Di Jingkai, Song Liying, Liu Yaru, Zhang Zhibo, Wu Yawen, Chen Tingting, Xiang Chuan
The Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
Shanxi Medical University, Taiyuan, People's Republic of China.
J Pain Res. 2024 Nov 16;17:3803-3815. doi: 10.2147/JPR.S480925. eCollection 2024.
Despite the association between peripheral blood inflammatory biomarkers and a range of inflammatory diseases, the role of these biomarkers in osteoarthritis (OA) progression remains unclear. Additionally, whether alterations in these inflammatory markers impact the prognosis of OA patients remains an understudied area. The aim of our study was to investigate the specific associations between peripheral blood inflammatory markers and OA progression and OA-related mortality.
Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database from 1999 through 2018. The primary outcomes were all-cause mortality, cardiac mortality, and renal disease mortality, with information on the corresponding mortality rates for each participant obtained through association with the National Death Index (NDI). Multivariate logistic regression models were used to examine the relationship between peripheral blood lymphocyte counts and OA, and restricted cubic spline (RCS) analysis was utilized to assess whether there was a nonlinear relationship with OA and mortality of OA patients. Interaction and stratified analyses were employed to explore the association between peripheral blood leukocyte counts and OA.
This study included 1077 OA patients and 21,612 non-OA participants. In model 3 fully adjusted for covariates, eosinophil-to-lymphocyte ratio (ELR) and eosinophil (EOS) were positive risk factors promoting the development of OA (OR = 3.26, 95% CI: 1.49-7.14; OR = 1.79, 95% CI: 1.12-2.88). In stratified models for age, sex, BMI, smoking status, and alcohol consumption, the associations of ELR and EOS with OA were significantly different. RCS curves showed a J-shaped relationship between ELR and EOS and all-cause mortality in patients with OA. ELR was also found to significantly up-regulate cardiac mortality and renal mortality in patients with OA (OR = 3.92, 95% CI: 1.68-9.14; OR = 22.55, 95% CI: 6.55-77.70), while EOS was only significantly positively correlation (OR = 3.68, 95% CI: 1.94-7.01).
A significant relationship was found between ELR, EOS and OA. In addition, ELR and EOS were identified as potential predictors of mortality from different causes in patients with OA.
尽管外周血炎症生物标志物与一系列炎症性疾病之间存在关联，但这些生物标志物在骨关节炎（OA）进展中的作用仍不清楚。此外，这些炎症标志物的变化是否会影响OA患者的预后仍是一个研究不足的领域。我们研究的目的是调查外周血炎症标志物与OA进展及OA相关死亡率之间的具体关联。
数据来自1999年至2018年的美国国家健康与营养检查调查（NHANES）数据库。主要结局是全因死亡率、心脏疾病死亡率和肾脏疾病死亡率，通过与国家死亡指数（NDI）关联获取每位参与者的相应死亡率信息。使用多变量逻辑回归模型来检验外周血淋巴细胞计数与OA之间的关系，并利用受限立方样条（RCS）分析来评估与OA及OA患者死亡率是否存在非线性关系。采用交互作用和分层分析来探讨外周血白细胞计数与OA之间的关联。
本研究纳入了1077例OA患者和21612例非OA参与者。在对协变量进行完全调整的模型3中，嗜酸性粒细胞与淋巴细胞比值（ELR）和嗜酸性粒细胞（EOS）是促进OA发展的阳性危险因素（OR = 3.26，95%CI：1.49 - 7.14；OR = 1.79，95%CI：1.12 - 2.88）。在按年龄、性别、体重指数、吸烟状况和饮酒情况分层的模型中，ELR和EOS与OA的关联存在显著差异。RCS曲线显示OA患者中ELR和EOS与全因死亡率之间呈J形关系。还发现ELR显著上调OA患者的心脏疾病死亡率和肾脏疾病死亡率（OR = 3.92，95%CI：1.68 - 9.14；OR = 22.55，95%CI：6.55 - 77.70），而EOS仅呈显著正相关（OR = 3.68，95%CI：1.94 - 7.01）。
发现ELR、EOS与OA之间存在显著关系。此外，ELR和EOS被确定为OA患者不同原因死亡率的潜在预测指标。
