Division of Orthopedic Surgery, University of Toronto, Toronto, ON, Canada.
Obes Facts. 2013;6(6):536-41. doi: 10.1159/000357230. Epub 2013 Dec 6.
BACKGROUND/AIMS: Increasingly, an inflammatory modulating effect of adipokines within synovial joints is being recognized. To date, there has been no work examining a potential association between the presence of adipokines in the shoulder and patient-reported outcomes. This study undertakes an investigation assessing these potential links.
50 osteoarthritis patients scheduled for shoulder surgery completed a pre-surgery questionnaire capturing demographic information including validated, patient-reported function (Disabilities of the Arm, Shoulder, and Hand questionnaire) and pain (Short Form McGill Pain Questionnaire) measures. Synovial fluid (SF) samples were analyzed for leptin, adiponectin, and resistin levels using Milliplex MAP assays. Linear regression modeling was used to assess the association between adipokine levels and patient-reported outcomes, adjusted for age, sex, BMI, and disease severity.
54% of the cohort was female (n = 27). The mean age (SD) of the sample was 62.9 (9.9) years and the mean BMI (SD) was 28.1 (5.4) kg/m(2). From regression analyses, greater SF leptin and adiponectin levels, but not regarding resistin, were found to be associated with greater pain (p < 0.05). Adipokine levels were not associated with functional outcome scores.
The identified association between shoulder-derived SF leptin and adiponectin and shoulder pain is likely explained by the pro-inflammatory characteristics of the adipokines and represents potentially important therapeutic targets.
背景/目的:越来越多的研究认识到脂肪细胞因子在滑膜关节中的炎症调节作用。迄今为止,还没有研究检查脂肪细胞因子在肩部的存在与患者报告的结果之间的潜在关联。本研究旨在评估这些潜在的联系。
50 例接受肩部手术的骨关节炎患者完成了术前问卷调查,调查内容包括人口统计学信息,包括经过验证的、患者报告的功能(手臂、肩部和手残疾问卷)和疼痛(简明 McGill 疼痛问卷)测量。使用 Milliplex MAP 检测法分析滑液(SF)中的瘦素、脂联素和抵抗素水平。线性回归模型用于评估脂肪细胞因子水平与患者报告的结果之间的关联,调整了年龄、性别、BMI 和疾病严重程度。
该队列中有 54%(n = 27)为女性。样本的平均年龄(标准差)为 62.9(9.9)岁,平均 BMI(标准差)为 28.1(5.4)kg/m2。通过回归分析,SF 中的瘦素和脂联素水平越高,与疼痛程度越相关(p < 0.05),但抵抗素水平与疼痛程度无关。脂肪细胞因子水平与功能结果评分无关。
肩部 SF 中的瘦素和脂联素与肩部疼痛之间的关联可能与脂肪细胞因子的促炎特征有关,代表了潜在的重要治疗靶点。