| ObjectiveTo determine the serum levels of adipocytokines including leptin, adiponectin, visfatin and resistin and related pro-inflammatory cytokines IL-17/IL-6/IL-23in knee OA and analyze the relationship between adipocytokines and pro-inflammatory cytokines, the impact of adipocytokines on bone mineral density (BMD) in OA patients, and to explore the role of adipocytokines in the pathogenesis of OAand its clinical significance.Methods106knee OA patients who were received knee arthroscopy or joint replacement in shanghai fengxian district hospital from2009.1to2013.12was collected including male49cases, female57cases. Age was from39to78years old, and the average age was (57.6±6.3) years old. Duration of knee OA was from1to25years, and the average (8.3±3.7) years. Body mass index(BMI) was (20.3to26.8), and the average (23.7±2.4).30cases of knee meniscus injury or anterior cruciate ligament of knee who received treatment in our hospital at the same period were included. There were male14cases, female16cases Age was from35to75years old, and the average age was (54.2±5.8) years old. Duration of knee OA was from3to27days, and the average (7.2±3.4) days. BMI was (21.3to24.7), and the average (22.9±2.5). All the basic clinical indicators for each patient were recorded in details, such as height, weight, and BMI was calculated. Enzyme linked immunosorbent assay (ELISA) was used to examine the serum levels of leptin, adiponectin, visfatin and resistin and related cytokine IL-6/IL-17/IL-23of experimental subjects of knee OA patients. Dual x-ray absorbtiometry was used to detect the BMD of the pelvis, lumbar spine2-4(L2-4), femur(femur neck, Ward area, greater trochanter). Knee X-ray assessment contain Kellgren-Lawrence (K-L) grades and joint-space narrowing (JSN) grades. All the patients were grouped according to BMD, JSN, and the change of adipocytokines in synovial fluid of OA patients, the relationship between adipocytokines and pro-inflammatory cytokines, BMD was analyzed.Results1. The BMI in OA group was significantly higher than that of control group (P<0.05), and the severity is positively associated with BMI and duration of knee OA.2. The levels of leptin, adiponectin, visfatin and resistin in synovial fluid of OA patients were inordinately increased compared with those of control group. And adipocytokines increased as the severity of OA (P<0.05).3. The levels of IL-6/IL-17/IL-23in synovial fluid of OA patients were inordinately increased compared with those of control group. And pro-inflammatory cytokines increased as the severity of OA (P<0.05).4. Compared with normal BMD group, the levels of leptin and adiponectin in osteopenia group and osteoporosis group were gradually increased(P<0.05), while there was no significance difference on the visfatin and resistin between osteopenia group and osteoporosis group(P>0.05).5. The level of leptin was positive correlated with IL-17(r=0.547,P=0.041), the level of adiponectin was positive correlated with IL-17(r=0.649, P=0.034), IL-23(r=0.715, P=0.016), the level of visfatin was positive correlated with IL-6(r=0.548, P=0.041), IL-23(r=0.516,P=0.045), the level of resistin was positive correlated with IL-23(r=0.581, P=0.039).6. Negative correlation was found between leptin in synovial fluid and BMD of lumbar spine2-4(L2-4)(r=-0.431, P=0.048), Ward area(r=-0.631, P=0.034), Troch(r=-0.433, P=0.041). The level of adiponectin was negative correlated with BMD of lumbar spine2-4(L2-4)(r=-0.654, P=0.021), femur neck(r=-0.534, P=0.029), Ward area(r=-0.591, P=0.046), Troch(r=-0.541, P=0.043). There was negative correlation between visfatin and BMD of femur neck(r=-0.735, P=0.018), Ward area(r=-0.521, P=0.025). The level of resistin was negative correlated with BMD of lumbar spine2-4(L2-4)(r=-0.678, P=0.045).7. The K-L grades was positive correlated leptin(OR=2.16), adiponectin (OR=1.97), visfatin(OR=1.06)(all.P＜0.05). there was significant difference between leptin and K-L grades after adjusting age, gender, duration of OA, BMI and inflammatory factor(P<0.05).8. After adjusting age, gender, duration of OA, BMI, multiple linear regression showed that leptin, adiponectin and IL-6were independent influence factors of BMD. Conclusion1. The levels of adipocytokines including leptin, adiponectin, visfatin, resistin and inflammatory factors IL-6/IL-17/IL-23in synovial fluid of OA patients are higher than those in non OA patients., and adipocytokines and inflammatory factors increased as the severity of OA.2. The levels of adipocytokines including leptin, adiponectin, visfatin, resistin is highly correlated with BMD in OA patients, and they may be have a detrimental effect on the BMD in OA patients.3. Adipocytokines and inflammatory factors have a close relationship, which are jointly involved in the occurrence and development of OA, and may play a key role in the mechanism of OA.4. Intervention strategy on the adipocytokines may be a new ways to treat and prevent OA. |
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