Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Clin Chim Acta. 2012 Jan 18;413(1-2):303-7. doi: 10.1016/j.cca.2011.10.019. Epub 2011 Oct 20.
The aim of this study was to investigate apolipoprotein (apo) A-I, apo B, lipoprotein (Lp) (a), HDL-cholesterol (C), LDL-C, triglycerides (TG) and total cholesterol (TC) values in the serum and synovial fluid (SF) of untreated rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA) patients.
Paired SF and serum samples were collected simultaneously from 14 patients with RA, 14 with PsA, and 16 with OA and tested for apo A-I, apo B, HDL-C, LDL-C, Lp(a), TC and TG. Serum C reactive protein (CRP) and amyloid A (SAA) levels were also determined.
The inflammatory arthritis patients had higher SF lipid levels with the exception of HDL. Reflecting increased synovial permeability, the lipid SF/serum ratio was always higher in RA and PsA with respect to OA patients. The positive correlation between serum and SF apo A-I, apo B, HDL-C, TG, and Lp(a) levels confirmed that there is lipoprotein diffusion into the SF. RA and PsA patients had lower concentrations of all serum lipids except for Lp(a) with respect to OA patients. The levels in the RA patients were similar to those in healthy matched controls, while the PsA patients had significantly lower apo A-I and HDL levels and higher apo B and LDL values.
Lipid diffusion into the joint cavity, which largely depends on the degree of inflammation, may contribute to modulating local inflammatory processes.
本研究旨在探讨未经治疗的类风湿关节炎(RA)、银屑病关节炎(PsA)和骨关节炎(OA)患者血清和滑液(SF)中的载脂蛋白(apo)A-I、apo B、脂蛋白(Lp)(a)、高密度脂蛋白胆固醇(C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和总胆固醇(TC)值。
同时采集 14 例 RA、14 例 PsA 和 16 例 OA 患者的 SF 和血清样本,检测 apo A-I、apo B、HDL-C、LDL-C、Lp(a)、TC 和 TG。还测定了血清 C 反应蛋白(CRP)和淀粉样蛋白 A(SAA)水平。
除了 HDL,炎症性关节炎患者的 SF 脂质水平更高。反映出增加的滑膜通透性,RA 和 PsA 患者的脂质 SF/血清比值始终高于 OA 患者。血清和 SF apo A-I、apo B、HDL-C、TG 和 Lp(a)水平之间的正相关证实了脂蛋白向 SF 的扩散。与 OA 患者相比,RA 和 PsA 患者的所有血清脂质浓度均较低,除了 Lp(a)。RA 患者的水平与健康匹配对照相似,而 PsA 患者的 apo A-I 和 HDL 水平明显较低,apo B 和 LDL 值较高。
脂质向关节腔的扩散在很大程度上取决于炎症程度,可能有助于调节局部炎症过程。