Oren Trevor W, Botolin Sergiu, Williams Allison, Bucknell Allan, King Karen B
Department of Orthopaedics, University of Colorado School of Medicine, 12800 E. 19th Avenue, Aurora, CO 80045, USA.
J Rehabil Res Dev. 2011;48(10):1195-210. doi: 10.1682/jrrd.2010.09.0186.
Osteoarthritis patients with diabetes who receive total knee arthroplasty are more vulnerable to complications, including aseptic loosening and need for revision surgery. To elucidate mechanisms related to arthroplasty failure in diabetes, we examined serum and synovial fluid markers as well as collagen crosslinks in bone and cartilage of 20 patients (10 with diabetes, 10 controls without) undergoing this procedure. Hemoglobin A1c, body mass index, bone alkaline phosphatase, leptin, osteocalcin, and pyridinium were analyzed along with tissue content of the crosslinks hydroxylysylpyridinoline, lysylpyridinoline, and pentosidine. Pentosidine levels in tissue specimens from diabetic subjects were higher than in control subjects. Osteocalcin levels negatively correlated with hydroxylysylpyridinoline levels in cartilage. Osteocalcin levels also negatively correlated with pentosidine levels in cartilage, but only in subjects with diabetes. This study suggests potential metabolic mechanisms for arthroplasty failure in patients with diabetes.
接受全膝关节置换术的糖尿病骨关节炎患者更容易出现并发症，包括无菌性松动和翻修手术需求。为阐明糖尿病患者关节置换失败的相关机制，我们检测了20例接受该手术患者（10例糖尿病患者，10例非糖尿病对照患者）的血清和滑液标志物以及骨和软骨中的胶原交联。分析了糖化血红蛋白、体重指数、骨碱性磷酸酶、瘦素、骨钙素和吡啶鎓，以及交联物羟赖氨酸吡啶啉、赖氨酸吡啶啉和戊糖苷的组织含量。糖尿病受试者组织标本中的戊糖苷水平高于对照受试者。骨钙素水平与软骨中羟赖氨酸吡啶啉水平呈负相关。骨钙素水平也与软骨中戊糖苷水平呈负相关，但仅在糖尿病患者中如此。本研究提示了糖尿病患者关节置换失败的潜在代谢机制。
