Associations of Changes in Serum Inflammatory Factors, MMP-3, 25(OH)D and Intestinal Flora with Osteoporosis and Disease Activity in Rheumatoid Arthritis Patients
Associations of Changes in Serum Inflammatory Factors, MMP-3, 25(OH)D and Intestinal Flora with Osteoporosis and Disease Activity in Rheumatoid Arthritis Patients
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类风湿关节炎患者血清炎症因子、MMP-3、25(OH)D和肠道菌群变化与骨质疏松和疾病活动的关系
DOI：
10.7754/clin.lab.2020.200242
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发表时间：
2020-01-01
影响因子：
0.7
通讯作者：
Bai Lijie
中科院分区：
文献类型：
--
作者：
Wang Yong;Li Hongbin;Bai Lijie
背景：探讨类风湿关节炎（RA）患者血清炎症因子、基质金属蛋白酶-3 （MMP-3）、25-羟基维生素D [25(OH)D]、肠道菌群变化与骨质疏松和疾病活动度的关系，为临床诊断和治疗提供参考。方法：选取98例RA患者作为研究对象（RA组），根据疾病活动度评分（DAS28）分为活动期组（n = 56）和缓解期组（n = 42）。另选取同期在我院体检的健康人群50人作为对照组。比较三组患者血清炎症因子、MMP-3、25(OH)D、肠道菌群的变化，并分析各组受试者骨质疏松情况。此外，使用Pearson's方法分析RA患者血清炎症因子、MMP-3、25(OH)D和肠道菌群的变化与骨质疏松症和疾病活动性的关系。结果：与对照组比较，血清MMP-3、白细胞介素-6 （IL-6）、IL-10、CRP水平明显降低。活动期组和缓解期组的大肠杆菌数量显著升高，血清25(OH)D水平、骨密度（BMD）、乳酸菌和双歧杆菌数量显著降低，且活动期组更为显著（p < 0.05）。RA患者骨质疏松及疾病活动度与血清IL-6、IL-10、CRP、MMP-3、大肠杆菌、BMD呈正相关，与25(OH)D、乳酸菌、双歧杆菌呈负相关（p < 0.05），与sharp评分无相关性（p < 0.05）。结论：RA患者血清炎症因子、MMP-3、25(OH)D及肠道菌群的变化与骨质疏松及疾病活动度有一定的相关性，具有一定的临床应用价值。
Background: To explore the associations of changes in serum inflammatory factors, matrix metalloproteinase-3 (MMP-3), 25-hydroxy vitamin D [25(OH)D], and intestinal flora with osteoporosis and disease activity in rheumatoid arthritis (RA) patients, so as to provide references for clinical diagnosis and treatment.Methods: A total of 98 RA patients were selected as the objects of study (RA group), and divided into active-stage group (n = 56) and remission-stage group (n = 42) according to the disease activity score (DAS28). Another 50 healthy people receiving physical examination in our hospital during the same period were selected as the control group. The changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora were compared among the three groups, and the osteoporosis of the subjects was analyzed in each group. Moreover, the associations of changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora with osteoporosis and disease activity in RA patients were analyzed using the Pearson's method.Results: Compared with those in the control group, the levels of serum MMP-3, interleukin-6 (IL-6), IL-10, and Creactive protein (CRP). The Escherichia coli count were significantly increased, while the level of serum 25(OH)D, bone mineral density (BMD), and Lactobacillus and Bifidobacterium counts were significantly decreased in the active-stage group and remission-stage group, more obviously in active-stage group (p < 0.05). The osteoporosis and disease activity in RA patients were positively correlated with serum IL-6, IL-10, CRP, MMP-3, Escherichia coli and BMD, but negatively correlated with 25(OH)D, Lactobacillus and Bifidobacterium (p < 0.05), and not correlated with the sharp score (p > 0.05).Conclusions: There are certain associations of changes in serum inflammatory factors, MMP-3, 25(OH)D, and intestinal flora with osteoporosis and disease activity in RA patients, showing certain value in clinical application.