Arce-Rosas Jorge I, González-Hernández Luz A, Cabrera-Silva Rodolfo I, Alvarez-Zavala Monserrat, Sánchez-Reyes Karina, Tafoya Arreguín Gustavo A, Martinez Ruíz Jose de Jesús, Cerda de la Torre Rodrigo, Ramos-Solano Moisés, Andrade-Villanueva Jaime F
Servicio de Traumatología y Ortopedia, Hospital Civil de Guadalajara 'Fray Antonio Alcalde', Guadalajara, Jalisco, Mexico.
Unidad de VIH, Hospital Civil de Guadalajara 'Fray Antonio Alcalde', Guadalajara, Jalisco, Mexico; Universidad de Guadalajara, Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco, Mexico.
Knee. 2022 Dec;39:100-105. doi: 10.1016/j.knee.2022.08.005. Epub 2022 Sep 28.
Knee Osteoarthritis (KOA) is a multifactorial disease with several mechanisms to promote articular cartilage damage. New molecules, such as ghrelin, have been recently reported to participate in the pathogenesis and progression of KOA. In HIV + patients, arthralgias are the most frequent musculoskeletal manifestations, mainly affecting joints such as the knee. Also, it has been reported that HIV + patients have a reduction of ghrelin even with treatment compared to HIV- patients. However, there is no report in the literature evaluating ghrelin and KOA in the HIV + population. We aimed to evaluate whether serum ghrelin levels can function as a biomarker for OA in HIV + patients.
We recruited 40 patients, 20 HIV+, and 20 HIV- controls, and grouped as follows: HIV+/KOA+; HIV+/KOA-; HIV-/KOA+; HIV-/KOA-. Clinical features were obtained during clinical visits. Peripheral blood samples were acquired to measure serum ghrelin levels.
The HIV+/KOA + group significantly reduced serum ghrelin levels when compared with the other groups. Comparing the ghrelin levels with the patients' nadir of CD4 T-cells count, we identified a statistically significant negative correlation in the KOA- group (r = -0.80, P < 0.007). An ROC curve analysis, for the accuracy of ghrelin levels to identified HIV+/KOA + from HIV+/KOA- patients, found an area under the curve of 0.83 (95 % CI 0.65-0.10; P = 0.017), with a cut-off < 4026 pg/mL serum ghrelin levels, with a sensitivity of 0.62 (95 % CI 0.32-0.86), and a specificity of 0.10 (95 % CI 0.59-0.10).
This study shows the potential use of ghrelin levels as a biomarker for KOA in the high-risk HIV population that should be further analyzed.
膝骨关节炎（KOA）是一种多因素疾病，有多种机制可促进关节软骨损伤。最近有报道称，诸如胃饥饿素等新分子参与了KOA的发病机制和进展过程。在HIV阳性患者中，关节痛是最常见的肌肉骨骼表现，主要影响膝关节等关节。此外，有报道称，与HIV阴性患者相比，即使接受治疗，HIV阳性患者的胃饥饿素水平也会降低。然而，文献中尚无关于评估HIV阳性人群中胃饥饿素与KOA的报道。我们旨在评估血清胃饥饿素水平是否可作为HIV阳性患者骨关节炎的生物标志物。
我们招募了40名患者，20名HIV阳性和20名HIV阴性对照，分组如下：HIV阳性/KOA阳性；HIV阳性/KOA阴性；HIV阴性/KOA阳性；HIV阴性/KOA阴性。在临床就诊期间获取临床特征。采集外周血样本以测量血清胃饥饿素水平。
与其他组相比，HIV阳性/KOA阳性组的血清胃饥饿素水平显著降低。将胃饥饿素水平与患者CD4 T细胞计数最低点进行比较，我们发现在KOA阴性组中存在统计学上显著的负相关（r = -0.80，P < 0.007）。一项ROC曲线分析，为了评估胃饥饿素水平区分HIV阳性/KOA阳性患者与HIV阳性/KOA阴性患者的准确性，发现曲线下面积为0.83（95% CI 0.65 - 0.10；P = 0.017），血清胃饥饿素水平临界值 < 4026 pg/mL，敏感性为0.62（95% CI 0.32 - 0.86），特异性为0.10（95% CI 0.59 - 0.10）。
本研究表明胃饥饿素水平有可能作为高危HIV人群中KOA的生物标志物，应进一步分析。
