安徽医科大学学报2013，Vol.48Issue(5)：512-516,5.
膝骨关节炎患者血清瘦素水平变化及其临床意义
Changes and clinical significance of serum leptin in knee osteoarthritis
摘要
Abstract
Objective To determine the serum levels of leptin ( LPT )in knee radiographic osteoarthritis( KOA )and the association of serum leptin with bone mineral density in knee radiographie osteoarthritis. According to the ISCD and clinical practice,87 subjests were divided into normal bone group, osteopenia group and osteoporosis group. Based on the international obesity group ( ISAO ) diagnostic criteria, subjects were divided into normal weight group, overweight group and obesity group. Methods Serum leptin levels were detected by enzyme-linked immu-nosorbent assay ( ELISA ) in 87 cases with OA. BMD( bone mineral density ) was measured by dual enery X-ray ab-sorptiometry ( DXA ) at the whole body, pelvic, lumbar spine and femora. Body compositions including lean tissue mass and body fat mass were measured by DXA. Joint osteophytes and joint-space narrowing were assessed by X-ray,and their relationship was analyzed. Results ①women LPT levels obviously were higher than male( P < 0. 01 ); ② positive correlation was detected between serum leptin levels and the following: waist circumference, hip circumference, waist hip ratio, BMI, body fat percentage, total cholesterol ( TC ), low density lipoprotein ( LDL ), the whole body fat weight, trunk fat weight of the patients with OA( both P < 0. 05 ); and negative correlation was found between serum leptin levels and the whole body bone mineral density ( P < 0 . 0 5 ) . Waist circumfer- ence, TC and age were influencing factors of serum leptin levels. ③the LPT levels of normal BMD group, osteope-nia group and osteoporosis group were gradually increased. Serum leptin levels in osteoporosis group were obviously higher than that in osteopenia group ( P < 0. 05 ), and both groups were higher than normal group ( P < 0. 05 ); ④ serum leptin levels were found to have positive correlation in the medial femoral OP of the knees ( P < 0. 05 , respectively ). Leptin was the main risk factor of both lateral tibiofemoral joint-space narrowing of the knees ( P < 0. 05 , respectively ). The medial tibial OP of both knees were the main influencing factors of pain ( P < 0. 05 ). Conclusion Obesity is the risk factor in knee OA. Leptin may be mediated in obesity in knee OA articular cartilage damage effect. Osteophytes and joint-space narrowing grades are more sensitive, reliable than the traditional X-ray K-L grades. Osteophytes are closely related to the patients pain.关键词
膝关节/骨关节炎/肥胖/瘦素/骨密度Key words
knee/ osteoarthritis/ obesity/ leptin/ bone mineral density分类
医药卫生引用本文复制引用
何凡,徐建华,丁长海,张明铭,张锐..膝骨关节炎患者血清瘦素水平变化及其临床意义[J].安徽医科大学学报,2013,48(5):512-516,5.基金项目
国家自然科学基金(编号:81172865) （编号:81172865）
