Zhang Shiyong, Zhong Yanlin, Wang Xudong, Jiang Wei, Chen Xicong, Kang Yunze, Li Zhiwen, Liao Weiming, Zheng Linli, Sheng Puyi, Zhang Ziji
Department of Joint Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
Department of Bone and Joint, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China.
Osteoarthr Cartil Open. 2024 Jun 19;6(3):100496. doi: 10.1016/j.ocarto.2024.100496. eCollection 2024 Sep.
Numerous studies have established the role of inflammation in osteoarthritis (OA) progression, yet limited research explores the association between systemic inflammatory indicators and pre-diagnosis OA risk. This study aimed to investigate the association between peripheral inflammatory indicators and the risk of OA using data from the UK Biobank.
The study analyzed data from 417,507 participants in the UK Biobank, including neutrophil count, lymphocyte count, monocyte count, platelet count, and C-reactive protein meter. Additionally, derived ratios such as NLR(neutrophils-lymphocytes ratio), PLR(Platelets-lymphocytes ratio), SII(systemic immune-inflammation index), and LMR (lymphocytes-monocytes ratio) were examined. Cox proportional hazards models and restricted cubic spline models were used to assess both linear and nonlinear associations.
Over a mean follow-up period of 12.7 years, a total of 49,509 OA events were identified. The findings revealed that CRP (HR:1.06, 95%CI:1.05-1.07), NLR (HR:1.02, 95%CI:1.01-1.03), PLR (HR:1.02, 95%CI:1.01-1.03), and SII (HR:1.03, 95%CI:1.01-1.04) were associated with an increased risk of OA, while LMR (HR:0.97, 95%CI:0.96-0.99) showed a significant negative correlation with OA risk. Subgroup analyses further emphasized that these associations were significant across most of the population. Although neutrophils, lymphocytes, monocytes, and platelets showed a nominal association with the risk of OA, the results were unreliable, especially for specific joint OA.
The study provides evidence of a significant association between elevated peripheral inflammatory indicators and OA risk. These findings underscore the importance of low-grade chronic inflammation in OA development. The potential clinical utility of these indicators as early predictors of OA is suggested, warranting further exploration.
众多研究已证实炎症在骨关节炎(OA)进展中的作用,但探索全身炎症指标与OA预诊断风险之间关联的研究有限。本研究旨在利用英国生物银行的数据调查外周炎症指标与OA风险之间的关联。
该研究分析了英国生物银行中417,507名参与者的数据,包括中性粒细胞计数、淋巴细胞计数、单核细胞计数、血小板计数和C反应蛋白测量值。此外,还检查了衍生比率,如中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)、全身免疫炎症指数(SII)和淋巴细胞与单核细胞比率(LMR)。使用Cox比例风险模型和受限立方样条模型评估线性和非线性关联。
在平均12.7年的随访期内,共确定了49,509例OA事件。研究结果显示,C反应蛋白(HR:1.06,95%CI:1.05 - 1.07)、NLR(HR:1.02,95%CI:1.01 - 1.03)、PLR(HR:1.02,95%CI:1.01 - 1.03)和SII(HR:1.03,95%CI:1.01 - 1.04)与OA风险增加相关,而LMR(HR:0.97,95%CI:0.96 - 0.99)与OA风险呈显著负相关。亚组分析进一步强调,这些关联在大多数人群中都很显著。尽管中性粒细胞、淋巴细胞、单核细胞和血小板与OA风险存在名义上的关联,但结果不可靠,尤其是对于特定关节的OA。
该研究提供了外周炎症指标升高与OA风险之间存在显著关联的证据。这些发现强调了低度慢性炎症在OA发展中的重要性。提示了这些指标作为OA早期预测指标的潜在临床应用价值,值得进一步探索。