与软骨损伤程度的关系[J].中华老年多器官疾病杂志,2017,16(4):245-248.
[7] 陈墅,刘宁,周义钦,等.髌下脂肪垫在膝骨关节炎发病和进展中的作用[J].中华骨科杂志,2018,38(15):953-960.
[8] BENEDETTI G,MIOSSEC P.Interleukin-17 contributes to the chronicity of inflammatory diseases such as rheumatoid arthritis[J].Eur J Immunol,2014,44(2):339-347.
[9] LU N,LU J,ZHOU C,et al.Association between transforming growth factor-beta 1 gene single nucleotide polymorphisms and knee osteoarthritis susceptibility in a Chinese Han population[J].J Int Med Res,2017,45(5):1495-1504.
[10] CHEN B,DENG Y,TAN Y,et al.Association between severity of knee osteoarthritis and serum and synovial fluid interleukin-17 concentrations[J].J Int Med Res,2014,42(1):138-144.
[11] DELIGNE C,CASULLI S,PIGENET A,et al.Differential expression of interleukin-17 and interleukin-22 in inflamed and non-inflamed synovium from osteoarthritis patients[J].Osteoarthritis Cartilage,2015,23(11):1843-1852.
[12] 温锦益,廖子鸿,戴冠东,等.膝关节类风湿性关节炎患者关节液中脂联素水平与病情严重程度的关系[J].中国现代药物应用,2016,10(12):40-42.
[13] 王晓滨,尹自龙,薛庆云.关节液中脂联素水平与膝关节骨关节炎严重程度的相关性研究[J].中国骨与关节外科,2014,7(2):96-100.
[14] HE J,CAO W,AZEEM I,et al.Transforming growth factor β1 being considered a novel biomarker in knee osteoarthritis[J].Clin Chim Acta,2017,472(9):96-101.
[2] DUAN L,ZHANG W,ZHANG F,et al.Myrtol improves post-traumatic knee osteoarthritis by regulation of reactive oxygen species,transforming growth factor-β1 and apoptosis in a mouse model[J].Exp Ther Med,2018,15(1):393-399.
[3] VRGOC G,VRBANEC J,EFTEDAL R K,et al.Interleukin-17 and Toll-like receptor 10 genetic polymorphisms and susceptibility to large joint osteoarthritis[J].J Orthop Res,2018,36(6):1684-1693.
[4] 王强,苟海昕,曹月龙,等.膝骨关节炎X线分级与疼痛程度的相关性分析[J].中国中医骨伤科杂志,2015,23(6):18-21.
[5] 中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[6] 陈亮,刘玉杰,魏民.脂联素在膝骨关节炎患者软骨中的表达与软骨损伤程度的关系[J].中华老年多器官疾病杂志,2017,16(4):245-248.
[7] 陈墅,刘宁,周义钦,等.髌下脂肪垫在膝骨关节炎发病和进展中的作用[J].中华骨科杂志,2018,38(15):953-960.
[8] BENEDETTI G,MIOSSEC P.Interleukin-17 contributes to the chronicity of inflammatory diseases such as rheumatoid arthritis[J].Eur J Immunol,2014,44(2):339-347.
[9] LU N,LU J,ZHOU C,et al.Association between transforming growth factor-beta 1 gene single nucleotide polymorphisms and knee osteoarthritis susceptibility in a Chinese Han population[J].J Int Med Res,2017,45(5):1495-1504.
[10] CHEN B,DENG Y,TAN Y,et al.Association between severity of knee osteoarthritis and serum and synovial fluid interleukin-17 concentrations[J].J Int Med Res,2014,42(1):138-144.
[11] DELIGNE C,CASULLI S,PIGENET A,et al.Differential expression of interleukin-17 and interleukin-22 in inflamed and non-inflamed synovium from osteoarthritis patients[J].Osteoarthritis Cartilage,2015,23(11):1843-1852.
[12] 温锦益,廖子鸿,戴冠东,等.膝关节类风湿性关节炎患者关节液中脂联素水平与病情严重程度的关系[J].中国现代药物应用,2016,10(12):40-42.
[13] 王晓滨,尹自龙,薛庆云.关节液中脂联素水平与膝关节骨关节炎严重程度的相关性研究[J].中国骨与关节外科,2014,7(2):96-100.
[14] HE J,CAO W,AZEEM I,et al.Transforming growth factor β1 being considered a novel biomarker in knee osteoarthritis[J].Clin Chim Acta,2017,472(9):96-101.