Gold Judith E, Hallman David M, Hellström Fredrik, Björklund Martin, Crenshaw Albert G, Djupsjobacka Mats, Heiden Marina, Mathiassen Svend Erik, Piligian George, Barbe Mary F
Centre for Musculoskeletal Research (CBF), Department of Occupational and Public Health Sciences, University of Gävle, SE - 801 76 Gävle, Sweden.
Scand J Work Environ Health. 2016 Mar;42(2):103-24. doi: 10.5271/sjweh.3533. Epub 2015 Nov 24.
This study systematically summarizes biochemical biomarker research in non-traumatic musculoskeletal disorders (MSD). Two research questions guided the review: (i) Are there biochemical markers associated with neck and upper-extremity MSD? and (ii) Are there biochemical markers associated with the severity of neck and upper-extremity MSD?
A literature search was conducted in PubMed and SCOPUS, and 87 studies met primary inclusion criteria. Following a quality screen, data were extracted from 44 articles of sufficient quality.
Most of the 87 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. A response rate was explicitly stated in only 11 (13%) studies. Less than half of the studies controlled for potential confounding through restriction or in the analysis. Most sufficient-quality studies were conducted in older populations (mean age in one or more analysis group >50 years). In sufficient-quality articles, 82% demonstrated at least one statistically significant association between the MSD and biomarker(s) studied. Evidence suggested that: (i) the collagen-repair marker TIMP-1 is decreased in fibro proliferative disorders, (ii) 5-HT (serotonin) is increased in trapezius myalgia, and (iii) triglycerides are increased in a variety of MSD. Only 5 studies showed an association between a biochemical marker and MSD severity.
While some MSD biomarkers were identified, limitations in the articles examined included possible selection bias, confounding, spectrum effect (potentially heterogeneous biomarker associations in populations according to symptom severity or duration), and insufficient attention to comorbid conditions. A list of recommendations for future studies is provided.
本研究系统总结了非创伤性肌肉骨骼疾病（MSD）的生化生物标志物研究。两个研究问题指导了本次综述：（i）是否存在与颈部和上肢MSD相关的生化标志物？以及（ii）是否存在与颈部和上肢MSD严重程度相关的生化标志物？
在PubMed和SCOPUS中进行文献检索，87项研究符合主要纳入标准。经过质量筛选，从44篇质量足够的文章中提取数据。
87项研究中的大多数为横断面研究，将患者的便利样本用作病例组和对照组。只有11项（13%）研究明确说明了应答率。不到一半的研究通过限制或在分析中控制了潜在的混杂因素。大多数质量足够的研究是在老年人群中进行的（一个或多个分析组的平均年龄>50岁）。在质量足够的文章中，82%表明所研究的MSD与生物标志物之间至少存在一种具有统计学意义的关联。有证据表明：（i）胶原修复标志物TIMP-1在纤维增生性疾病中降低，（ii）5-羟色胺（血清素）在斜方肌肌痛中升高，以及（iii）甘油三酯在多种MSD中升高。只有5项研究显示生化标志物与MSD严重程度之间存在关联。
虽然识别出了一些MSD生物标志物，但所审查文章中的局限性包括可能的选择偏倚、混杂因素、谱效应（根据症状严重程度或持续时间，人群中生物标志物关联可能存在异质性）以及对合并症关注不足。提供了一份未来研究的建议清单。
