[1]陆辉,陆鑫,孙郁雨△.类风湿关节炎患者血清肝癌衍生生长因子、白细胞衍生趋化因子2水平与骨代谢指标及并发骨质疏松的关系[J].中国中医骨伤科杂志,2024,32(12):47-52.[doi:10.20085/j.cnki.issn1005-0205.241209 ]
　LU Hui,LU Xin,SUN Yuyu.Relationship between Serum Hepatoma-Derived Growth Factor and Leukocyte Cell-Derived Chemotaxin-2 Levels with Bone Metabolism Indicators and Concurrent Osteoporosis in Patients with Rheumatoid Arthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(12):47-52.[doi:10.20085/j.cnki.issn1005-0205.241209 ]
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类风湿关节炎患者血清肝癌衍生生长因子、白细胞衍生趋化因子2水平与骨代谢指标及并发骨质疏松的关系()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年12期
页码:
47-52
栏目:
临床研究
出版日期:
2024-12-15

文章信息/Info

Title:
Relationship between Serum Hepatoma-Derived Growth Factor and Leukocyte Cell-Derived Chemotaxin-2 Levels with Bone Metabolism Indicators and Concurrent Osteoporosis in Patients with Rheumatoid Arthritis
文章编号:
1005-0205(2024)12-0047-06
作者:
陆辉1; 陆鑫1; 孙郁雨1△
1南通市第三人民医院(南通大学附属南通第三医院)(江苏 南通,226000)
Author(s):
LU Hui1; LU Xin1; SUN Yuyu1△
1Nantong Third People's Hospital(Third Affiliated Nantong Hospital of Nantong University),Nantong 226000,Jiangsu China.
关键词:
类风湿关节炎;  骨质疏松;  肝癌衍生生长因子;  白细胞衍生趋化因子2;  骨代谢指标
Keywords:
rheumatoid arthritis;  osteoporosis;  hepatoma-derived growth factor;  leukocyte cell-derived chemotaxin-2;  bone metabolism indicators
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.241209
文献标志码:
A
摘要:
目的:探讨类风湿关节炎(RA)患者血清肝癌衍生生长因子(HDGF)、白细胞衍生趋化因子2(LECT2)水平与骨代谢指标及并发骨质疏松的关系。方法:选取2021年1月至2023年12月80例类风湿关节炎患者为类风湿关节炎组,依据28个关节疾病活动度评分(DAS28)将类风湿关节炎患者分为高度组20例、中度组28例和低度组32例; 依据是否合并骨质疏松分为骨质疏松组(50例)和无骨质疏松组(30例); 选取同期健康人群80例作为对照组。采用全自动电化学发光分析仪检测骨代谢指标Ⅰ型前胶原氨基端前肽(PINP)、25-羟维生素 D(25(OH)D)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、N端骨钙素(N-MID)、骨碱性磷酸酶(B-ALP)水平,采用酶联免疫吸附(ELISA)法检测血清肝癌衍生生长因子、白细胞衍生趋化因子2水平; 采用Pearson法分析相关性; 采用多因素Logistic回归分析影响因素; 绘制受试者工作特征(ROC)曲线分析指标诊断价值,曲线下面积(AUC)比较采用Z检验。结果:类风湿关节炎组血清HDGF、LECT2、β-CTX水平高于对照组,PINP、25(OH)D、N-MID、B-ALP水平低于对照组,差异有统计学意义(P<0.05)。高度组类风湿关节炎患者血清HDGF、LECT2、β-CTX水平高于中度组及低度组,PINP、25(OH)D、N-MID、B-ALP水平低于中度组及低度组,差异有统计学意义(P<0.05); 中度组血清HDGF、LECT2、β-CTX水平高于低度组,PINP、25(OH)D、N-MID、B-ALP水平低于低度组,差异有统计学意义(P<0.05)。血清HDGF和LECT2水平与β-CTX正相关,与PINP、25(OH)D、N-MID、B-ALP负相关,差异有统计学意义(P<0.05)。骨质疏松组血清HDGF和LECT2水平、重度患者比例高于无骨质疏松组,差异有统计学意义(P<0.05)。HDGF和LECT2是类风湿关节炎患者并发骨质疏松危险因素,差异有统计学意义(P<0.05)。血清HDGF和LECT2诊断类风湿关节炎患者并发骨质疏松的曲线下面积分别为0.847和0.841,低于联合诊断曲线下面积(0.927),差异有统计学意义(P<0.05); HDGF和LECT2诊断临界值分别为4.78 ng/mL和34.63 ng/mL。结论:类风湿关节炎患者血清HDGF和LECT2水平显著升高,与骨代谢指标均呈显著相关性,且可能与骨质疏松的发生有关。当HDGF和LECT2检测水平高于诊断临界值时,患者发生骨质疏松可能性极高,临床医师可根据其检测值进行预防性用药。
Abstract:
Objective:To explore the relationship between serum levels of hepatoma-derived growth factor(HDGF)and leukocyte cell-derived chemotaxin-2(LECT2)with bone metabolism indicators and concurrent osteoporosis in patients with rheumatoid arthritis(RA).Methods:80 RA patients were selected as the RA group from January 2021 to December 2023.Based on the 28 joint disease activity scores(DAS28),RA patients were separated into a high RA group of 20 cases,a moderate RA group of 28 cases,and a low RA group of 32 cases.According to the presence or absence of osteoporosis,there were 50 cases in the osteoporosis group and 30 cases in the non osteoporosis group.Another 80 healthy individuals from the same period were selected as the control group.Fully automated electrochemiluminescence analyzer was applied to detect bone metabolism indicators such as procollagen type Ⅰ N-terminal propeptide(PINP),25 hydroxyvitamin D(25(OH)D),β C-terminal cross-linked telopeptides of type Ⅰ collagen(β-CTX),N-terminal osteocalcin(N-MID),and bone alkaline phosphatase(B-ALP)levels.Enzyme linked immunosorbent assay(ELISA)method was applied to detect serum levels of HDGF and LECT2.Pearson method was applied to analyze correlation.Multivariate Logistic regression was applied to analyze influencing factors.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of indicators,and area under the curve(AUC)comparison was used Z-test.Results:The serum levels of HDGF,LECT2,and β-CTX in the RA group were higher than those in the control group,while the levels of PINP,25(OH)D,N-MID,and B-ALP were lower than those in the control group(P<0.05).The serum levels of HDGF,LECT2,and β-CTX in the high RA group were higher than those in the moderate RA and low RA groups,while the levels of PINP,25(OH)D,N-MID,and B-ALP were lower than those in the moderate and low RA groups(P<0.05).The serum levels of HDGF,LECT2,and β-CTX in the moderate RA group were higher than those in the low RA group,while the levels of PINP,25(OH)D,N-MID,and B-ALP in moderate RA group were lower than those in the low RA group(P<0.05).The levels of serum HDGF and LECT2 were positively correlated with β-CTX,and negatively correlated with PINP,25(OH)D,N-MID,and B-ALP(P<0.05).The serum levels of HDGF and LECT2 and the proportion of severe patients in the osteoporosis group were higher than those in the non osteoporosis group(P<0.05).HDGF and LECT2 were risk factors for osteoporosis in RA patients(P<0.05).The AUC for diagnosing osteoporosis in RA patients with serum HDGF and LECT2 were 0.847 and 0.841,respectively,and were lower than the AUC of combined diagnosis(0.927)(P<0.05).The diagnostic thresholds for HDGF and LECT2 were 4.78 ng/mL and 34.63 ng/mL,respectively.Conclusion:The serum levels of HDGF and LECT2 in RA patients are obviously elevated,and are obviously correlated with bone metabolism indicators,and it may be associated with the occurrence of osteoporosis.When the levels of HDGF and LECT2 are higher than the diagnostic threshold,the likelihood of osteoporosis in patients is extremely high,and clinical physicians can take preventive medication based on their detection values.

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备注/Memo

备注/Memo:
△通信作者 E-mail:sunyuyunt@126.com
更新日期/Last Update: 2024-12-05