中国骨与关节外科
中國骨與關節外科
중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2014年
2期
96-100
,共5页
脂联素%疾病严重程度%骨关节炎%滑液
脂聯素%疾病嚴重程度%骨關節炎%滑液
지련소%질병엄중정도%골관절염%활액
Adiponectin%Disease severity%Osteoarthritis,synovial fluid
背景：众所周知，肥胖是引起骨关节炎发生、发展的危险因素之一。肥胖人群容易发生关节炎的原因是超载作用和代谢因素。脂肪组织是一个活跃的器官，它的分泌脂肪细胞因子包括脂联素进入全身循环，参与了骨关节炎的发病。<br> 目的：测量骨关节炎患者血清和关节滑液中脂联素水平，分析其与膝关节骨关节炎严重程度的相关性。<br> 方法：64例膝关节骨关节炎患者（关节炎组）和19例因半月板或韧带损伤患者（对照组，行关节镜检查后排除软骨损伤）被纳入本研究。采用Kellgren-Lawrence（KL）标准对关节炎患者的膝关节前后位X线片进行评估分级。使用酶联免疫吸附试验检测脂联素在对照组和关节炎组患者血清和关节滑液中的表达水平。使用WOMAC量表（Western On-tario and McMaster Universities Arthritis Index）评估患者膝关节功能。<br> 结果：骨关节炎组患者血清中的脂联素水平[（6177.8±991.0）ng/ml]高于对照组[（5793.4±673.3）ng/ml]，但差异无统计学意义（P=0.12）。但在骨关节炎组患者，血清中的脂联素浓度[（6177.8±991.0）ng/ml]显著高于关节滑液中的脂联素[（824.3±304.7）ng/ml，P<0.001）。关节炎患者关节液中脂联素浓度与评估疾病的严重程度呈负相关（r=-0.51，P<0.001），但血清脂联素浓度与疾病的严重程度关联不显著（r=-0.17，P=0.18）。血清脂联素水平、滑膜液脂联素水平与MOMAC疼痛评分均不显著相关（r=-0.01和r=-0.13，P＞0.05）。<br> 结论：骨关节炎患者滑膜液中脂联素水平与膝关节炎严重程度呈负相关。检测关节滑液中的脂联素可能有助于早期发现关节炎。
揹景：衆所週知，肥胖是引起骨關節炎髮生、髮展的危險因素之一。肥胖人群容易髮生關節炎的原因是超載作用和代謝因素。脂肪組織是一箇活躍的器官，它的分泌脂肪細胞因子包括脂聯素進入全身循環，參與瞭骨關節炎的髮病。<br> 目的：測量骨關節炎患者血清和關節滑液中脂聯素水平，分析其與膝關節骨關節炎嚴重程度的相關性。<br> 方法：64例膝關節骨關節炎患者（關節炎組）和19例因半月闆或韌帶損傷患者（對照組，行關節鏡檢查後排除軟骨損傷）被納入本研究。採用Kellgren-Lawrence（KL）標準對關節炎患者的膝關節前後位X線片進行評估分級。使用酶聯免疫吸附試驗檢測脂聯素在對照組和關節炎組患者血清和關節滑液中的錶達水平。使用WOMAC量錶（Western On-tario and McMaster Universities Arthritis Index）評估患者膝關節功能。<br> 結果：骨關節炎組患者血清中的脂聯素水平[（6177.8±991.0）ng/ml]高于對照組[（5793.4±673.3）ng/ml]，但差異無統計學意義（P=0.12）。但在骨關節炎組患者，血清中的脂聯素濃度[（6177.8±991.0）ng/ml]顯著高于關節滑液中的脂聯素[（824.3±304.7）ng/ml，P<0.001）。關節炎患者關節液中脂聯素濃度與評估疾病的嚴重程度呈負相關（r=-0.51，P<0.001），但血清脂聯素濃度與疾病的嚴重程度關聯不顯著（r=-0.17，P=0.18）。血清脂聯素水平、滑膜液脂聯素水平與MOMAC疼痛評分均不顯著相關（r=-0.01和r=-0.13，P＞0.05）。<br> 結論：骨關節炎患者滑膜液中脂聯素水平與膝關節炎嚴重程度呈負相關。檢測關節滑液中的脂聯素可能有助于早期髮現關節炎。
배경：음소주지，비반시인기골관절염발생、발전적위험인소지일。비반인군용역발생관절염적원인시초재작용화대사인소。지방조직시일개활약적기관，타적분비지방세포인자포괄지련소진입전신순배，삼여료골관절염적발병。<br> 목적：측량골관절염환자혈청화관절활액중지련소수평，분석기여슬관절골관절염엄중정도적상관성。<br> 방법：64례슬관절골관절염환자（관절염조）화19례인반월판혹인대손상환자（대조조，행관절경검사후배제연골손상）피납입본연구。채용Kellgren-Lawrence（KL）표준대관절염환자적슬관절전후위X선편진행평고분급。사용매련면역흡부시험검측지련소재대조조화관절염조환자혈청화관절활액중적표체수평。사용WOMAC량표（Western On-tario and McMaster Universities Arthritis Index）평고환자슬관절공능。<br> 결과：골관절염조환자혈청중적지련소수평[（6177.8±991.0）ng/ml]고우대조조[（5793.4±673.3）ng/ml]，단차이무통계학의의（P=0.12）。단재골관절염조환자，혈청중적지련소농도[（6177.8±991.0）ng/ml]현저고우관절활액중적지련소[（824.3±304.7）ng/ml，P<0.001）。관절염환자관절액중지련소농도여평고질병적엄중정도정부상관（r=-0.51，P<0.001），단혈청지련소농도여질병적엄중정도관련불현저（r=-0.17，P=0.18）。혈청지련소수평、활막액지련소수평여MOMAC동통평분균불현저상관（r=-0.01화r=-0.13，P＞0.05）。<br> 결론：골관절염환자활막액중지련소수평여슬관절염엄중정도정부상관。검측관절활액중적지련소가능유조우조기발현관절염。
Background:Obesity is a well-known risk factor for the development and the progression of osteoarthritis. The overloading and metabolic factors may contribute to the high prevalence of osteoarthritis among obese individuals. Adipose tissue is an active organ that secrets adipokines into the systemic circulation. Among these, adiponectin has been implicated in the pathogenesis of osteoarthritis. <br> Objective:To investigate the correlation between adiponectin concentrations in plasma and synovial fluid and knee osteoar-thritis severity. <br> Methods:Sixty-four osteoarthritis patients and nineteen controls (meniscus or ligament injury without cartilage injury under arthroscopy) were enrolled in this study. The progression of osteoarthritis was classified by Kellgren-Lawrence grading scale by evaluating X-ray changes observed in anteroposterior knee radiography. Western Ontario and McMaster Universi-ties Arthritis Index (WOMAC) was used to rate knee function. The concentrations of adiponectin in plasma and synovial flu-id were determined by commercial enzyme-linked immunosorbent assay. <br> Results:Plasma levels of adiponectin were higher in osteoarthritis patients as compared with the controls, but there were no significant difference between them ([6177.8±991.0] ng/ml vs [5793.4±673.3] ng/ml, P=0.12). Adiponectin levels in plasma of osteoarthritis patients were significantly higher with regard to paired synovial fluid ([6177.8 ± 991.0] ng/ml vs [824.3 ± 304.7] ng/ml, P<0.001). The concentration of adiponectin of synovial fluid was negatively correlated wtih the severity of osteoarthritis (r=-0.51, P<0.001), while plasma adiponectin concentration was not correated to the severity of osteoarthri-tis(r=-0.17, P=0.18). Neither adiponectin of synovial fluid nor plasma adiponectin were correlated with WOMAC score (r=-0.13, r=-0.01, P>0.05). <br> Conclusions:The concentration of leptin of synovial fluid were is closely related to the radiographic severity of osteoarthri tis. Therefore, it is recommanded that adiponectin of synovial fluid can be used as an effective marker for early detection of osteoarthritis.
