Wang Qian, Bi Long, Ma Jie
Orthopedic Operating Room, the First Affiliated Hospital of Air Force Military Medical University of Chinese People's Liberation Army, Xi'an 710032, Shaanxi, China.
Zhongguo Gu Shang. 2023 Nov 25;36(11):1052-7. doi: 10.12200/j.issn.1003-0034.2023.11.009.
To analyze the correlation between the expression of silencing information regulator 2 related enzyme 1 (SIRT1), tumor necrosis factor like weak inducer of apoptosis (TWEAK) and knee osteoarthritis.
Total of 103 patients with knee joint (knee osteoarthritis group) from February 2019 to August 2021 were selected including 40 males and 63 females with an average age of (62.02±6.09) years;according to the modified Mankin score, 103 patients were divided into mild group (Mankin score 1-4 points, 31 cases) and moderate group (Mankin score 5-8 points, 40 cases) and severe group (Mankin score ≥9, 32 cases). Another 105 physical examination volunteers were selected as the control group including 46 males and 59 females with an average age of (62.11±6.34) years old. The levels of SIRT1 and TWEAK in articular effusion and serum were detected in the knee osteoarthritis group, while serum SIRT1 and TWEAK were detected in the control group only. The relationship between SIRT1, TWEAK and the occurrence and disease of knee osteoarthritis were analyzed.
Articular cavity fluid TWEAK, serum TWEAK, CRP, IL-6, IL-1β, white blood cell count and ESR were higher than those in the control group(<0.05), articular cavity fluid SIRT1 and serum SIRT1 were lower than those in the control group(<0.05). TWEAK level in the severe group was higher than that in the moderate and mild groups(<0.05), SIRT1 was lower than that in the moderate and mild groups (<0.05). The level of SIRT1 in articular cavity effusion was positively correlated with the serum level of SIRT1 (<0.05), and negatively correlated with CRP, IL-6, IL-1β, white blood cell count, modified Mankin score and ESR (<0.05). TWEAK level in articular cavity fluid was positively correlated with serum TWEAK level (<0.05), C-reactive protein(CRP), interleukin(IL)-6, IL-1β, white blood cell count, modified Mankin score and erythrocyte sedimentation rate(ESR) (<0.05). Body mass index, undertaking heavy physical work, and articular cavity fluid TWEAK were risk factors for the occurrence of knee osteoarthritis(<0.05), and articular cavity fluid SIRT1 was a protective factor for the occurrence of knee arthritis (<0.05). The area under curve(AUC) of SIRT1 and TWEAK for knee osteoarthritis was 0.641 and 0.653, and the AUC of SIRT1 and TWEAK for knee osteoarthritis was 0.879, which was higher than SIRT1 and TWEAK alone (z=6.105 and 6.225, <0.05).
The level of SIRT1 in articular fluid in patients with knee arthritis is decreased and the level of TWEAK is increased. Low SIRT1 and high TWEAK are associated with the onset and exacerbation of knee osteoarthritis.
分析沉默信息调节因子2相关酶1（SIRT1）、肿瘤坏死因子样凋亡弱诱导剂（TWEAK）的表达与膝关节骨关节炎的相关性。
选取2019年2月至2021年8月膝关节病患者103例（膝关节骨关节炎组），其中男40例，女63例，平均年龄（62.02±6.09）岁；根据改良Mankin评分将103例患者分为轻度组（Mankin评分1 - 4分，31例）、中度组（Mankin评分5 - 8分，40例）和重度组（Mankin评分≥9分，32例）。另选取105例体检志愿者作为对照组，其中男46例，女59例，平均年龄（62.11±6.34）岁。检测膝关节骨关节炎组关节积液及血清中SIRT1、TWEAK水平，对照组仅检测血清SIRT1、TWEAK水平，分析SIRT1、TWEAK与膝关节骨关节炎发生、病情的关系。
关节腔积液TWEAK、血清TWEAK、CRP、IL - 6、IL - 1β、白细胞计数及ESR高于对照组（P<0.05），关节腔积液SIRT1及血清SIRT1低于对照组（P<0.05）。重度组TWEAK水平高于中度及轻度组（P<0.05），SIRT1低于中度及轻度组（P<0.05）。关节腔积液SIRT1水平与血清SIRT1水平呈正相关（P<0.05），与CRP、IL - 6、IL - 1β、白细胞计数、改良Mankin评分及ESR呈负相关（P<0.05）。关节腔积液TWEAK水平与血清TWEAK水平、C反应蛋白（CRP）、白细胞介素（IL）- 6、IL - 1β、白细胞计数、改良Mankin评分及红细胞沉降率（ESR）呈正相关（P<0.05）。体重指数、从事重体力劳动及关节腔积液TWEAK是膝关节骨关节炎发生的危险因素（P<0.05），关节腔积液SIRT1是膝关节骨关节炎发生的保护因素（P<0.05）。SIRT1、TWEAK诊断膝关节骨关节炎的曲线下面积（AUC）分别为0.641、0.653，二者联合诊断膝关节骨关节炎的AUC为0.879，高于单独的SIRT1和TWEAK（z = 6.105、6.225，P<0.05）。
膝关节骨关节炎患者关节液中SIRT1水平降低，TWEAK水平升高。低SIRT1和高TWEAK与膝关节骨关节炎的发生及病情加重相关。
