青少年特发性脊柱侧凸患者血浆matrilin-1蛋白水平及其临床意义

目的 探讨青少年特发性脊柱侧凸(AIS)患者外周血中matrilin-1蛋白水平的变化及其在AIS发病机制中的作用.方法 将2006年6月至2007年3月诊治的25例AIS患者作为AIS组,25名性别、年龄相匹配的健康体检青少年作为对照组.所有入选对象符合以下标准:无骨骼疾病、代谢疾病、生长发育异常;无影响骨代谢的系统疾病及其他情况;近期未服用激素;无先天性心脏病手术史.AIS组记录末次随访或术前最大Cobb角、侧凸弯型,并分为进展型及非进展型两组.进展型侧凸(侧凸进展成为严重脊柱侧凸)定义为骨骼发育未成熟时,Cobb角＞40°或骨骼发育成熟时,Cobb角＞50°.采用PCR-RFLP基因分型方法 对所有对象进行基因分型,运用酶联免疫吸附(ELISA)法检测AIS组与对照组外周血浆中matrilin-1蛋白浓度并比较其差异,并对不同基因型之间matrilin-1蛋白的表达进行比较.分析血浆matrilin-1蛋白浓度与脊柱侧凸进展的关系.结果 AIS组血浆matrilin-1蛋白浓度显著低于对照组(P=0.002).AIS组及对照组的基因型GG个体血浆matrilin-1蛋白浓度均低于基因型AA或AG个体,而对于相同基因型的个体AIS组血浆matrilin-1蛋白水平更低.进展型AIS患者血浆matrilin-1蛋白水平明显较非进展型AIS患者低.结论 AIS患者外周血matrilin-1蛋白水平与脊柱侧凸的进展相关.对外周血matrilin-1蛋白浓度的检测,有助于AIS的早期筛查及诊断,可作为预测脊柱侧凸进展的一个独立指标.

Decreased circulating matrilin-1 levels in adolescent idiopathic scoliosis

Objective To determine the circulating matrilin-1 levels in adolescent idiopathic scoliosis (AIS),and to investigate its potential role in etiopathogenisis of AIS.Methods This study population consisted of 25 patients with AIS from June 2006 to March 2007 and 25 age-matched normal controls.All subjects of the study met the following criteria:no evidence of bone diseases,metabolic diseases or growth disturbances;no evidence of systemic illness or other condition known to affect bone metabolism;and no history of recent steroid intake and surgery of congenital cardiopathy.The maximum Cobb angle and curve pattern of AIS group were recorded.All AIS patients were categorized by progressive and non-progressive groups.Progression to a severe curve was defined per usual clinical criteria (progression to a ＞40°curve in an individual still growing or progression to a＞50°curve in an adult).Measurements of genotype by PCR-RFLP methods and circulating matrilin-1 by ELISA assay were performed in both AIS and control groups.The circulating matrilin-1 levels were compared between AIS and control groups,and also among different genotype individuals.The relationship between matrilin-1 levels and cure progression were also analyzed.Results Compared with control group,a marked decrease of plasma matrilin-1 levels was found in AIS groups(P=0.0002).Matrilin-1 levels of both AIS and control groups with GG genotype tended to be lower than with AA and AG genotypes,and this trend was stronger in AIS groups.Compared with nonprogressive AIS group,plasma matrilin-1 levels in progressive AIS group were significantly lower.Conclusions There is an association between matrilin-1 levels and curve progression.Measurement of circulating matrilin-1 levels is helpful for early screening and diagnosis of AIS,and it may be considered as an independent index to predict curve progression.