Department of Endocrinology, Shandong Provincial Hospital Affiliated with Shandong University, Jinan, China.
Eur Rev Med Pharmacol Sci. 2018 Jan;22(2):472-478. doi: 10.26355/eurrev_201801_14197.
To investigate whether serum levels of inflammatory factors and estradiol (E2) are involved in the pathogenesis of postmenopausal women with knee osteoarthritis (OA).
58 randomly patients diagnosed with postmenopausal knee OA that underwent orthopedic surgery from October 2013 to October 2016 in our hospital were selected. These patients, considered as the experimental group, according to the degree of cartilage damage, were divided into light, medium and heavy groups. 58 patients with menstrual disorders without knee OA were in the control group. 35 cases without osteoarthritis were included in the normal control group. Serum levels of interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), erythrocyte sedimentation rate (ESR), high sensitive C- reactive protein (CRP), estradiol (E2) and IL-1, IL-6 and TNF-α levels in the synovial fluid of the experimental group were measured.
The serum levels of IL-1, IL-6, TNF-α, and CRP in the normal control group, the control group and the experimental group were gradually increasing, the difference was statistically significant (p<0.05). The level of serum E2 was gradually decreasing (p<0.05); the difference of ESR between normal control group and control group had no significant difference (p>0.05), but the level of ESR in experimental group was higher than the normal control group and the control group (p<0.05). The serum levels of IL-1, TNF-α in experimental group of mild, moderate and severe sub-group were gradually increasing, the difference was statistically significant (p<0.05); while the level of IL-6 in the early, middle stage of OA increased significantly, and the late was reduced (p<0.05). The level of E2 was gradually decreased in the mild, moderate and severe sub-group of the experimental group, which had statistically significant difference (p<0.05). The level of serum E2 in the experimental group was positively correlated with the levels of IL-1, IL-6 and TNF-α in synovial fluid (p<0.05).
The lack of estradiol is associated with the pathogenesis of OA in postmenopausal women, the inflammatory factors of IL-1, IL-6, TNF-α in postmenopausal increased in serum and synovial fluid may promote and aggravate the OA.
探讨炎症因子和雌二醇（E2）在绝经后膝骨关节炎（OA）发病机制中的作用。
选择 2013 年 10 月至 2016 年 10 月在我院骨科行手术治疗的绝经后膝 OA 患者 58 例为研究对象（实验组），根据软骨损伤程度分为轻、中、重度组。另选取同期因月经紊乱就诊且无膝 OA 的 58 例患者为对照组，选取同期无 OA 且行膝关节置换术的 35 例患者为正常对照组。检测实验组患者血清白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、红细胞沉降率（ESR）、高敏 C 反应蛋白（CRP）、雌二醇（E2）水平及关节滑液中 IL-1、IL-6、TNF-α 水平。
正常对照组、对照组及实验组患者血清中 IL-1、IL-6、TNF-α、CRP 水平逐渐升高，差异有统计学意义（p<0.05）；血清 E2 水平逐渐降低，差异有统计学意义（p<0.05）；正常对照组与对照组 ESR 比较差异无统计学意义（p>0.05），但实验组 ESR 水平高于正常对照组和对照组，差异有统计学意义（p<0.05）。实验组轻、中、重度亚组患者血清中 IL-1、TNF-α 水平逐渐升高，差异有统计学意义（p<0.05）；而 OA 早期、中期 IL-6 水平显著升高，晚期降低，差异有统计学意义（p<0.05）。实验组轻、中、重度亚组患者血清 E2 水平逐渐降低，差异有统计学意义（p<0.05）。实验组患者血清 E2 水平与关节滑液中 IL-1、IL-6、TNF-α 水平呈正相关（p<0.05）。
雌二醇缺乏与绝经后女性 OA 的发病机制有关，绝经后血清和关节滑液中 IL-1、IL-6、TNF-α 等炎症因子的增加可能促进和加重 OA。
