血清MMP-3、MMP-9、MMP-13及DAS28、NFCS评分与老年类风湿关节炎患者骨质疏松发生风险的相关性研究  

The correlation between serum MMP-3,MMP-9,MMP-13,DAS28,NFCS scores and the risk of osteoporosis in elderly patients with rheumatoid arthritis

作　　者：张彦[1] 蒋琳 李梦婷[1] 顾怡 ZHANG Yan;JIANG Lin;LI Mengting;GU Yi(Department of Rheumatology,Jiangsu University Affiliated Aoyang Hospital,Zhangjiagang 215600,China)

机构地区：[1]江苏大学附属澳洋医院风湿科,张家港215600

出　　处：《国际免疫学杂志》2024年第4期370-377,共8页International Journal of Immunology

基　　金：江苏省社会发展重点资助项目(BE2020680)。

摘　　要：目的探讨血清基质金属蛋白酶-3(matrix metalloproteinase-3, MMP-3)、基质金属蛋白酶-9(matrix metalloproteinase-9, MMP-9)、基质金属蛋白酶-13(matrix metalloproteinase-13, MMP-13)水平及28个关节疾病活动度评分(disease activity score, DAS28)、甲襞微循环积分(nailfold capillaroscopic score, NFCS)与老年类风湿关节炎(rheumatoid arthritis, RA)患者骨质疏松症(osteoporosis, OP)发生风险的相关性。方法选取2019年1月至2022年11月于江苏大学附属澳洋医院收治的老年RA患者120例, 根据是否合并OP将其分为OP组(67例)和非OP组(53例)。比较OP组与非OP组血清MMP-3、MMP-9、MMP-13水平及DAS28、NFCS评分等临床资料, 采用多因素Logistic回归模型分析血清MMP-3、MMP-9、MMP-13水平及DAS28、NFCS评分与老年RA患者发生OP风险的关系。结果 OP组病程长于非OP组[年:(11.38±1.89)比(6.97±1.15), t=14.93, P<0.05], 体质量指数(body mass index, BMI)、25-羟维生素D[25(OH)D]低于非OP组[ kg/m2:(22.35±2.30)比(25.71±2.79);ng/mL:(12.34±2.05)比(16.40±2.72 ), t值分别为7.23、9.32, P值均<0.05], 使用糖皮质激素史占比和DAS28、NFCS、类风湿因子(rheumatoid factor, RF)、MMP-3、MMP-9、MMP-13高于非OP组[例:25比10;分:(6.81±1.13)比(5.13±0.85);(7.60±1.25)比(3.74±0.62);IU/mL:(93.20±15.53)比(60.54±10.09);ng/mL:(289.60±13.30)比(157.43±10.24);ng/mL:(710.60±118.54)比(413.30±68.00);(44.26±1.25)比(27.10±1.44) , χ^(2)/t值分别为4.87、8.99、20.56、13.38、59.68、16.26、69.82, P值均<0.05]。非条件逐步多因素Logistic回归分析结果:病程≥9年、使用糖皮质激素史、DAS28评分≥6.10分、NFCS积分≥6.00分、RF≥79.60 IU/mL、MMP-3≥225.05 ng/mL、MMP-9≥587.22 ng/mL、MMP-13≥35.58 ng/mL是老年RA患者发生OP的独立危险因素(P<0.05);BMI≥24.00 kg/m^(2)、25(OH)D≥14.70 ng/mL是老年RA患者发生OP的独立保护因素(P<0.05)。结论老年RA患者发生OP的危险因素较多, 不仅与病程、BMI、使用糖皮质激Objective To explore the correlation between serum levels of matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9),matrix metalloproteinase-13(MMP-13),28 joint disease range of motion scores(DAS28),nail fold microcirculation integral(NFCS)and the risk of osteoporosis(OP)in elderly patients with rheumatoid arthritis(RA).Methods A total of 120 elderly RA patients admitted to Jiangsu University Affiliated Aoyang Hospital from January 2019 to November 2022 were selected,and they were divided into OP group(67 cases)and non-OP group(53 cases)according to whether OP was combined or not.Compare clinical data such as serum MMP-3,MMP-9,MMP-13 levels,DAS28,NFCS scores,etc.between the OP group and the non OP group.Multivariate Logistic regression model was used to analyze the relationship between serum levels of MMP-3,MMP-9,MMP-13,DAS28,NFCS scores and OP risk in elderly RA patients.Results The course of disease in OP group was longer than that in non-OP group[(11.38±1.89)years vs(6.97±1.15)years,t=14.93,P<0.05],body mass index(BMI)and 25-hydroxyvitamin D[25(OH)D]were lower than those in non-OP group[kg/m^(2):(22.35±2.30)vs(25.71±2.79);ng/mL:(12.34±2.05)vs(16.40±2.72),t values were 7.23 and 9.32,both P values<0.05].The history of glucocorticoid use and DAS28,NFCS,rheumatoid factor(RF),MMP-3,MMP-9 and MMP-13 were higher than those in the non-OP group[case:25 vs 10;score:(6.81±1.13)vs(5.13±0.85);(7.60±1.25)vs(3.74±0.62);IU/mL:(93.20±15.53)vs(60.54±10.09);ng/mL:(289.60±13.30)vs(157.43±10.24);ng/mL:(710.60±118.54)vs(413.30±68.00);(44.26±1.25)vs(27.10±1.44),χ^(2)/t values were 4.87,8.99,20.56,13.38,59.68,16.26,69.82,all P values<0.05].The unconditional multivariable Logistic stepwise regression analysis revealed that duration of disease≥9 years,history of glucocorticoid use,DAS28 score≥6.10,NFCS score≥6.00,RF≥79.60 IU/mL,MMP-3≥225.05 ng/mL,MMP-9≥587.22 ng/mL,MMP-13≥35.58 ng/mL were risk factors for OP in elderly patients with RA(P<0.05);BMI≥24.00 kg/m^(2) and 25(OH)D≥14.70 ng/mL

关 键 词：基质金属蛋白酶 甲襞微循环积分 类风湿关节炎 骨质疏松症 

分 类 号：R580[医药卫生—内分泌] R593.22[医药卫生—内科学]