生长分化因子 15 是与腰背痛相关残疾的生物标志物。

Growth and differentiation factor 15 is a biomarker for low back pain-associated disability.

机构信息

Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 6905126 Tel-Aviv, Israel.

The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, 31021 Haifa, Israel.

出版信息

Cytokine. 2019 May;117:8-14. doi: 10.1016/j.cyto.2019.01.011. Epub 2019 Feb 15.

Abstract

The development of low back pain (LBP) is often associated with obesity and sarcopenia. However, the mechanisms of this association remain unclear. To clarify this, we measured circulating levels of a selected panel of soluble factors, presumably involved in obesity and sarcopenia pathogenesis, and correlated them with several LBP-related characteristics, taking into account body composition and other relevant covariates. In the cross-sectional study of 1078 individuals, we collected data on self-reported LBP, body composition (including fat and skeletal muscle mass) assessed by the bioimpedance method and anthropometrically, and measured plasma levels of several cytokines by ELISA. In the statistical analysis, we took into account familial composition of the sample and possible putative genetic effects. We report that LBP-affected individuals were significantly older, with increased obesity and decreased skeletal mass, respectively, compared with the non-affected group. In univariate analyses, plasma concentrations of Growth and differentiation factor 15 (GDF-15), leptin, chemerin and follistatin were found significantly elevated in the LBP-affected groups (with or without sciatic pain) and were highly significantly (p < 0.001) associated with other LBP-related phenotypes, specifically, disease duration, disability and physician consults. However, after adjustment for one another, age, sex, body composition and putative genetic factors, the only associations between GDF-15 and LBP disability and medical consulting phenotypes, remained significant. In conclusion, we report for the first time, a significant and independent association between plasma GDF-15 concentrations and LBP-associated disability. Longitudinal studies are needed to determine whether GDF-15 could be a novel therapeutic target for prevention and/or treatment of LBP.

摘要

腰痛(LBP)的发展通常与肥胖和肌肉减少症有关。然而,这种关联的机制尚不清楚。为了阐明这一点,我们测量了循环中一组选定的可溶性因子的水平,这些因子可能与肥胖和肌肉减少症的发病机制有关,并将其与几个与 LBP 相关的特征相关联,同时考虑到身体成分和其他相关协变量。在对 1078 人的横断面研究中,我们收集了与自我报告的 LBP 相关的数据、通过生物阻抗法和人体测量学评估的身体成分(包括脂肪和骨骼肌量),并通过 ELISA 测量了几种细胞因子的血浆水平。在统计分析中,我们考虑了样本的家族构成和可能存在的潜在遗传效应。我们报告称,与未受影响的组相比,受 LBP 影响的个体年龄明显较大,肥胖程度增加,骨骼肌量减少。在单变量分析中,受 LBP 影响的组(有或没有坐骨神经痛)的生长分化因子 15(GDF-15)、瘦素、趋化素和卵泡抑素的血浆浓度明显升高,并且与其他与 LBP 相关的表型高度显著相关(p < 0.001),特别是疾病持续时间、残疾和医生咨询。然而,在相互调整后,年龄、性别、身体成分和潜在的遗传因素,GDF-15 与 LBP 残疾和医疗咨询表型之间仅存在显著关联。总之,我们首次报道了血浆 GDF-15 浓度与 LBP 相关残疾之间的显著和独立关联。需要进行纵向研究,以确定 GDF-15 是否可以成为预防和/或治疗 LBP 的新治疗靶点。

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