Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Street, Hefei, China.
Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Street, Hefei, China; Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.
Osteoarthritis Cartilage. 2017 Sep;25(9):1428-1435. doi: 10.1016/j.joca.2017.05.015. Epub 2017 Jun 15.
The roles of ghrelin in knee osteoarthritis (OA) are unclear. This study aimed to examine cross-sectional associations of ghrelin with knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee OA.
This study included 146 patients with symptomatic knee OA. Serum levels of ghrelin and cartilage or bone biomarkers including cartilage oligomeric matrix protein (COMP), cross linked C-telopeptide of type I collagen (CTXI), cross linked N-telopeptide of type I collagen (NTXI), N-terminal procollagen III propeptide (PIIINP), and matrix metalloproteinase (MMP)-3, 10, 13 were measured using Enzyme-linked immunosorbent assay (ELISA). Knee symptoms were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Infrapatellar fat pad (IPFP) volume, IPFP signal intensity alternation, cartilage defects, bone marrow lesions (BMLs) and effusion-synovitis were assessed using the (MRI). Osteophytes and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas.
After adjustment for potential confounders, ghrelin quartiles were positively associated with knee symptoms including pain, stiffness, dysfunction and total score (quartile 4 vs 1: β 24.19, 95% CI 8.13-40.25). Ghrelin quartiles were also significantly associated with increased IPFP signal intensity alteration (quartile 4 vs 1: OR 3.57, 95% CI 1.55-8.25) and NTXI, PIIINP, MMP3 and MMP13. Ghrelin was not significantly associated with other joint structures and biomarkers.
Serum levels of ghrelin were significantly associated with increased knee symptoms, IPFP signal intensity alteration and serum levels of MMP3, MMP13, NTXI and PIIINP, suggesting that ghrelin may have a role to play in knee OA.
瘦素在膝骨关节炎（OA）中的作用尚不清楚。本研究旨在探讨瘦素与膝骨关节炎患者膝关节症状、关节结构及软骨或骨生物标志物的横断面相关性。
本研究纳入了 146 例有症状的膝骨关节炎患者。采用酶联免疫吸附试验（ELISA）法检测血清瘦素及软骨或骨生物标志物，包括软骨寡聚基质蛋白（COMP）、I 型胶原交联 C 端肽（CTXI）、I 型胶原交联 N 端肽（NTXI）、III 型前胶原 N 端肽（PIIINP）和基质金属蛋白酶（MMP）-3、10、13。采用西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评估膝关节症状。采用（MRI）评估髌下脂肪垫（IPFP）体积、IPFP 信号强度改变、软骨缺损、骨髓病变（BML）和积液-滑膜炎。采用国际骨关节炎研究协会图谱评估骨赘和关节间隙狭窄（JSN）。
在调整了潜在混杂因素后，瘦素四分位数与膝关节症状（疼痛、僵硬、功能障碍和总分）呈正相关（四分位 4 与 1 相比：β24.19，95%CI8.13-40.25）。瘦素四分位数与 IPFP 信号强度改变（四分位 4 与 1 相比：OR3.57，95%CI1.55-8.25）和 NTXI、PIIINP、MMP3 和 MMP13 也显著相关。瘦素与其他关节结构和生物标志物无显著相关性。
血清瘦素水平与膝关节症状加重、IPFP 信号强度改变以及 MMP3、MMP13、NTXI 和 PIIINP 血清水平升高显著相关，提示瘦素可能在膝骨关节炎中起作用。
