血清和尿液生物标志物与腰椎个体影像学特征的相关性：约翰斯顿县骨关节炎项目。
Association between serum and urine biomarkers and lumbar spine individual radiographic features: the Johnston County Osteoarthritis Project.
机构信息
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27708, USA.
出版信息
Osteoarthritis Cartilage. 2012 Nov;20(11):1286-93. doi: 10.1016/j.joca.2012.08.003. Epub 2012 Aug 10.
OBJECTIVE
(1) To determine associations between radiographic features of lumbosacral (LS) spine disc space narrowing (DSN) and osteophytes (OST) and joint metabolism biomarkers (serum cartilage oligomeric matrix protein (COMP), hyaluronic acid (HA), collagen neoepitope (C2C), C-propeptide of type II procollagen (CP-II), urine C-terminal cross-linking telopeptide (CTX-II) and N-terminal telopeptide (NTX-I)). (2) To explore interactions with race, gender and low back symptoms.
DESIGN
Cross-sectional analysis of 547 participants enrolled in the Johnston County (JoCo) Osteoarthritis Project from 2003 to 2004. Mean biomarker levels were estimated with linear regression. Proportional and partial-proportional odds models were used to estimate associations. Interactions were tested with likelihood ratio tests at a P-value < 0.10. Biomarkers were natural log (ln) transformed.
RESULTS
Significant differences in mean biomarker levels were found across severity of DSN for lnHA and lnC2C and lnCTX-II across severity of both DSN and OST. Moderate-to-strong associations were found between biomarkers of type II collagen and DSN, whereas associations with OST were weak. An association between lnHA and DSN was seen in women (adjusted odds ratio [aOR] = 1.34 (95% confidence intervals (CI) 1.08, 1.65)) but no association among men (aOR = 0.90 (95% CI 0.63, 1.26)). In Caucasians there was a decreased association with NTX-I and OST (aOR = 0.67 (95% CI 0.49, 0.91)) and no association in African Americans (AAs) (aOR = 1.06 (95% CI 0.76, 1.47)). There was a positive association of lnCOMP with DSN among those with low back symptoms (aOR = 1.82 (95% CI 1.02, 3.27)), but no association in those without low back symptoms (aOR = 0.65 (95% CI 0.35, 1.20)).
CONCLUSION
Joint metabolism biomarkers suggest biological differences in the pathologic process involved in DSN and OST that may be gender (HA) and ethnicity (NTX-I) specific.
目的
（1）确定腰骶椎（LS）椎间盘狭窄（DSN）和骨赘（OST）的放射学特征与关节代谢生物标志物（血清软骨寡聚基质蛋白（COMP）、透明质酸（HA）、胶原新表位（C2C）、II 型前胶原 C 端肽（CP-II）、尿 C 端交联肽（CTX-II）和 N 端肽（NTX-I））之间的关联。（2）探讨与种族、性别和下腰痛症状的相互作用。
设计
2003 年至 2004 年，对约翰斯顿县（JoCo）骨关节炎项目的 547 名参与者进行了横断面分析。使用线性回归估计平均生物标志物水平。使用比例和部分比例优势模型估计关联。在 P 值<0.10 时，通过似然比检验测试相互作用。生物标志物进行自然对数（ln）转换。
结果
在 DSN 严重程度方面，lnHA 和 lnC2C 以及 DSN 和 OST 严重程度方面的 lnCTX-II 的平均生物标志物水平存在显著差异。II 型胶原生物标志物与 DSN 之间存在中度至强关联，而与 OST 的关联较弱。在女性中，lnHA 与 DSN 之间存在关联（调整后的优势比[aOR]1.34（95%置信区间[CI]1.08，1.65）），但在男性中没有关联（aOR 0.90（95% CI 0.63，1.26））。在白种人中，与 NTX-I 和 OST 的关联减弱（aOR 0.67（95% CI 0.49，0.91）），而在非裔美国人（AA）中没有关联（aOR 1.06（95% CI 0.76，1.47））。在有下腰痛症状的患者中，lnCOMP 与 DSN 呈正相关（aOR 1.82（95% CI 1.02，3.27）），但在没有下腰痛症状的患者中没有关联（aOR 0.65（95% CI 0.35，1.20））。
结论
关节代谢生物标志物表明 DSN 和 OST 涉及的病理过程存在生物学差异，这些差异可能具有性别（HA）和种族（NTX-I）特异性。
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