The Levels And Significance Of Receptor Activator Of Nuclear Factor-KB Ligand?Tumor Necrosis Factor-??Osteoprotegerin In Serum For Patients With Psoriasis Vulgaris

Objective:To detect the levels of serum receptor activator of nuclear factor-KB ligand (RANKL),tumor necrosis factor-a(TNF-?),osteoprotegerin(OPG) and bone mineral density (BMD) in patients with psoriasis vulgaris. The patients were classified by psoriasis area and severity index (PASI), the association of RANKL,TNF-a, OPG levels with PASI and BMD were analyzed by using statistical methods to further explore bone metabolism in patients with psoriasis for clinical guidance.Methods:To gather 47 patients with psoriasis vulgaris, who were classified by PASI. The patients were classified into three groups:<10 (?),10?20 (?) and?20 (?). BMD of femoral neck were detected by BMD meter; In the same conditions,routine blood were tested by automatic blood analyzer;erythrocyte sedimentation rate (ESR) were tested by automatic blood sedimentation deposited tester; the concentration of immunoglobulin G (IgG), complement 3 (C3),c-reactive protein (CRP) and calcium (Ca) were tested by automatic biochemical analyzer; the levels of RANKL, TNF-a and OPG were detected by enzyme-linked immunosorbent assay (ELISA);Compared with the controls group at the same time.All experimental data were analyzed by single factor variance with SPSS 13.0 statistical software.Results:1.The levels of RANKL, TNF-aand OPG in patients with psoriasis vulgaris.The level of RANKL, TNF-a and OPG (173.8±23.lpg/ml,38.0±9.pg/ml, 680±68pg/ml) in patients group compared with controls group (75.9±5.8pg/ml, 7.5±1.8pg/ml,795±195/pg//ml),the differences were statistically significant (P<0.05). The levels of RANKL, TNF-a and OPG in patients group were higher than controls group, while the levels of OPG were lower than controls group.2.The relationship between the levels of RANKL, TNF-a, OPG and PASI in patients.The difference between the levels of RANKL, TNF-a, OPG in PASI I and ? were statistically significant (P<0.05). The levels of RANKL, TNF-a were positively correlated with PASI (r=0.674,0.646, P<0.05), the levels of OPG were negatively correlated with PASI (r=-0.669, P<0.05) in patients group,.3.The levels of BMD in patients with psoriasis vulgaris.The levels of BMD in patients groups (0.3±0.27g/cm2) compared with controls group (0.79±0.21g/cm2), the differences were statistically significant (P<0.05). The levels of BMD in patients group were lower than controls group.4.The relationship between levels of BMD and PASI in patients with psoriasis vulgaris.The levels of BMD were negatively correlated with PASI in patients group (r=0.664, P<0.05).5.The relationship between levels of RANKL, TNF-a,OPG and BMD in patients with psoriasis vulgaris.In patients group, the levels of RANKL,TNF-a were negatively correlated with BMD (r=-0.614,-0.811, P<0.05); the levels of OPG were positively correlated with BMD (r=0.647, P<0.05).Conclusion:1. Compared with controls group, the level of RANKL and TNF-a were higher,the levels of OPG and Ca were lower in patients group. Compared between three groups classified by PASI, BMD decreased significantly. RANKL, TNF-a and OPG may be involved in the pathogenesis of psoriasis osteoporosis. RANKL, TNF-a may have function of bone absorption and promote progression of osteoporosis, OPG may have function of bone formation and inhibit progression of osteoporosis. Compared between three groups classified by PASI, the more serious skin lesions, the lower of BMD. The severity of skin lesions affected bone metabolism and BMD,which were susceptible to cause bone loss and osteoporosis.2. The levels of RANKL, TNF-a and OPG in Patients with psoriasis vulgaris can be used to assess the severity of osteoporosis. Docters should pay attention to variation of RANKL, TNF-a and OPG in patients with psoriasis, the state of bone metabolism in patients with psoriasis should pay further attention to research and adopt prevent -osteoporosis drug therapy when necessary.