Level Analysis And Clinical Significance Of Adipokines And Cytokines In Peripheral Blood And Synovial Fluid Of Patients With Knee Osteoarthritis

Objective:To determine whether adipokines and cytokines are related to the pathogenesis of knee osteoarthritis(KOA),we analyzed the differences of adipokines and cytokines in serum and synovial fluid between KOA patients with total knee arthroplasty and those who underwent internal fixation after fractures of the tibial plateau or lower femur.To clarify the role of adipokines and cytokines in serum and synovial fluid in the pathogenesis of KOA.Methods:In this study,24 KOA patients with total knee arthroplasty were selected as the KOA group,and 24 patients who underwent internal fixation after tibial plateau or lower femur fracture were selected as the control group.General informations(gender,age,height,weight,whether patients with hypertension,diabetes mellitus,coronary heart disease)were collected in the KOA group and the control group.Laboratory indicators(erythrocyte sedimentation rate,C reactive protein,blood cell analysis,liver function,kidney function,blood lipids)were obtained from the clinical laboratory of Shanxi Hua Jin Orthopedic Hospital.Peripheral blood and synovial fluid were collected from all patients.All blood samples were collected on an empty stomach on the morning of the second day of hospitalization,immediately centrifuged and stored in a-80℃ refrigerator.All synovial fluid were collected intraoperatively,centrifuged immediately and stored in a-80℃refrigerator.The absolute logarithms of adipokines(adiponectin,visfatin,resistin,leptin and chemerin)and cytokines(interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α))in peripheral blood and synovial fluid of each group were determined by enzyme-linked immunosorbent assay.The differences in laboratory indicators between the groups were analyzed.All antibodies used for ELISA were purchased from Rui Xin Biotech.Results:1.There was no statistical difference in age,gender,height and weight between the KOA group and the control group.BMI was statistically significant between the two groups(p=0.009).BMI was significantly higher in the KOA group than in the control group and the difference was statistically remarkable.There was no significant difference between the two groups in whether hypertension,diabetes mellitus,coronary heart disease were complicated(p> 0.05).2.There was no significant difference in CRP,WBC,HB,PLT,Ly,ALT,AST,ALP,GGT,BUN,Cr,UA,TC,TG,HDL,LDL,APOA and APOB between KOA group and control group.The level of ESR was notably higher in the KOA group than in the control group,with a statistically significant discrepancy(p=0.003);the Ly% level was remarkably higher in the KOA group than in the control group,with a statistically marked difference(p= 0.006).3.Compared with the control group,the serum adiponectin,visfatin,resistin,leptin and chemerin levels in KOA group were significantly higher than that the control group,with statistical differences(p < 0.001).4.In the KOA group,the serum levels of IL-1β,IL-6 and TNF-α were statistically significantly higher than those in the control group(p<0.001,p=0.001,p<0.001respectively).the serum levels of IL-10 in KOA group was lower than those in the control group,with no statistical difference between the two groups(p=0.070).5.Compared with the control group,the levels of adiponectin,visfatin,resistin,leptin and chemerin in the synovial fluid of KOA group were substantially higher than that of the control group,with statistical differences(p < 0.001).6.Compared with the control group,in the KOA group,the levels of IL-1β,IL-6 and TNF-α in the synovial fluid were strikingly higher than that of the control group,and the differences were statistically significant(p < 0.001,p =0.016,p < 0.001,respectively).The level of IL-10 in the synovial fluid of patients in the KOA group was lower than that of the control group,and the difference was considered statistically relevant in both groups(p <0.001).Conclusion:BMI,ESR and Ly% in KOA group were statistically higher than that of the control group,suggesting that obesity and inflammation were involved in the pathogenesis of KOA.The serum and synovial fluid levels of adiponectin,visfatin,resistin,leptin and chemerin of patients in KOA group were substantially higher than that of the control group.The levels of cytokines such as IL-1β,IL-6,and TNF-α in both serum and synovial fluid were strikingly higher in KOA group than in control group,while IL-10 levels in synovial fluid were considered significantly lower in KOA group than that of the control group.It is further suggested that adipokines and cytokines may be involved in the development of KOA.