OPG-RANKL-RANK系统对绝经后女性类风湿关节炎患者骨代谢的影响
The impact of OPG/RANKL/RANK to bone mineral density in postmenopausal female patients with rheumatoid arthritis
  
DOI:10.3969/j.issn.1006.7108.2016.03.003
中文关键词:  类风湿关节炎  核因子-kB受体活化因子配体  骨保护素;白介素-6  骨密度
英文关键词:Rheumatoid arthritis  RANKL  OPG  IL-6  BMD
基金项目:2013江苏省科技厅临床专项(BL2013034)
作者单位
徐建明 袁风红 高恺言 俞可佳 胥魏 胡赟霞 刘婷 时一添 邹耀红* 南京医科大学附属无锡人民医院风湿免疫科无锡214023 
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中文摘要:
      目的 探讨绝经女性类风湿关节炎(RA)患者外周血核因子-kB受体活化因子配体(RANKL)、骨保护素(OPG)与炎症因子及骨代谢指标之间的相关性。方法 收集绝经女性RA患者45例和健康对照组25例。采用双能X射线骨密度测量仪 (DEXA)测骨密度,酶联免疫吸附法(ELISA)测定人外周血清RANKL、OPG、IL-6水平,并详细记录临床、实验室资料。两组间计量资料比较采用t检验,相关分析釆用Pearson积差相关法。结果 ①与健康对照组相比,绝经女性RA组的骨密度、OPG/ RANKL低于对照组,RANKL、IL-6水平高于对照组(P?0.05),OPG在两组间并无统计学差异(P>0.05)。②绝经女性RA患者OP组较非OP组有更高的抗CCP抗体水平(P<0.05),RANKL、OPG、DAS28评分等并无差异(P>0.05)。③绝经女性RA 患者外周血中 RANKL 与 DAS28 评分、PINP、β-CTX、IL-6 正相关(r = 0. 357,0.381,0. 370,0.330,P< 0. 05),OPG 与 PINP、β- CTX、IL-6正相关(r=0. 561,0.511,0. 328,P<0. 05)。结论 绝经女性RA患者RANKL水平与炎症因子IL-6的诱导密切相关,但作为动态变化指标,仅反映近期骨代谢状况,并不能反映长期骨密度的变化。
英文摘要:
      Objective To assess the RANKL、OPG,inflammatory cytokines and bone metabolism among postmenopausal women with RA,and to investigate their relationships. Methods A total of 45 RA patients and 25 healthy controls are involved,both are postmenopausal women. Bone mineral density(BMD) were measured by dual energy X-ray absorptiometry. The level of RANKL, OPG and IL-6 were detected by ELISA. The clinical and lab data were also recorded in details.T-test were used for data analysis, and Pearson’s test were adsopted for correlation analysis. Results ① Compared with controls, the level of BMD and OPG/ RANKL in RA patients decreased significantly, while the level of RANKL and IL-6 increaesd obviously (P <0. 05). OPG had no statistical difference between two groups,② RA patients determined as OP had higher anti-CCP ( P < 0.05) than the Non-OP patients. The level of RANKL, OPG, DAS28 score and others had no statistical difference between two groups(P >0.05).③The level of RANKL was positively correlated with DAS28 score, PINP, β-CTX and IL-6(r = 0. 357,0. 381,0. 370,0. 330,P <0.05). The level of OPG was positively correlated with PINP, β-CTX and IL-6 ( r = 0.561,0.511,0. 328, P < 0. 05 ). Conclusion RANKL levels of postmenopausal women with RA is closely related to the inflammatory cytokines IL-6. However, it just reflects recent bone metabolism, does not reflect the changes of bone mineral density for a long time as a dynamic index.
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