抵抗素水平与股骨头坏死塌陷进程的相关性
|
摘要
目的比较不同分期的股骨头坏死患者的血清抵抗素水平,探究抵抗素水平与股骨头坏死塌陷进程的相关性。方法选取88例股骨头坏死患者(实验组,ARCO分期Ⅱ期26例、Ⅲ期34例、Ⅳ期28例)和50例健康成年人(对照组),收集实验组患者的影像资料,按国际骨循环协会ARCO标准分为ARCOⅡ期、ARCOⅢ期、ARCOⅣ期。使用ELISA检测所有患者的血清抵抗素水平,运用统计学方法分析比较不同ARCO分期、不同坏死原因及塌陷前后两组试验对象血清中抵抗素水平的差异。结果 (1)实验组患者血清的抵抗素浓度水平高于对照组(P=0.026);(2)与对照组相比,实验组ARCOⅢ期、ARCOⅣ期患者的血清抵抗素水平显著升高(P=0.001);(3)在实验组中,ARCOⅡ期患者的抵抗素水平与ARCOⅢ期、ARCOⅣ期患者相比具有明显差异(P=0.000),ARCOⅢ期、ARCOⅣ期患者的抵抗素水平均高于ARCOⅡ期,血清抵抗素水平在股骨头坏死塌陷后呈升高趋势,ARCOⅢ期、ARCOⅣ期患者相比差异无统计学意义(P> 0.05);(4)抵抗素水平在酒精性、药物性、特发性、创伤性股骨头坏死患者的表达未见明显差异;(5)ROC分析提示血清抵抗素水平在诊断股骨头坏死塌陷存在一定的敏感性和特异性(分别为77.4%、61.5%)。结论抵抗素与股骨头坏死塌陷进程密切相关,抵抗素水平在股骨头坏死塌陷后明显升高,可为股骨头坏死后塌陷的临床诊断提供参考。
Objective We aimed to explor the correlation between the serum resistin levels and the collapse process of femoral head necrosis. Methods Eighty-eight patients with osteonecrosis of the femoral head were included in this study(26,34 and 28 cases at ARCO stage Ⅱ,Ⅲ and Ⅳ, respectively). Fifty healthy controls were enrolled. The serum resistin levels were detected with ELISA method. We compared the serum resistin levels between the patient group and control group. The differences of serum resistin levels between different ARCO stagesand various disease causes were analyzed in the patient group. Results The resistin levels were significantly higher in patients with osteonecrosis of the femoral than healthy control group(P = 0.026). Compared with control group, the resistin levels significantly increased in patients at ARCO stage Ⅲ and ARCO stage Ⅳ respectively(P = 0.001).The resistin levels of procollapse group(ARCO stage Ⅲ and Ⅳ) were significantly higher than that of precollapse group(ARCO stage Ⅱ)(P = 0.000). There was no statistic difference between ARCO stage Ⅲ andⅣ in resistin levels(P > 0.05). No statistical significance was found between different disease causes. ROC curve analysis of resisrin level indicated theertain accuracy(AUC = 0.749),sensitivity and significant specificity(77.4%, 61.5%, respectively) in the diagnosis of femoral head necrosis. Conclusions Resistin is closely related to the collapse process of femoral head necrosis. The level of resistin was significantly increased after the collapse of femoral head, which could be useful for the clinical diagnosis of the collapse of femoral head necrosis.
Objective We aimed to explor the correlation between the serum resistin levels and the collapse process of femoral head necrosis. Methods Eighty-eight patients with osteonecrosis of the femoral head were included in this study(26,34 and 28 cases at ARCO stage Ⅱ,Ⅲ and Ⅳ, respectively). Fifty healthy controls were enrolled. The serum resistin levels were detected with ELISA method. We compared the serum resistin levels between the patient group and control group. The differences of serum resistin levels between different ARCO stagesand various disease causes were analyzed in the patient group. Results The resistin levels were significantly higher in patients with osteonecrosis of the femoral than healthy control group(P = 0.026). Compared with control group, the resistin levels significantly increased in patients at ARCO stage Ⅲ and ARCO stage Ⅳ respectively(P = 0.001).The resistin levels of procollapse group(ARCO stage Ⅲ and Ⅳ) were significantly higher than that of precollapse group(ARCO stage Ⅱ)(P = 0.000). There was no statistic difference between ARCO stage Ⅲ andⅣ in resistin levels(P > 0.05). No statistical significance was found between different disease causes. ROC curve analysis of resisrin level indicated theertain accuracy(AUC = 0.749),sensitivity and significant specificity(77.4%, 61.5%, respectively) in the diagnosis of femoral head necrosis. Conclusions Resistin is closely related to the collapse process of femoral head necrosis. The level of resistin was significantly increased after the collapse of femoral head, which could be useful for the clinical diagnosis of the collapse of femoral head necrosis.
引文
[1]CHOI H R,STEINBERG M E,CHENG E Y.Osteonecrosis of the femoral head:diagnosis and classification systems[J].Curr Rev Musculoskelet Med,2015,8(3):210-220.
[2]CHEN W M.Osteonecrosis of the femoral head:surgical perspective[J].Formosan J Surg,2011,4(44):131-135.
[3]KUBO T,UESHIMA K,SAITO M,et al.Clinical and basic research on steroid-induced osteonecrosis of the femoral head in Japan[J].J Orthop Sci,2016,21(4):407-413.
[4]任毅,左之才,万涛梅.抵抗素在胰岛素抵抗中的作用机制及其受体信号通路研究进展[J].生理学报,2016,1(68):65-74.
[5]CALVET J,ORELLANA C,GRATACóS J,et al.Synovial fluid adipokines are associated with clinical severity in knee osteoarthritis:a cross-sectional study in female patients with joint effusion[J].Arthritis Res Ther,2016,18(1):207.
[6]NISHIMUTA J F,LEVENSTON M E.Meniscus is more susceptible than cartilage to catabolic and anti-anabolic effects of adipokines[J].Osteoarthritis Cartilage,2015,23(9):1551-1562.
[7]GAN S D and PATEL K R,Enzyme Immunoassay and EnzymeLinked Immunosorbent Assay.J Invest Dermatol,2013,133(9):1-3.
[8]SONG Y,DU Z,REN M,et al.Association of gene variants of transcription factors PPARγ,RUNX2,Osterix genes and COL2A1,IGFBP3 genes with the development of osteonecrosis of the femoral head in Chinese population[J].Bone,2017,101:104-112.
[9]谢林,王坤正.骨、脂肪、神经三者相互作用在激素性股骨头坏死中作用的探讨[J].中华关节外科杂志(电子版),2013,6(7):390-392.
[10]BERNER H S,LVNGSTADAAS S P,SPAHR A,et al.Adiponectin and its receptors are expressed in bone-forming cells.[J]Bone,2004,35:842-849.
[11]LEE Y J,PARK J H,JU S K,et al.Leptin receptor isoform expression in rat osteoblasts and their functional analysis.[J]FEBS Lett,2002,528(1-3):43-47.
[12]SCOTECE M,CONDE J,GóMEZ R,et al.Beyond Fat Mass:Exploring the Role of Adipokines in Rheumatic Diseases[J].Scient World J,2011,11:1932-1947.
[13]郭万首.股骨头坏死早期的关节软骨改变[D].中国协和医科大学,2008.
[14]JUNKER S,FROMMER K,KRUMBHOLZ G,et al.Expression of adipokines in osteoarthritis osteophytes and their effect on osteoblasts[J].Matrix Biology,2017,62:75-91.
[15]ASHLEIGH M,REBECCA L,LIAM M,et al.Resistin promotes the abnormal Type I collagen phenotype of subchondral bone in obese patients with end stage hip osteoarthritis[J].Sci Rep,2017,7(1):4042.
[16]KLEMETTILA J P,KAMPMAN O,SEPPALA N,et al.Resistin as an inflammatory marker in patients with schizophrenia treated with clozapine[J].Nord J Psychiatry,2017,71(2):89-95.
[17]陈雷雷.股骨头坏死ARCOⅢ期软骨病变研究及证型相关性分析[D].广州中医药大学,2012.
[18]WANG A,REN M,WANG J.The pathogenesis of steroid-induced osteonecrosis of the femoral head:A systematic review of the literature[J].Gene,2018,671:103-109.
[19]PIUZZI N S,CHAHLA J,SCHROCK J B,et al.Evidence for the Use of Cell-Based Therapy for the Treatment of Osteonecrosis of the Femoral Head:A Systematic Review of the Literature[J].J Arthroplasty,2017,32(5):1698-708.
[20]ZHOU L,JANG K Y,MOON Y J,et al.Leptin ameliorates ischemic necrosis of the femoral head in rats with obesity induced by a high-fat diet[J].Sci Rep,2015,5(1):9397.
[21]ZHANG H,XIAO F,LIU Y,et al.A higher frequency of peripheral blood activated B cells in patients with non-traumatic osteonecrosis of the femoral head[J].Int Immunopharmacol,2014,20(1):95-100.
[2]CHEN W M.Osteonecrosis of the femoral head:surgical perspective[J].Formosan J Surg,2011,4(44):131-135.
[3]KUBO T,UESHIMA K,SAITO M,et al.Clinical and basic research on steroid-induced osteonecrosis of the femoral head in Japan[J].J Orthop Sci,2016,21(4):407-413.
[4]任毅,左之才,万涛梅.抵抗素在胰岛素抵抗中的作用机制及其受体信号通路研究进展[J].生理学报,2016,1(68):65-74.
[5]CALVET J,ORELLANA C,GRATACóS J,et al.Synovial fluid adipokines are associated with clinical severity in knee osteoarthritis:a cross-sectional study in female patients with joint effusion[J].Arthritis Res Ther,2016,18(1):207.
[6]NISHIMUTA J F,LEVENSTON M E.Meniscus is more susceptible than cartilage to catabolic and anti-anabolic effects of adipokines[J].Osteoarthritis Cartilage,2015,23(9):1551-1562.
[7]GAN S D and PATEL K R,Enzyme Immunoassay and EnzymeLinked Immunosorbent Assay.J Invest Dermatol,2013,133(9):1-3.
[8]SONG Y,DU Z,REN M,et al.Association of gene variants of transcription factors PPARγ,RUNX2,Osterix genes and COL2A1,IGFBP3 genes with the development of osteonecrosis of the femoral head in Chinese population[J].Bone,2017,101:104-112.
[9]谢林,王坤正.骨、脂肪、神经三者相互作用在激素性股骨头坏死中作用的探讨[J].中华关节外科杂志(电子版),2013,6(7):390-392.
[10]BERNER H S,LVNGSTADAAS S P,SPAHR A,et al.Adiponectin and its receptors are expressed in bone-forming cells.[J]Bone,2004,35:842-849.
[11]LEE Y J,PARK J H,JU S K,et al.Leptin receptor isoform expression in rat osteoblasts and their functional analysis.[J]FEBS Lett,2002,528(1-3):43-47.
[12]SCOTECE M,CONDE J,GóMEZ R,et al.Beyond Fat Mass:Exploring the Role of Adipokines in Rheumatic Diseases[J].Scient World J,2011,11:1932-1947.
[13]郭万首.股骨头坏死早期的关节软骨改变[D].中国协和医科大学,2008.
[14]JUNKER S,FROMMER K,KRUMBHOLZ G,et al.Expression of adipokines in osteoarthritis osteophytes and their effect on osteoblasts[J].Matrix Biology,2017,62:75-91.
[15]ASHLEIGH M,REBECCA L,LIAM M,et al.Resistin promotes the abnormal Type I collagen phenotype of subchondral bone in obese patients with end stage hip osteoarthritis[J].Sci Rep,2017,7(1):4042.
[16]KLEMETTILA J P,KAMPMAN O,SEPPALA N,et al.Resistin as an inflammatory marker in patients with schizophrenia treated with clozapine[J].Nord J Psychiatry,2017,71(2):89-95.
[17]陈雷雷.股骨头坏死ARCOⅢ期软骨病变研究及证型相关性分析[D].广州中医药大学,2012.
[18]WANG A,REN M,WANG J.The pathogenesis of steroid-induced osteonecrosis of the femoral head:A systematic review of the literature[J].Gene,2018,671:103-109.
[19]PIUZZI N S,CHAHLA J,SCHROCK J B,et al.Evidence for the Use of Cell-Based Therapy for the Treatment of Osteonecrosis of the Femoral Head:A Systematic Review of the Literature[J].J Arthroplasty,2017,32(5):1698-708.
[20]ZHOU L,JANG K Y,MOON Y J,et al.Leptin ameliorates ischemic necrosis of the femoral head in rats with obesity induced by a high-fat diet[J].Sci Rep,2015,5(1):9397.
[21]ZHANG H,XIAO F,LIU Y,et al.A higher frequency of peripheral blood activated B cells in patients with non-traumatic osteonecrosis of the femoral head[J].Int Immunopharmacol,2014,20(1):95-100.