Clinical Research Centre, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Centre of Orthopaedics, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
J Am Med Dir Assoc. 2019 Oct;20(10):1242-1246. doi: 10.1016/j.jamda.2019.07.001. Epub 2019 Aug 20.
Resistin acts as an endogenous ligand of Toll-like receptor (TLR)-4 that triggers major inflammatory pathways and mediates inflammatory processes. The role of resistin in osteoarthritis (OA) pathogenesis is unclear. The aim of this study is to describe the longitudinal associations of serum levels of resistin with knee synovitis measures and structural abnormalities in patients with knee OA.
A prospective cohort study.
Patients (n = 200) with symptomatic knee OA (mean age 63.1 years, range 49-79; female 46.5%) participated.
All measures were performed at baseline and 2 years later. Serum resistin was measured using enzyme-linked immunosorbent assay. Infrapatellar fat pad (IPFP) high signal intensity alteration and effusion synovitis were measured from magnetic resonance imaging (MRI). Knee structures including cartilage volume, cartilage defects, and bone marrow lesions (BMLs) were also assessed by MRI semiquantitatively or quantitatively. Linear or logistic mixed effects regression analyses were used in longitudinal analyses.
Serum resistin was positively associated with high signal intensity alteration measures of IPFP as well as the presence [relative risk = 1.06, 95% confidence interval (CI) 1.02, 1.10] and volume (β = 0.77, 95% CI 0.01, 1.53) of effusion synovitis in multivariable analyses. Serum levels of resistin were also positively associated with higher tibiofemoral cartilage defect (β = 1.98, 95% CI 0.34, 3.57) and BML scores (β = 3.18, 95% CI 0.99, 5.37) after adjustment for covariates.
Higher serum levels of resistin are associated with knee synovitis surrogate measures and structural abnormalities, suggesting that obesity may promote OA not only by increasing weight loading on joints but also by triggering 1 or more inflammatory pathways.
抵抗素作为 Toll 样受体 (TLR)-4 的内源性配体，可触发主要炎症途径并介导炎症过程。抵抗素在骨关节炎 (OA) 发病机制中的作用尚不清楚。本研究旨在描述血清抵抗素水平与膝骨关节炎患者膝关节滑膜炎指标和结构异常的纵向相关性。
前瞻性队列研究。
患有症状性膝骨关节炎的患者（n=200；平均年龄 63.1 岁，范围 49-79；女性 46.5%）参与了本研究。
所有措施均在基线和 2 年后进行。使用酶联免疫吸附试验测量血清抵抗素。从磁共振成像 (MRI) 测量髌下脂肪垫 (IPFP) 高信号强度改变和关节腔积液滑膜炎。还通过 MRI 半定量或定量评估膝关节结构，包括软骨体积、软骨缺损和骨髓病变 (BML)。线性或逻辑混合效应回归分析用于纵向分析。
在多变量分析中，血清抵抗素与 IPFP 的高信号强度改变指标以及关节腔积液滑膜炎的存在[相对风险=1.06，95%置信区间 (CI) 1.02,1.10]和体积（β=0.77，95%CI 0.01,1.53）呈正相关。在调整协变量后，血清抵抗素水平也与更高的胫股关节软骨缺损（β=1.98，95%CI 0.34,3.57）和 BML 评分（β=3.18，95%CI 0.99,5.37）呈正相关。
较高的血清抵抗素水平与膝关节滑膜炎替代指标和结构异常相关，表明肥胖不仅通过增加关节负重，还通过触发 1 个或多个炎症途径促进 OA。
