血清IL-2、IL-17和骨密度关系及其对骨质疏松症的预测价值

doi:10.3877/cma.j.issn.2096-0263.2023.05.007

目的

检测骨质疏松症患者体内淋巴细胞亚群相应细胞因子的表达并进一步探讨其与疾病的相关性，探讨白介素-2（IL-2）和白介素-17（IL-17）对于骨质疏松疾病诊断的预测价值。

方法

收集40例骨质疏松症[男13例，女27例，年龄（75.58±1.90）岁]和35例[男10例，女25例，年龄（71.67±1.99）岁]年龄相仿的健康人血清样本，使用流式细胞术、化学发光法分别检测其淋巴细胞亚群相应细胞因子水平、Ⅰ型胶原羧基端前肽（PINP）及β-胶原降解产物（β-CTX）水平；使用双能X线骨密度仪检测受试者骨密度；使用受试者工作曲线评价IL-17和IL-2的预测效能。

结果

较健康对照组[（386.9±39.81）pg/ml]相比，骨质疏松症患者体内β-CTX表达上调[（563.7±57.25）pg/ml]，差异具有统计学意义（P<0.05）；PINP表达具有上调趋势，差异无统计学意义；此外IL-2、IL-10、IL-17呈现明显高表达（P<0.05）；进一步分析发现IL-2和IL-17的表达与骨密度具有明显的相关性（r=-0.272，r=-0.380，P<0.05），ROC曲线进一步计算出IL-17和IL-2曲线下面积分别为0.874和0.625。

结论

骨质疏松患者IL-17和IL-2表达水平明显上调，且IL-17可作为骨质疏松症诊断的预测指标。

关键词: 骨质疏松, 淋巴细胞, IL-17, ROC

Objective

To detect the expression of cytokines corresponding to lymphocyte subpopulations in patients with osteoporosis and further investigate their correlation with osteoporosis, and to explore the predictive value of interleukin-17 (IL-17) and interleukin-2 (IL-2) of osteoporosis.

Methods

Serum samples were collected from 40 cases (13 males and 27 females, 75.58±1.90 years) of osteoporosis and 35 healthy subjects (10 males and 25 females, 71.67±1.99 years) of similar age, and their lymphocyte subpopulation corresponding cytokine levels, type I collagen carboxy-terminal prepeptide (PINP) and β-collagen degradation product (β-CTX) levels were measured using flow cytometry and chemiluminescence, respectively; BMD of the patients was measured using dual-energy X-ray bone densitometry; the working curves of the subjects were used to evaluate the predictive efficacy of IL 17 and IL-2 predictive efficacy by subject work curves.

Results

Compared to healthy controls (386.9±39.81 pg/ml), β-CTX expression was up-regulated in osteoporosis patients (563.7±57.25 pg/ml) with statistically significant differences (P<0.05), and PINP expression had a tendency to be up-regulated without statistically significant differences; in addition, IL-2, IL-10 and IL-17 showed significantly high expression (P<0.05), while only the expression of IL-2 and IL-17 correlated with BMD (r=-0.272, r=-0.380, P<0.05); further the ROC curve calculated that the area under the curve of IL-17 and IL-2 were 0.874 and 0.625, respectively.

Conclusions

IL-17 and IL-2 expression levels were significantly up-regulated in osteoporotic patients, and IL-17 can be used as a predictor for the diagnosis of osteoporosis.

Key words: osteoporosis, lymphocyte, IL-2, IL-17

图6~8 骨质疏松患者和健康对照组体内IL-2、IL-10、IL-17表达水平。图6　在OP组和CTRL组中IL-2的表达差异；图7　在OP组和CTRL组中IL-10的表达差异；图8　在OP组和CTRL组中IL-17的表达差异

表1 两组患者基线数据比较

组别	例数	性别（男/女，例）	年龄（岁，±s）	吸烟史（是/否，例）	高血压史（是/否，例）	高血糖史（是/否，例）
骨质疏松组	40	13/27	75.58±1.90	8/32	13/27	11/29
健康对照组	35	10/25	71.67±1.99	9/26	14/21	8/27
统计量（t或χ²值）		0.135	1.879	0.348	0.456	0.213
P值		0.713	0.064	0.555	0.500	0.645

表1 两组患者基线数据比较

组别	例数	性别（男/女，例）	年龄（岁，±s）	吸烟史（是/否，例）	高血压史（是/否，例）	高血糖史（是/否，例）
骨质疏松组	40	13/27	75.58±1.90	8/32	13/27	11/29
健康对照组	35	10/25	71.67±1.99	9/26	14/21	8/27
统计量（t或χ²值）		0.135	1.879	0.348	0.456	0.213
P值		0.713	0.064	0.555	0.500	0.645

图15~16 IL-2和IL-17在骨质疏松中的诊断价值。图15 IL-2对骨质疏松诊断评价ROC曲线；图16 IL-17对骨质疏松诊断评价ROC曲线

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Relationship between serum IL-2, IL-17 and bone mineral density and their predictive value for osteoporosis

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Relationship between serum IL-2, IL-17 and bone mineral density and their predictive value for osteoporosis