Study On The Changes Of Serum Levels Of Bone Turnover Factors In OA Patients By High-throughout Assay

The first part: Summary of Research BackgroundThe second part: Study on the changes of serum levels of bone turnover factors in OA patients by high-throughout assayThe Research BackgroundOsteoarthritis(OA)is one of the most common progressive joint diseases in orthopedic clinic.Already clear,bone metabolic abnormalities are closely associated with the illness and disease outcome of the OA,some factors proved to participate in the regulation of the balance of synthesis and catabolism of bone,these factors including PTH and OPN,OPG,LEPTIN,LEPTIN,DKK1,TNF-α,SOST,,at present,these bone transformation precise role in regulating factor on the pathogenesis of OA,remains to be further clarified.Research Rurpose 1 The correlation between serum bone conversion factor and the severity of varus deformity of knee joint in patients with primary OA was retrospectively studied;2 The correlation between the degree of joint damage and serum DKK1,OPG,TNF-α and other factors in patients with OA was retrospectively studied;3 The changes of bone conversion factors in patients with OA complicated with hypertension before and after primary arthroplasty were retrospectively compared.The Research MethodsIn order to study the osteoarthritis patients serum bone conversion factors correlated with the severity of patients with knee varus deformity,we collected from June 2014 to April 2015,nanjing drum tower hospital joint surgical treated 139 cases of primary knee arthritis patients serum samples,using Luminex MAP (?) high-throughput detection of bone conversion regulating factor PTH,OPG,LEPTIN,DKK1,TNF alpha,OPN,SOST concentrations in the serum,etc.For each patient,full-length radiographs of lower limbs bearing weight were taken,and the proximal medial tibia Angle(MPTA) and HKA Angle were measured.The normal MPTA Angle was 87°±2°,and the patients were divided into MPTA& LT groups.85° varus group and 85°--90° normal group and gt;90° valgus group.To investigate the correlation between DKK1,OPG,TNF-α and the degree of joint lesions in OA patients,148 patients with knee OA aged 47-85 years and 101 healthy controls were included in this study.Anteroposterior and lateral X-ray examination was performed in patients with knee osteoarthritis and the severity of the affected knee joint was evaluated.The Kellgren--Lawrence grading method was used for imaging rating.Serum DKK1,TNF-α and OPG levels were detected using Luminex Map (?) technology.To analyze OA patients with hypertension in patients with preoperative and postoperative serum bone changes of the conversion factor levels,we collected from June 2014 to April 2015,nanjing drum tower hospital joint surgery were lines of unilateral total knee and total hip replacement for the first time a total of 122 patients with primary knee and hip osteoarthritis,standardized patients undergoing total knee replacement and total hip replacement.Blood samples were collected preoperatively,1 postoperative,3 postoperative,and 5 postoperative days.There were 38 patients with OA complicated with hypertension.Luminex Map (?) technology was used for high throughput detection of serum concentrations of factors related to bone conversion regulation.The Results Of The StudyMPTA Angle & lt;There were 73 cases in the 85° group and 66 cases in the 85°-90° normal group,MPTA Angle >There were 3 cases in the 90° group.Serum concentrations of DKK1 and TNF-α in the varus Angle group were lower than those in the normal Angle group,and serum OPN in the varus Angle group was higher than that in the normal Angle group.Serum OPG level was negatively correlated with MPTA.Serum levels of OPG and TNF-α in patients with knee osteoarthritis were significantly higher than those in the control group.The serum DKK1 level in the patients with knee osteoarthritis was lower than that in the control group,and the serum DKK1 level was significantly correlated with the imaging severity of knee osteoarthritis.DKK1,OPG,TNF-α had different degree of correlation with the incidence of knee osteoarthritis.DKK1 showed 78.6% sensitivity and 40% specificity(cut-off value :3956 pg/ml)in predicting the incidence of knee osteoarthritis by ROC curve analysis.TNF-α level showed 74.1% sensitivity and 76.0% specificity(cut-off value :1.53pg/ml),and OPG level showed 88.1% sensitivity and 81% specificity(cut-off value :308.4pg/ml).TNF-α and OPG showed independent predictive power in univariate and multivariate analyses of the incidence of knee osteoarthritis.A total of 122 patients with OA met the inclusion criteria,aged 46-86 years,with an average age of 66.9 years;The course of disease was 1-25 years,with an average of 18.3 years.Among them,there were 32 males and 89 females.There were 28 cases of hip OA and 94 cases of knee OA.A total of 38 patients with hypertension associated with OA were included according to medical history inquiry and blood pressure monitoring.Preoperative serum Leptin level in OA group was lower than that in OA group with hypertension,while OPN and SOST were significantly increased.The values of ALB,HCT and HGB on day 1,3 and 5 after operation were all lower than those before operation,P<0.05,the difference was statistically significant.The Research Conclusion1 In KOA patients,the severity of tibial varus deformity was positively correlated with serum OPN levels,but negatively correlated with DKK1 and TNF-α levels.2 Three factors,including TNF-α,DKK1 and OPG,have been shown to be correlated with the incidence of OA.Comprehensive analysis of these three factors can guide the prediction of the degree of joint damage in patients,and they can be used as biomarkers for the effective reaction of the incidence of knee osteoarthritis.Joint replacement surgery has different effects on serum bone conversion related factors in patients with OA alone and patients with OA combined with hypertension,among which Leptin,OPN and SOST have the most significant effects.The third part Overview Bone immunology: osteoclasts interact with the immune system...