褪黑素与膝骨关节炎关节结构及血清标志物的相关性研究  

Relationship between serum melatonin and joint structures and serum biomarkers in patients with knee osteoarthritis

作　　者：常冰茹 徐建华[1] 王康[1] 吴娟[1] 阮光峰 任家乐 卞福勤 丁长海[1,2] Chang Bingru;Xu Jianhua;Wang Kang(Dept of Rheumatology and Immunology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022 [2]澳大利亚塔斯马尼亚大学孟席斯医学研究所,霍巴特70000

出　　处：《安徽医科大学学报》2019年第4期646-650,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81172865)

摘　　要：目的探讨膝骨关节炎(OA)患者血清褪黑素(MT)水平和关节结构及血清标志物之间的相关性。方法入组169例膝OA患者,对患者一般情况进行问卷调查,使用磁共振对患者膝关节进行摄片,利用Osirix软件测量膝关节软骨体积,并对关节软骨缺损、软骨下骨髓损害进行评级。使用ELISA法测定患者血清MT、基质金属蛋白酶(MMP)-3、MMP-10、MMP-13、白介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、瘦素、抵抗素和脂联素水平。采用SPSS软件多元回归方法分析血清MT水平与膝OA关节结构及血清标志物的相关性。结果 (1)将患者以MT中位数(0. 91 ng/ml)水平分为两组,两组间性别、年龄、身体质量指数、关节软骨体积、关节软骨缺损、软骨下骨髓损害和血清IL-8、瘦素、脂联素、MMP-10及MMP-13水平差异均无统计学意义。在MT高水平组中,患者血清MMP-3水平更低,但血清IL-6、TNF-α和抵抗素水平更高,差异均有统计学意义(P <0. 05);(2)调整混杂因素(包括性别、年龄和身体质量指数)后,血清MT水平与MMP-3水平呈负相关性(OR=0. 55,95%CI:0. 37～0. 81,P=0. 03),血清MT水平与IL-6、TNF-α和瘦素水平呈正相关性(OR=2. 05,95%CI:1. 27～3. 29,P=0. 003; OR=2. 25,95%CI:1. 40～3. 63,P=0. 001; OR=1. 59,95%CI:1. 05～2. 42,P=0. 028),与其他血清标志物无显著相关性;(3)调整混杂因素后(包括性别、年龄和身体质量指数),血清MT水平和关节软骨体积、关节软骨缺损和软骨下骨髓损害均无显著相关性。结论血清MT水平与膝OA患者MMP-3水平呈负相关性,与血清IL-6、TNF-α和瘦素水平呈正相关性,与关节结构无相关性。结果显示MT在膝OA中可能发挥一定作用,但需要进一步临床研究证实。Objective To investigate the relationship between serum levels of melatonin(MT)and joint structures and biomarkers in patients with knee osteoarthritis(OA).Methods A total of 169 subjects with knee OA were enrolled in this study.Magnetic resonance imaging(MRI)was used to detect cartilage volume,cartilage defects and bone marrow lesions(BMLs).Serum levels of MT,matrix metalloproteinase(MMP)-3,MMP-10,MMP-13,interleukin(IL)-6,IL-8,tumor necrosis factor-alpha(TNF-α),leptin,resistin and adiponectin were measured by using ELISA.SPSS software was used to analyze the association between serum levels of MT and joint structures and biomarkers in patients with knee OA.Results Subjects were split based on the median level of MT(0.91 ng/ml).Patients with higher and lower levels of MT were similar in age,gender,body mass index(BMI),cartilage volume,cartilage defects,BMLs and levels of IL-8,leptin,adiponectin,MMP-10 and MMP-13.However,patients with higher level of MT had higher levels of IL-6,TNF-α,resistin and lower level of MMP-3(P<0.05).After adjustment for potential confounders(age,gender and body mass index),serum levels of MT were significantly and negatively associated with MMP-3(OR=0.55,95%CI:0.37~0.81,P=0.03),and were significantly and positively associated with IL-6,TNF-αand leptin(OR=2.05,95%CI:1.27~3.29,P=0.003;OR=2.25,95%CI:1.40~3.63,P=0.001;OR=1.59,95%CI:1.05~2.42,P=0.028,respectively).Serum levels of MT were not significantly associated with other biomarkers.There was no significant association between serum levels of melatonin and cartilage volume,cartilage defects and BMLs,before or after adjustment for potential confounders.Conclusion Serum levels of MT is negatively associated with MMP-3 and positively associated with IL-6,TNF-αand leptin,but not with joint structural changes.These suggest that MT may play a role in knee OA which needs to be examined by further studies.

关 键 词：骨关节炎 褪黑素 软骨 炎症因子 脂肪因子 

分 类 号：R684.3[医药卫生—骨科学]