Abstract
Objective:To investigate the predictive value of serum levels of secreted frizzled-related protein 5(SFRP5),progranulin(PGRN),and growth differentiation factor 15(GDF15)for the progression of knee osteoarthritis(KOA).Methods:A total of 123 patients with KOA admitted from March 2022 to March 2025 and 120 healthy volunteers recruited during the same period were selected.Clinical da-ta including gender,age,Kellgren-Lawrence(K-L)grade,body mass index(BMI),and disease course were collected for KOA patients,while clinical data including gender and age were collected for healthy volunteers.Venous blood was drawn from subjects in the early morning fasting state,and serum levels of SFRP5,PGRN,and GDF15 were detected by ELISA.The KOA patients were included in the KOA group,and the healthy volunteers were included in the healthy control group to compare serum levels of SFRP5,PGRN,and GDF15 between the two groups.The KOA patients with K-L gradesⅠandⅡwere included in the early stage group,while those with gradesⅢandⅣwere included in the progressive stage group;and the age,gender,BMI,disease course,and serum levels of SFRP5,PGRN,and GDF15 were compared be-tween the two groups.Spearman correlation analysis was used to analyze the correlation between serum levels of SFRP5,PGRN,GDF15,and K-L grades;dibasic logistic regression model was used to analyze the relationship between serum levels of SFRP5,PGRN,GDF15,and KOA progression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum SFRP5,PGRN,and GDF15 levels for KOA progression.Results:The serum SFRP5 levels in the KOA group were lower than those in the healthy control group(t=6.676,P=0.000),while the serum PGRN and GDF15 levels were higher than those in the healthy control group(t=6.692,P=0.000;t=7.751,P=0.000).Among the 123 patients with KOA enrolled in the study,there were 31 cases in the early stage group and 92 cases in the progressive stage group.There were no statistically significant differences in gender and age between the two groups(χ2=0.004,P=0.947;t=1.874,P=0.063),while there were statistically significant differences in BMI and disease course between the two groups(t=4.605,P=0.000;Z=3.452,P=0.000).Moreover,serum SFRP5 levels in the progressive stage group were lower than those in the early stage group(t=4.601,P=0.000),and serum PGRN and GDF15 levels were higher than those in the early stage group(t=4.926,P=0.000;t=5.135,P=0.000).Correlation analysis results showed that serum SFRP5 level was negatively correlated with K-L grade(rs=-0.622,P=0.000),while serum PGRN and GDF15 levels were positively correlated with K-L grade(rs=0.645,P=0.000;rs=0.681,P=0.000).Dibasic logistic regression analysis results showed that serum SFRP5 level was a protective factor for KOA progression(β=-0.427,OR=0.652,95%CI(0.517,0.822),P=0.000),while serum PGRN and GDF15 levels were risk factors for KOA progres-sion(β=0.196,OR=1.216,95%CI(1.079,1.371),P=0.001;β=0.017,OR=1.017,95%CI(1.007,1.027),P=0.001).The area under the ROC curve for serum SFRP5,PGRN,GDF15 levels alone and their combination in predicting KOA progression was 0.786,0.764,0.803,and 0.913,respectively.The area under the ROC curve for the combined prediction was greater than that of the three indivi-dual predictions(Zcombined-SFRP5=3.987,P=0.000;Zcombined-PGRN=4.555,P=0.000;Zcombined-GDF15=3.764,P=0.000).Conclusion:Serum SFRP5 level is a protective factor for KOA progression,while serum PGRN and GDF15 levels are risk factors for KOA progression.Serum SFRP5,PGRN,and GDF15 levels can all effectively predict KOA progression,and the combination of the three has better predictive efficacy.关键词
骨关节炎,膝/疾病恶化/分泌型卷曲相关蛋白/颗粒蛋白前体/生长分化因子15/Logistic模型/因素分析,统计学/ROC曲线Key words
osteoarthritis,knee/disease progression/secreted frizzled-related proteins/progranulins/growth differentiation factor 15/logistic models/factor analysis,statistical/ROC curve
