中国骨质疏松杂志

骨质疏松合并骨关节炎患者血清中Wnt通路调节因子研究

Study on the regulatory factors of Wnt pathway in the combination of osteoporosis and osteoarthritis

DOI：10.3969/j.issn.1006-7108.2019.12.011

英文关键词:osteoarthritis osteoporosis Wnt signaling pathway inflammatory response bone mineral density

基金项目:中华中医药学会中医管理局中医治未病技术操作规范项目[SATCM-2015-BZ(352)]

作者	单位
陈清河1 陈闻佳2 曾维铨1*	1.福建中医药大学附属人民医院骨伤科，福建福州 350004 2.福建省直机关医院内分泌科，福建福州 350003

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中文摘要:

目的探讨骨质疏松(osteoporosis，OP)合并骨关节炎（osteoarthritis，OA）患者血清中β-catenin、Dickkopf-1（DKK-1）和Matrix metalloproteinase-9（MMP-9)的表达模式及其与临床参数的相关性。方法选取2017年1月至2018年3月在本院就诊的肌肉骨骼疾病患者158例，根据其症状分为OP（58例）、OA（52例）和OP＋OA（48例），另外选取40例健康个体作为对照组。所有受试者血清中的β-catenin、DKK-1和MMP-9表达量采用酶联免疫吸附方法（enzyme-linked immuno-sorbent assay，ELISA）进行检测。用Pearson相关性分析方法来检测这三种因子的表达量和临床参数：红细胞沉降率(erythrocyte sedimentation rate，ESR) 、C-反应蛋白(C-reactive protein，CRP) 、骨密度（bone mineral density，BMD），分析三者之间的关系。结果各组参与者在年龄上和体质量指数上无明显差别（P=0.356，P=0.438)。各组骨骼疾病患者（OP、OA和OP＋OA）在性别比例上均约为1：2。与健康组相比，OP＋OA组患者血清中的β-catenin含量明显下降（P=0.024)，而DKK-1（P=0.013)和MMP-9（P=0.003) 的表达水平显著升高，这种表达模式和OP组患者的表达模式相似。在OP＋OA组中β-catenin含量比OP组明显升高（P=0.047)，但比OA组明显降低（P=0.018)；而DKK-1和MMP-9含量与OP组（P=0.041/0.007)和OA组（P=0.006/0.002)相比明显升高。Pearson相关分析显示OP+OA组患者血清β-catenin和DKK-1与临床参数ESR/CRP存在相关性（r =0.713/0.621，r =0.462/0.321)；β-catenin和腰椎BMD/股骨颈BMD存在正相关（r =0.425/0.545)，但DKK-1与腰椎BMD/股骨颈BMD 呈负相关（r = -0.376/-0.315)；MMP-9仅和腰椎BMD/股骨颈BMD存在弱负相关性（r = -0.525/-0.324)。结论 OA+OP组血清β-catenin、DKK-1和MMP-9的表达不是OP组与OA组相关产物的简单混合。β-catenin/DKK-1/MMP-9与OP/OA临床参数的相关性表明这些因子表达的变化可作为临床炎症程度和骨质量诊断的参考。

英文摘要:

Objective To investigate the expression patterns of β-catenin, Dickkopf-1 (DKK-1) and Matrix metalloproteinase-9 (MMP-9) in serum of patients with osteoporosis (OP) and osteoarthritis (OA), as well as their correlation with clinical parameters. Methods According to the symptoms of the subjects, they were divided into healthy, OP, OA, and OP + OA groups. The expressions of β-catenin, DKK-1 and MMP-9 in the serum of all subjects were detected by ELISA (Enzyme-Linked Immuno-Sorbent Assay). Pearson correlation analysis was used to examine the relationship between the expression levels of these three factors and the clinical parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and bone mineral density (BMD). Results There were no significant differences in age and body mass index between any two of the healthy, OP, OA, and OP + OA groups. Patients in the groups of OP, OA, and OP + OA were similar in sex ratio (1:2). Compared with the healthy group, the level of serum β-catenin in OP + OA group was significantly increased (P = 0.024) while the expression levels of DKK-1 (P = 0.013) and MMP-9 (P = 0.003) were significantly decreased, which was similar to those in OP group. In addition, the content of β-catenin in OP + OA group was significantly higher than that in OP group (P = 0.047) but significantly lower than that in OA group (P = 0.018); however, the levels of DKK-1 and MMP-9 were significantly higher than those in the OP group (P = 0.041/0.007) and OA group (P = 0.006/0.002). Pearson correlation analysis showed that serum β-catenin and DKK-1 were correlated with ESR/CRP (r = 0.713/0.621 and r = 0.462/0.321). Lumbar spine BMD/femoral neck BMD was positively associated with β-catenin (r = 0.425/0.545), but negatively correlated with DKK-1 (r = -0.376/-0.315). There was a weak negative correlation between MMP-9 and lumbar spine BMD and femoral neck BMD (r = -0.525/-0.324). Conclusion The expression of serum β-catenin, DKK-1 and MMP-9 in OA + OP group is not a simple mixture of those products from the OP and OA groups. The correlation between β-catenin / DKK-1 / MMP-9 and OP / OA clinical parameters indicated that the expression changes of these factors could be used as a diagnostic reference for the degree of inflammation and bone quality in clinical setting.

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