Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.
The First Clinical College, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.
Cartilage. 2021 Dec;13(1_suppl):1465S-1473S. doi: 10.1177/19476035211007919. Epub 2021 Apr 17.
The aim of this study was to detect levels of common lipid species in serum and synovial fluid (SF) of primary knee osteoarthritis (OA) patients and investigate their correlations with disease severity.
The study enrolled 184 OA patients receiving arthroscopic debridement or total knee arthroplasty and 180 healthy controls between April 2012 and March 2018. Total triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) levels were analyzed in serum and SF of OA patients, and in serum of healthy individuals. The Noyes rating criteria, Kellgren-Lawrence (KL) grading system, and Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores were, respectively, used to assess cartilage damage, radiographic severity, and symptomatic severity of OA.
No significant differences were found in serum TG and ApoB levels between the 2 groups, while OA patients had higher TC and LDL-C levels and lower HDL-C and ApoA1 levels ( < 0.05). Pearson correlation analysis revealed SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage scores, KL grades as well as WOMAC scores ( < 0.05), which were still significant after adjusting for confounding factors ( < 0.05). Receiver operating characteristic curve analysis revealed SF HDL-C (area under the curve [AUC]: 0.816) and ApoA1 (AUC: 0.793) were also good predictors of advanced-stage OA ( < 0.001).
SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage, radiographic severity, and symptomatic severity of primary knee OA, emerging as potential biomarkers for radiographic advanced-stage OA, which may serve as predictors of disease severity.
本研究旨在检测原发性膝骨关节炎（OA）患者血清和滑液（SF）中常见脂质种类的水平，并探讨其与疾病严重程度的关系。
本研究纳入了 2012 年 4 月至 2018 年 3 月期间接受关节镜清理术或全膝关节置换术的 184 例 OA 患者和 180 例健康对照者。分析了 OA 患者血清和 SF 中的总甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白 A1（ApoA1）和载脂蛋白 B（ApoB）水平，并分析了健康个体的血清水平。采用 Noyes 评分标准、Kellgren-Lawrence（KL）分级系统和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分分别评估软骨损伤、影像学严重程度和 OA 的症状严重程度。
两组患者血清 TG 和 ApoB 水平无显著差异，而 OA 患者 TC 和 LDL-C 水平较高，HDL-C 和 ApoA1 水平较低（<0.05）。Pearson 相关分析显示 SF HDL-C 和 ApoA1 水平与软骨损伤评分、KL 分级以及 WOMAC 评分呈负相关（<0.05），调整混杂因素后仍有统计学意义（<0.05）。受试者工作特征曲线分析显示 SF HDL-C（曲线下面积 [AUC]：0.816）和 ApoA1（AUC：0.793）也是晚期 OA 的良好预测指标（<0.001）。
SF HDL-C 和 ApoA1 水平与原发性膝 OA 的软骨损伤、影像学严重程度和症状严重程度呈负相关，可能成为影像学晚期 OA 的潜在生物标志物，可作为疾病严重程度的预测指标。
