Lian Wei, Liu Hui, Sun Li Yan, Liu Yun Qi, Cui Si Lu, Wang Yue, Song Quan Quan, Deng Qing, Wang Shao Ping, Cao Yan Hong, Zhang Xue Ying, Jiang Yuan Yuan, Lv Hong Yan, Duan Li Bin, Yu Jun
Institute for Kashin-Beck Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.
Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Harbin, 23618504, China.
J Orthop Surg Res. 2018 May 29;13(1):128. doi: 10.1186/s13018-018-0840-z.
Kashin-Beck disease (KBD) is an endemic, chronic, degenerative osteoarthropathy. KBD is usually diagnosed by using X-ray image and clinical symptoms, lacking of serological biomarkers. The serum level of PIICP, PIIANP, and PIIBNP can specifically reflect the damage of the cartilage. So, in this study, the serum levels of PIICP, PIIANP, and PIIBNP were detected in order to determine whether they can be used as potential biomarkers for the diagnosis of KBD.
Using a status survey, the survey sites were selected in the KBD historical endemic areas and non-endemic areas in Jilin and Heilongjiang provinces. All local residents have undergone clinical examination, X-ray examination of the hands and knees, and questionnaire survey. A total of 554 people were surveyed, and 184 residents who are eligible for inclusion criteria were selected as our subjects. Fifty-six cases were diagnosed as KBD and 63 individuals were included as internal control and 65 subjects were included as external control. And blood samples of surveyed subjects were collected, and the serum was separated to detect the levels of PIICP, PIIANP, and PIIBNP by ELISA. Statistical analysis was performed using the SPSS software.
There were no statistically significant differences in age and sex among the three groups. The Kruskal-Wallis H test showed that the serum levels of PIICP, PIIANP, and PIIBNP were significantly different among the three groups. Multiple comparisons using Dunnett's T3 test revealed that serum levels of PIICP, PIIANP, and PIIBNP were significantly lower in KBD patients than in internal and external control. However, there was no significant difference between the internal and external control.
The results preliminarily indicated that the levels of PIICP, PIIANP, and PIIBNP in serum could reflect the abnormal synthesis of type II collagen in KBD patients and suggested that these indicators might be used as potential biomarkers for the diagnosis of KBD.
大骨节病（KBD）是一种地方性、慢性、退行性骨关节炎。大骨节病通常通过X线影像和临床症状进行诊断，缺乏血清学生物标志物。血清中Ⅱ型前胶原羧基端前肽（PIICP）、Ⅱ型前胶原氨基端前肽（PIIANP）和Ⅱ型前胶原β-羧基端前肽（PIIBNP）水平可特异性反映软骨损伤情况。因此，本研究检测血清中PIICP、PIIANP和PIIBNP水平，以确定它们是否可作为大骨节病诊断的潜在生物标志物。
采用现况调查，在吉林和黑龙江省大骨节病历史病区和非病区选择调查点。所有当地居民均接受了临床检查、手和膝关节X线检查及问卷调查。共调查554人，选取184名符合纳入标准的居民作为研究对象。其中56例被诊断为大骨节病，63例作为内对照，65例作为外对照。采集调查对象的血样，分离血清，采用酶联免疫吸附测定（ELISA）法检测PIICP、PIIANP和PIIBNP水平。使用SPSS软件进行统计分析。
三组在年龄和性别上无统计学显著差异。Kruskal-Wallis H检验显示，三组间血清PIICP、PIIANP和PIIBNP水平有显著差异。采用Dunnett's T3检验进行多重比较发现，大骨节病患者血清PIICP、PIIANP和PIIBNP水平显著低于内对照和外对照。然而，内对照和外对照之间无显著差异。
结果初步表明，血清中PIICP、PIIANP和PIIBNP水平可反映大骨节病患者Ⅱ型胶原的合成异常，提示这些指标可能作为大骨节病诊断的潜在生物标志物。
