关节液中脂联素水平与膝关节骨关节炎严重程度的相关性研究

背景：众所周知，肥胖是引起骨关节炎发生、发展的危险因素之一。肥胖人群容易发生关节炎的原因是超载作用和代谢因素。脂肪组织是一个活跃的器官，它的分泌脂肪细胞因子包括脂联素进入全身循环，参与了骨关节炎的发病。 目的：测量骨关节炎患者血清和关节滑液中脂联素水平，分析其与膝关节骨关节炎严重程度的相关性。 方法：64例膝关节骨关节炎患者（关节炎组）和19例因半月板或韧带损伤患者（对照组，行关节镜检查后排除软骨损伤）被纳入本研究。采用Kellgren-Lawrence（KL）标准对关节炎患者的膝关节前后位X线片进行评估分级。使用酶联免疫吸附试验检测脂联素在对照组和关节炎组患者血清和关节滑液中的表达水平。使用WOMAC量表（Western On-tario and McMaster Universities Arthritis Index）评估患者膝关节功能。 结果：骨关节炎组患者血清中的脂联素水平[（6177.8±991.0）ng/ml]高于对照组[（5793.4±673.3）ng/ml]，但差异无统计学意义（P=0.12）。但在骨关节炎组患者，血清中的脂联素浓度[（6177.8±991.0）ng/ml]显著高于关节滑液中的脂联素[（824.3±304.7）ng/ml，P〈0.001）。关节炎患者关节液中脂联素浓度与评估疾病的严重程度呈负相关（r=-0.51，P〈0.001），但血清脂联素浓度与疾病的严重程度关联不显著（r=-0.17，P=0.18）。血清脂联素水平、滑膜液脂联素水平与MOMAC疼痛评分均不显著相关（r=-0.01和r=-0.13，P＞0.05）。 结论：骨关节炎患者滑膜液中脂联素水平与膝关节炎严重程度呈负相关。检测关节滑液中的脂联素可能有助于早期发现关节炎。

Correlation between adiponectin in synovial fluid and knee osteoarthritis severity

Background：Obesity is a well-known risk factor for the development and the progression of osteoarthritis. The overloading and metabolic factors may contribute to the high prevalence of osteoarthritis among obese individuals. Adipose tissue is an active organ that secrets adipokines into the systemic circulation. Among these, adiponectin has been implicated in the pathogenesis of osteoarthritis. Objective：To investigate the correlation between adiponectin concentrations in plasma and synovial fluid and knee osteoar-thritis severity. Methods：Sixty-four osteoarthritis patients and nineteen controls （meniscus or ligament injury without cartilage injury under arthroscopy） were enrolled in this study. The progression of osteoarthritis was classified by Kellgren-Lawrence grading scale by evaluating X-ray changes observed in anteroposterior knee radiography. Western Ontario and McMaster Universi-ties Arthritis Index （WOMAC） was used to rate knee function. The concentrations of adiponectin in plasma and synovial flu-id were determined by commercial enzyme-linked immunosorbent assay. Results：Plasma levels of adiponectin were higher in osteoarthritis patients as compared with the controls, but there were no significant difference between them （[6177.8±991.0] ng/ml vs [5793.4±673.3] ng/ml, P=0.12）. Adiponectin levels in plasma of osteoarthritis patients were significantly higher with regard to paired synovial fluid （[6177.8 ± 991.0] ng/ml vs [824.3 ± 304.7] ng/ml, P〈0.001）. The concentration of adiponectin of synovial fluid was negatively correlated wtih the severity of osteoarthritis （r=-0.51, P〈0.001）, while plasma adiponectin concentration was not correated to the severity of osteoarthri-tis（r=-0.17, P=0.18）. Neither adiponectin of synovial fluid nor plasma adiponectin were correlated with WOMAC score （r=-0.13, r=-0.01, P〉0.05）. Conclusions：The concentration of leptin of synovial fluid were is closely related to the radiographic severity of osteoarthri tis. Therefore, it