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目的：研究脂联素（adiponectin,ADP）在代谢综合征型膝关节骨性关节炎（metabolic syndrome knee osteoarthritis,Mets-KOA）患者关节液及血清中的表达水平。方法：32例接受全膝关节置换手术的膝关节骨性关节炎患者，其中16例为Mets-KOA(Mets-KOA组)，16例为单纯KOA(pure-KOA组)。比较两组患者临床特征、关节液和血清中ADP水平及其与临床特征的相关性。结果：Mets-KOA组腰围、空腹血糖、血清甘油三酯、极低密度脂蛋白胆固醇水平分别为（90.93±7.75）cm、（5.76±1.25）mmol/L、（2.33±1.07）mmol/L、（0.43±0.23）mmol/L，高于pure-KOA组的（85.64±6.28）cm、（4.98±0.52）mmol/L、（1.34±0.57）mmol/L、（0.27±0.11）mmol/L，高密度脂蛋白胆固醇浓度为（1.14±0.18）mmol/L，低于pure-KOA组的（1.30±0.19）mmol/L（均P<0.05）。Mets-KOA组西安大略大学和麦克马斯特大学骨关节炎指数（Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC）功能评分、疼痛评分分别为（108.78±14.18）分、32.50(30.25,35.65)分，高于pure-KOA组的（96.45±15.28）分、23.50(21.15,29.25)分（均P<0.05）。两组患者WOMAC僵直评分、体质量指数、总胆固醇、低密度脂蛋白胆固醇、血沉、C反应蛋白及Kellgren-Lawrence分级比较，差异均无统计学意义（P>0.05）。Mets-KOA组关节液和血清中脂联素浓度分别为（612.24±122.98）pg/mL、（5 851.30±1 783.11）pg/mL，低于pure-KOA组的（707.73±127.03）pg/mL、（7 817.29±2 808.10）pg/mL（均P<0.05）;MetsKOA组女性关节液和血清脂联素浓度分别为（611.51±110.30）pg/mL、（5 813.14±1 658.26）pg/mL，低于pure-KOA组女性的（731.24±113.64）pg/mL、（8 188.69±2 933.05）pg/mL（均P<0.05）。相关性分析显示，Mets-KOA组患者关节液和血清中脂联素浓度与空腹血糖存在负相关关系（r关节液=-0.350,P=0.049;r血清=-0.385,P=0.033）。结论：Mets-KOA患者关节液和血清中ADP水平明显低于单纯KOA患者，且与空腹血糖负相关，提示脂联素在Mets-KOA发病中扮演重要角色。
Abstract：Objective: To investigate the expression level of adiponectin(ADP)in the synovial fluid and serum of patients with metabolic syndrome knee osteoarthritis(Mets-KOA). Methods: Among 32 patients with knee osteoarthritis who underwent total knee replacement surgery, 16 cases were classified as the Mets-KOA(Mets-KOA group), and the other 16 cases were classified as the pure-KOA(pure-KOA group). Compare the clinical characteristics, ADP levels in the synovial fluid and serum, and their correlations with clinical features between the two groups of patients. Results:The waist circumference, fasting blood glucose, serum triglycerides, and very low-density lipoprotein cholesterol levels in the MetsKOA group were(90.93±7.75)cm,(5.76±1.25)mmol/L,(2.33±1.07)mmol/L, and(0.43±0.23)mmol/L respectively, which were higher than(85.64±6.28)cm,(4.98±0.52)mmol/L,(1.34±0.57)mmol/L,(0.27±0.11)mmol/L in the pure-KOA group, while the high-density lipoprotein cholesterol concentration was(1.14±0.18)mmol/L, which was lower than(1.30±0.19)mmol/L in the pure-KOA group(all P<0.05). The functional score on the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) and pain score in the Mets-KOA group were(108.78±14.18) points and 32.50(30.25, 35.65) points respectively,which were higher than(96.45±15.28) points and 23.50(21.15, 29.25) points in the pure-KOA group(both P<0.05). There were no statistically significant differences in the WOMAC stiffness scores, body mass index, total cholesterol, low-density lipoprotein cholesterol, erythrocyte sedimentation rate, C-reactive protein, and Kellgren-Lawrence grading between the two groups of patients(P>0.05). The levels of adiponectin in the synovial fluid and serum in the Mets-KOA group were(612.24±122.98) pg/mL and(5 851.30±1 783.11) pg/mL respectively, which were lower than(707.73±127.03) pg/mL and(7 817.29 ±2 808.10) pg/mL in the pure-KOA group(both P <0.05). The levels of adiponectin in the synovial fluid and serum in the female patients in the Mets-KOA group were(611.51±110.30) pg/mL and(5 813.14±1 658.26) pg/mL respectively, which were lower than(731.24±113.64) pg/mL and(8 188.69±2 933.05) pg/mL in the pure-KOA group(both P<0.05). The correlation analysis showed that the levels of adiponectin in the synovial fluid and serum in the Mets-KOA group were negatively correlated with fasting blood glucose(r for synovial fluid=-0.350, P=0.049; r for serum=-0.385, P=0.033). Conclusion:The ADP levels in the synovial fluid and serum in the Mets-KOA patients are significantly lower than those in the pure-KOA patients, and are negatively correlated with fasting blood glucose, suggesting that adiponectin plays an important role in the pathogenesis of Mets-KOA.
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基本信息:
DOI：10.19767/j.cnki.32-1412.2025.06.003
中图分类号:R684.3
引用信息:
[1]熊培康,王高强,仇赛,等.脂联素在代谢综合征型膝关节骨性关节炎中的表达研究[J].交通医学,2025,39(06):561-566.DOI:10.19767/j.cnki.32-1412.2025.06.003.
基金信息:
南通市基础科学研究和社会民生科技计划项目（JCZ2022129）