摘要
目的研究脂肪细胞因子和炎症因子对膝骨关节炎关节结构、骨密度的影响及与实验室指标的相关性。方法选取2022年3月-2023年2月在我院诊治的60例膝骨关节炎患者为研究对象,观察不同关节结构、骨密度、性别、身体质量指数(BMI)膝骨关节炎患者脂肪细胞因子[瘦素(LPT)、脂联素(ADP)、抵抗素(RST)]和炎症因子[白介素6(IL-6)、白介素17(IL-17)、白介素23(IL-23)]水平,采用Logistic多因素回归分析影响血清LPT、ADP、RST、IL-6、IL-17、IL-23的危险因素以及血清LPT、ADP、RST、IL-6、IL-17、IL-23水平与患者临床、实验室指标[性别、年龄、病程、腰臀比、BMI、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、骨关节炎指数(WOMAC总分)、膝骨关节炎严重程度(Lequesne)指数]的相关性。结果K-L分级2级、3级、4级的患者血清LPT、ADP、RST、IL-6、IL-17、IL-23水平比较,差异无统计学意义(P>0.05);骨密度正常组、减少组、疏松组的患者RST、IL-6、IL-17、IL-23水平比较,差异无统计学意义(P>0.05),骨质疏松组LPT、ADP高于骨密度正常组(P<0.05),但骨密度减少组LPT、ADP与疏松组比较,差异无统计学意义(P>0.05);男性血清LPT、IL-6水平高于女性(P<0.05),男性血清ADP、RST、IL-17、IL-23与女性比较,差异无统计学意义(P>0.05);Logistic多因素回归分析显示,BF%、TC、年龄是LPT的影响因素,HDL是ADP的影响因素,WOMAC、Lequesne是RST的影响因素,性别、腰臀比是IL-6的影响因素,WOMAC是IL-17、IL-23的影响因素(P<0.05);血清LPT与性别、腰臀比、BMI、体脂BF%、TC呈正相关(P<0.05),ADP与TG呈负相关,RST与HDL呈正相关(P<0.05);IL-6与性别、体脂BF%、TG呈负相关,IL-23与WOMAC呈正相关(P<0.05);LPT、ADP、RST、IL-6、IL-17、IL-23与年龄、病程、Lequesne指数无明显相关性(P>0.05)。结论脂肪细胞因子和炎症因子参与膝骨关节炎的发生、发展,其中LPT、ADP可能对骨密度有损害,LPT、IL-6对关节结构可能有损害。同时体脂BF%、腰臀比随关节K-L分级加重而增高,且性别、肥胖与膝骨关节炎的发生具有密切的关系。
Objective To study the effects of adipocytokines and inflammatory factors on joint structure and bone mineral density of knee osteoarthritis and their correlation with laboratory indexes.Methods Sixty patients with knee osteoarthritis diagnosed and treated in our hospital from March 2022 to February 2023 were selected as the research objects.The levels of adipocytokines[leptin(LPT),adiponectin(ADP),resistin(RST)]and inflammatory factors[interleukin 6(IL-6),interleukin 17(IL-17),interleukin 23(IL-23)]in patients with knee osteoarthritis of different joint structures,bone mineral density,gender and body mass index(BMI)were observed.Logistic multivariate regression analysis was used to analyze the risk factors affecting serum LPT,ADP,RST,IL-6,IL-17,IL-23,and the correlation between serum LPT,ADP,RST,IL-6,IL-17,IL-23 levels and clinical and laboratory indicators[gender,age,course of disease,waist-to-hip ratio,BMI,total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL),osteoarthritis index(WOMAC total score),knee osteoarthritis severity(Lequesne)index].Results There was no significant difference in serum LPT,ADP,RST,IL-6,IL-17 and IL-23 levels among patients with K-L grade 2,grade 3 and grade 4(P>0.05).There was no significant difference in the levels of RST,IL-6,IL-17 and IL-23 among the normal bone mineral density group,the reduction group and the osteoporosis group(P>0.05).The levels of LPT and ADP in the osteoporosis group were higher than those in the normal bone mineral density group(P<0.05),however,there was no significant difference in LPT and ADP between the bone mineral density reduction group and the osteoporosis group(P>0.05).The levels of serum LPT and IL-6 in males were higher than those in females(P<0.05),but there was no significant difference in serum ADP,RST,IL-17 and IL-23 between males and females(P>0.05).Logistic multivariate regression analysis showed that BF%,TC and age were the influencing factors of LPT,HDL was the influencing factor of ADP,WOMAC and Lequesne were the influencing factors of RST,gender and waist-hip ratio were the influencing factors of IL-6,WOMAC was the influencing factors of IL-17 and IL-23(P<0.05).Serum LPT was positively correlated with gender, waist-to-hip ratio, BMI, BF%, TC(P<0.05), ADP was negatively correlated with TG, and RST was positively correlated with HDL (P<0.05). IL-6 was negatively correlated with gender, BF% and TG, and IL-23 was positively correlated with WOMAC (P<0.05). There was no significant correlation between LPT, ADP, RST, IL-6, IL-17, IL-23 and age, course of disease, Lequesne index (P>0.05). Conclusion Adipocytokines and inflammatory factors are involved in the occurrence and development of knee osteoarthritis. LPT and ADP may damage bone mineral density, and LPT and IL-6 may damage joint structure. At the same time, body fat BF% and waist-to-hip ratio increased with the aggravation of joint K-L classification, and gender and obesity were closely related to the occurrence of knee osteoarthritis.
作者
艾尼·买买提
巴吾东·买合苏木
颜飞华
Aini·Maimaiti;Bawudong·Maihesumu;YAN Feihua(Department of Joint and Orthopaedics,the First People's Hospital of Kashi Region,Kashi 844000,Xinjiang,China)
出处
《医学信息》
2025年第10期81-85,共5页
Journal of Medical Information
关键词
脂肪细胞因子
炎症因子
膝骨关节炎
关节结构
骨密度
Adipocytokines
Inflammatory factors
Knee osteoarthritis
Joint structure
Bone mineral density
作者简介
艾尼·买买提(1988.11-),新疆喀什人,硕士,主治医师,主要从事骨与关节疾病的外科治疗研究;通讯作者:颜飞华(1972.12-),男,湖南涟源人,本科,主任医师,主要从事骨与关节疾病的外科治疗及关节置换研究。
