血清OPG、RANKL及白介素-34在克罗恩病患者骨代谢中的相关分析  

Relationship among OPG,RANKL and interleukin-34 in bone metabolism in patients with Crohn’s disease

作　　者：严淑[1] 苗鲁杰 汪良芝[1] YAN Shu;MIAO Lujie;WANG Liangzhi(Department of General Practice,The Third Hospital Affiliated to Medical College of Soochow University,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院全科医学科,江苏常州213003 [2]苏州大学附属第三医院消化内科,江苏常州213003

出　　处：《实用医学杂志》2018年第21期3589-3592,共4页The Journal of Practical Medicine

基　　金：常州市卫生人才培养工程资助项目(编号:2016CZBJ019)

摘　　要：目的探讨克罗恩病(CD)患者外周血细胞核因子-κB受体活化因子配体(RANKL)、骨保护素(OPG)及白介素(IL)-34的水平在CD患者骨代谢中的意义及相关性。方法收集34例CD患者的临床资料和健康对照组30例,采用ELISA方法测定外周血清OPG、RANKL及IL-34水平,双能X线骨密度仪(DEXA)测量骨密度(BMD),分析上述指标的关系及与BMD的相关性。结果 34例CD患者中16例(47.1%)骨量正常,13例(38.2%)骨量减少,5例(14.7%)骨质疏松。CD患者股骨颈及腰椎骨密度T值明显低于对照组[(-0.80±1.04)vs(0.17±1.02)、(-0.74±1.02)vs(0.20±1.01),P <0.01]。CD患者外周血OPG、RANKL及IL-34平显著高于对照组,差异有统计学意义(P <0.01)。在CD骨质疏松组中OPG、RANKL及IL-34水平显著高于骨量正常组,差异有统计学意义(P <0.01),骨质疏松组OPG及IL-34水平较骨量减少组升高,差异有统计学意义(P <0.05),RANKL水平仅高于骨量正常组,与骨量减少组比较,差异无统计学意义(P> 0.05)。相关分析显示,CD患者中IL-34与RANKL呈正相关,IL-34及RANKL水平与骨密度呈负相关,OPG与骨密度无相关性。结论 CD患者较正常人群易发生骨质疏松,IL-34在CD合并骨疏松患者中明显升高,与OPG、RANKL系统可能参与CD骨量丢失的过程。Objective To study the relationship among OPG,RANKL,interleukin-34 and bone mineral density in patients with Crohn??s disease(CD).Methods A total of thirty-four CD patients(CD group)and 30 healthy volunteers(control group)were enrolled.Serum levels of OPG,RANKL and IL-34 were determined using the ELISA method and bone mineral density(BMD)was measured by dual energy X-ray absorptiometry(DEXA).Result(1)Sixteen(47.1%)patients had normal bone mass,13(38.2%)osteopenia and 5(14.7%)osteoprosis in 34 CD patients.T-scores of femoral neck and lumbar spine in CD patients were obviously lower than those in the control group[(-0.80±1.04)vs(0.17±1.02),(-0.74±1.02)vs(0.21±1.01),P<0.01].(2)The serum levels of OPG,RANKL and IL-34 concentrations were significantly higher in CD patients when compared with those of controls(P<0.01).(3)The serum levels of OPG,RANKL and IL-34 were significantly higher in osteoporosis patients when compared with those in CD patients with normal BMD,and the levels of OPG and IL-34 in osteoporosis patients were significantly higher when compared with those in osteopenia patients.The levels of the RANKL in osteoporosis patients were higher than those in patients with normal BMD,but no statistical significance was found in osteoporosis patients and osteopenia patients.(4)Significant positive correlation was found between IL-34 and RANKL,and they both were significantly negatively correlated with BMD but no association was observed between OPG and BMD.Conclusion The incidence of osteopenia and osteoporosis in CD patients is high.The increased IL-34 and OPG/RANKL seem to be connected with the pathology of decreased BMD in CD.

关 键 词：克罗恩病 骨质疏松 IL-34 核因子-ΚB受体活化因子配体 骨保护素 

分 类 号：R574.62[医药卫生—消化系统] R580[医药卫生—内科学]