血清瘦素、骨保护素与特发性股骨头坏死相关性研究  

Research on the correlation between serum leptin and osteoprotegerin with idiopathic femoral head necrosis

作　　者：陆万里 李同林[1] 卞恒杰 周飞[1] 王睿[1] LU Wanli;LI Tonglin;BIAN Hengjie;ZHOU Fei;WANG Rui(Orthopedics Department,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210014,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院骨科,江苏南京210014

出　　处：《中国医药科学》2020年第21期18-22,共5页China Medicine And Pharmacy

基　　金：江苏省南京市科技发展计划项目(201605057)。

摘　　要：目的探讨血清瘦素、骨保护素水平与特发性股骨头坏死的相关性及其意义。方法纳入2017年1月~2019年12月于南京中医药大学附属南京市中西医结合医院骨科住院治疗的特发性股骨头坏死患者61例作为试验组。同期选择61名年龄(±1岁)、性别、BMI(±1kg/m2)与试验组配对的健康体检者作为对照组。入组者采集空腹静脉血样,检测血清瘦素和骨保护素水平并进行分析。结果试验组患者血清瘦素值为11.86(4.76~24.39)ng/mL,显著高于对照组的4.37(2.64~11.05)ng/mL(P=0.000);试验组患者血清骨保护素值为0.39(0.25~0.56)ng/mL,高于对照组的0.26(0.23~0.37)ng/mL(P=0.000)。特发性股骨头坏死ARCO分型IV期患者血清瘦素值为17.69(12.69~34.88)ng/mL,显著高于Ⅲ期患者血清瘦素值的5.50(3.25~9.49)ng/mL(P=0.000),且血清瘦素值与股骨头坏死分期呈正相关(r=0.583,P=0.000)。试验组及对照组血清瘦素值均与其BMI值呈正相关(P<0.05);试验组血清骨保护素值与其年龄呈正相关(P=0.000),与其BMI值呈负相关(P=0.015),差异有统计学意义。ROC曲线分析示血清瘦素、骨保护素在诊断特发性股骨头坏死时具有一定的敏感性和特异性(P=0.001)。结论瘦素、骨保护素在骨代谢中起到重要的作用。在特发性股骨头坏死患者体内,血清瘦素、骨保护素呈高表达状态,其参与股骨头坏死病理进程,并起到关键性的作用,可作为治疗股骨头坏死的潜在靶点。Objective To investigate the correlation between serum leptin and osteoprotegerin(OPG)levels with idiopathic femoral head necrosis.Methods A total of 61 patients with idiopathic femoral head necrosis admitted to the Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January 2017 to December 2019 were included as the experimental group.At the same time,healthy people with age(±1 year),sex and BMI(±1 kg/m2)matched with the experimental group were selected as the control group(n=61).Blood samples were collected from fasting vein to detect and analyze the serum leptin and OPG levels.Results Serum leptin level in the experimental group was 11.86(4.76~24.39)ng/mL,which was significantly higher than 4.37(2.64~11.05)ng/mL in the control group(P=0.000).The serum OPG level in the experimental group was 0.39(0.25~0.56)ng/mL,which was higher than 0.26(0.23~0.37)ng/mL in the control group(P=0.000).Serum leptin level in patients in stage IV of ARCO type of idiopathic femoral head necrosis was 17.69(12.69~34.88)ng/mL,which was significantly higher than 5.50(3.25~9.49)ng/mL in patients in stageⅢ(P=0.000),and serum leptin concentration level was positively correlated with the stage of femoral head necrosis(r=0.583,P=0.000).Serum leptin level was positively correlated with BMI in both the experimental group and the control group(P<0.05).The serum OPG level in the experimental group was positively correlated with age(P=0.000),and negatively correlated with BMI(P=0.015),with statistically significant differences.ROC curve analysis showed that serum leptin and OPG were of certain sensitivity and specificity in the diagnosis of idiopathic femoral head necrosis(P=0.001).Conclusion Leptin and OPG play an important role in bone metabolism.In patients with idiopathic femoral head necrosis,serum leptin and OPG are highly expressed,which participates in the pathological process of femoral head necrosis and plays a key role,and may be a potential target for the t

关 键 词：特发性股骨头坏死 瘦素 骨保护素 OPG/RANKL/RANK信号通路 

分 类 号：R274.9[医药卫生—中西医结合]