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膝骨关节炎老年患者的炎症标志物与身体功能

Inflammatory markers and physical function among older adults with knee osteoarthritis.

作者信息

Penninx Brenda W J H, Abbas Haider, Ambrosius Walter, Nicklas Barbara J, Davis Cralen, Messier Stephen P, Pahor Marco

机构信息

Sticht Center on Aging, Department of Internal Medicine, Wake Forest University School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157, USA.

出版信息

J Rheumatol. 2004 Oct;31(10):2027-31.

Abstract

OBJECTIVE

To investigate whether serum concentrations of various inflammatory markers are associated with physical function and disease severity among older obese adults with knee osteoarthritis (OA).

METHODS

Data are from baseline assessments in 274 patients with knee OA participating in an exercise and nutrition intervention study. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was used to assess self-reported physical function, pain, and stiffness. The presence of disability was assessed, walking speed was calculated on the basis of the 6-minute walk test, and knee radiographs determined the radiographic severity of OA. Serum concentration of interleukin 6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), and the soluble receptors IL-6sR, IL-2sR, TNF-sR1 and TNF-sR2 were measured by ELISA.

RESULTS

In multivariate regression analyses adjusted for age, sex, race, body mass index, comorbid conditions, and use of nonsteroid antiinflammatory drugs, higher serum levels of TNF-sR1 and TNF-sR2 were significantly associated with lower scores on the WOMAC physical function, with more symptoms of pain and stiffness, and with more reported physical disability. In addition, higher serum levels of TNF-sR1 and TNF-sR2 were significantly associated with slower walking speed, and tended to be associated with worse radiographic scores. Higher serum levels of IL-6 tended to be associated with slower walking speed, but no significant associations were observed for CRP, IL-6sR, or IL-2sR.

CONCLUSION

Especially high levels of the soluble receptors of TNF-alpha were found to be associated with lower physical function, increased OA symptoms, and worse knee radiographic scores in older obese adults with knee OA.

摘要

目的

探讨在老年肥胖膝骨关节炎(OA)患者中,各种炎症标志物的血清浓度是否与身体功能及疾病严重程度相关。

方法

数据来自274名参与运动与营养干预研究的膝OA患者的基线评估。采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估自我报告的身体功能、疼痛和僵硬程度。评估残疾情况,根据6分钟步行试验计算步行速度,膝关节X线片确定OA的放射学严重程度。通过酶联免疫吸附测定法(ELISA)测量白细胞介素6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)以及可溶性受体IL-6sR、IL-2sR、TNF-sR1和TNF-sR2的血清浓度。

结果

在对年龄、性别、种族、体重指数、合并症以及非甾体抗炎药使用情况进行校正的多变量回归分析中,较高的TNF-sR1和TNF-sR2血清水平与WOMAC身体功能评分较低、疼痛和僵硬症状较多以及报告的身体残疾较多显著相关。此外,较高的TNF-sR1和TNF-sR2血清水平与较慢的步行速度显著相关,并且倾向于与较差的放射学评分相关。较高的IL-6血清水平倾向于与较慢的步行速度相关,但未观察到CRP、IL-6sR或IL-2sR有显著相关性。

结论

在老年肥胖膝OA患者中,发现尤其高水平的肿瘤坏死因子-α可溶性受体与较低的身体功能、OA症状增加以及较差的膝关节放射学评分相关。

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