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血清炎症因子、MMP-3、25(OH)D 和肠道菌群变化与类风湿关节炎患者骨质疏松及疾病活动的相关性。

Associations of Changes in Serum Inflammatory Factors, MMP-3, 25(OH)D and Intestinal Flora with Osteoporosis and Disease Activity in Rheumatoid Arthritis Patients.

出版信息

Clin Lab. 2020 Dec 1;66(12). doi: 10.7754/Clin.Lab.2020.200242.

Abstract

BACKGROUND

To explore the associations of changes in serum inflammatory factors, matrix metalloproteinase-3 (MMP-3), 25-hydroxy vitamin D [25(OH)D], and intestinal flora with osteoporosis and disease activity in rheumatoid arthritis (RA) patients, so as to provide references for clinical diagnosis and treatment.

METHODS

A total of 98 RA patients were selected as the objects of study (RA group), and divided into active-stage group (n = 56) and remission-stage group (n = 42) according to the disease activity score (DAS28). Another 50 healthy people receiving physical examination in our hospital during the same period were selected as the control group. The changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora were compared among the three groups, and the osteoporosis of the subjects was analyzed in each group. Moreover, the associations of changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora with osteoporosis and disease activity in RA patients were analyzed using the Pearson's method.

RESULTS

Compared with those in the control group, the levels of serum MMP-3, interleukin-6 (IL-6), IL-10, and C-reactive protein (CRP). The Escherichia coli count were significantly increased, while the level of serum 25(OH)D, bone mineral density (BMD), and Lactobacillus and Bifidobacterium counts were significantly decreased in the active-stage group and remission-stage group, more obviously in active-stage group (p < 0.05). The osteoporosis and disease activity in RA patients were positively correlated with serum IL-6, IL-10, CRP, MMP-3, Escherichia coli and BMD, but negatively correlated with 25(OH)D, Lactobacillus and Bifidobacterium (p < 0.05), and not correlated with the sharp score (p > 0.05).

CONCLUSIONS

There are certain associations of changes in serum inflammatory factors, MMP-3, 25(OH)D, and in-testinal flora with osteoporosis and disease activity in RA patients, showing certain value in clinical application.

摘要

背景

探讨血清炎症因子、基质金属蛋白酶-3(MMP-3)、25-羟维生素 D[25(OH)D]和肠道菌群的变化与类风湿关节炎(RA)患者骨质疏松及疾病活动的关系,为临床诊断和治疗提供参考。

方法

选取 98 例 RA 患者作为研究对象(RA 组),根据疾病活动评分(DAS28)分为活动期组(n=56)和缓解期组(n=42)。另选取同期在我院体检的 50 例健康人作为对照组。比较三组血清炎症因子、MMP-3、25(OH)D、肠道菌群的变化,分析各组受试者的骨质疏松情况。采用 Pearson 法分析血清炎症因子、MMP-3、25(OH)D、肠道菌群变化与 RA 患者骨质疏松及疾病活动的关系。

结果

与对照组相比,活动期组和缓解期组患者血清 MMP-3、白细胞介素-6(IL-6)、IL-10、C 反应蛋白(CRP)、大肠杆菌计数均明显升高,血清 25(OH)D、骨密度(BMD)、乳酸菌和双歧杆菌计数均明显降低,且活动期组更明显(p<0.05)。RA 患者骨质疏松及疾病活动与血清 IL-6、IL-10、CRP、MMP-3、大肠杆菌与 BMD 呈正相关,与 25(OH)D、乳酸菌和双歧杆菌呈负相关(p<0.05),与峭度值无相关性(p>0.05)。

结论

血清炎症因子、MMP-3、25(OH)D、肠道菌群的变化与 RA 患者骨质疏松及疾病活动有一定的相关性,在临床应用中具有一定的价值。

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