Mattei J P, Ferrera V, Boutsen Y, Franceschi J P, Botti D, De Boissezon C, Kaphan G, Roux H
Department of Rheumatology, Hôpital de la Conception, Marseille, France.
Int J Clin Pharmacol Res. 1992;12(3):103-7.
The mechanisms involved in juxta-articular bone destruction are poorly understood. Osteocalcin or gamma-carboxyglutamic acid (GLA) protein is a small non-collagenous bone protein. It is a sensitive marker of osteoblastic bone formation. Its seric variations in the serum in such rheumatisms as rheumatoid arthritis remain unclear. Further information on local osteoblastic activity may be obtained by assaying the level of osteocalcin in the synovium. Its serum level can be evaluated by radioimmunoassay. The same method can be used in the synovial fluid. Paired serum and synovial fluid samples have been assayed from 63 patients, 33 patients with inflammatory arthritis (rheumatoid arthritis, psoriasis, chondrocalcinosis, pyogenic arthritis) and 30 patients with mechanical joint effusion (osteoarthritis, meniscal lesions). Serum levels of osteocalcin were the same in the inflammatory group (m: 8.69 +/- 0.68 ng/ml) and in the mechanical group (m: 10.2 +/- 0.67 ng/ml). In the synovial fluid, the levels of osteocalcin were significantly lower in the inflammatory group (m: 3.27 +/- 0.40 ng/ml) than in the mechanical group (m: 6.91 +/- 0.47 ng/ml). The same results were obtained with the ratio of synovial fluid osteocalcin on serum osteocalcin. There was a significant correlation between serum and synovial fluid osteocalcin and an inverse correlation between synovial fluid osteocalcin and the number of synovial fluid cells. The present study suggests that periarticular osteoblastic depression, among patients with inflammatory arthritis, is likely.
关节周围骨破坏所涉及的机制目前仍知之甚少。骨钙素或γ-羧基谷氨酸（GLA）蛋白是一种小的非胶原蛋白。它是成骨细胞骨形成的敏感标志物。在类风湿关节炎等风湿性疾病中，其血清中的变化尚不清楚。通过检测滑膜中骨钙素的水平，可能会获得有关局部成骨细胞活性的更多信息。其血清水平可通过放射免疫测定法进行评估。滑膜液也可采用同样的方法。对63例患者的血清和滑膜液配对样本进行了检测，其中33例为炎性关节炎患者（类风湿关节炎、银屑病、软骨钙质沉着症、化脓性关节炎），30例为机械性关节积液患者（骨关节炎、半月板损伤）。炎性组血清骨钙素水平（均值：8.69±0.68 ng/ml）与机械组（均值：10.2±0.67 ng/ml）相同。在滑膜液中，炎性组骨钙素水平（均值：3.27±0.40 ng/ml）显著低于机械组（均值：6.91±0.47 ng/ml）。滑膜液骨钙素与血清骨钙素的比值也得到了相同的结果。血清和滑膜液骨钙素之间存在显著相关性，滑膜液骨钙素与滑膜液细胞数量之间存在负相关。本研究表明，炎性关节炎患者关节周围成骨细胞可能存在抑制。
