血清Dickkopf-1与原发性痛风性关节炎骨破坏的相关性

目的:检测原发性痛风性关节炎患者血清Dickkopf-1(DKK-1)的浓度,探讨其与原发性痛风性关节炎骨破坏的相关性。方法:选取原发性痛风性关节炎患者150例、无症状高尿酸血症患者100例及正常对照100例,用ELISA法分别测定3组研究对象血清DKK-1浓度,同时检测血清中反映破骨细胞活性的抗酒石酸酸性磷酸酶5b(tartrate-resistant acid phosphatase 5b,TRAP5b)浓度,并研究分析原发性痛风性关节炎患者DKK-1与TRAP5b、血尿酸及其他临床和实验室指标的关系。结果:(1)原发性痛风性关节炎组(2 574.8±997.9)ng/L]、无症状高尿酸血症组(2 009.4±756.9)ng/L]血清DKK-1水平均显著高于正常对照组(981.8±770.7)ng/L,F=49.59,P<0.001],并且原发性痛风性关节炎组明显高于无症状高尿酸血症组(t=3.998,P<0.001)。(2)原发性痛风性关节炎组(3.2±1.4)U/L]、无症状高尿酸血症组(2.5±1.4)U/L]血清TRAP5b水平均显著高于正常对照组(0.2±0.2)U/L,F=103.039,P<0.001],并且原发性痛风性关节炎组明显高于无症状高尿酸血症组(t=3.391,P=0.004)。(3)在原发性痛风性关节炎组中,血清DKK-1水平越高,TRAP5b的水平亦越高(r=0.47,P<0.001)。(4)在原发性痛风性关节炎组中,血尿酸水平与血清DKK-1和TRAP5b均无相关性(P>0.05)。(5)在原发性痛风性关节炎组中,TRAP5b浓度与痛风石的存在和病程相关,合并痛风石组血清TRAP5b浓度高于无痛风石组(8.4±6.4)U/L vs.(4.0±1.6)U/L,t=-2.938,P=0.007],并且病程越长,血清TRAP5b浓度越高(r=0.455,P=0.01),但血清DKK-1浓度与病程和痛风石的存在与否无相关性(P>0.05)。结论:在原发性痛风性关节炎的患者中可以检测到血清DKK-1明显升高,并且DKK-1与反映破骨细胞活性和功能的TRAP5b呈正相关,提示DKK-1可能参与原发性痛风性关节炎骨破坏的发生。

Relation of serum Dickkopf-1 with bone destruction in patients with gouty arthritis

Objective:To explore the potential roles of serum Dickkopf-1(DKK-1) and tartrate-resis-tant acid phosphatase 5b(TRAP5b) in gouty arthritis.Methods: Blood serum DKK-1 and TRAP5b were assessed by ELISA method.The serum samples were collected from 150 patients with gouty arthritis,100 with hyperuricemia and 100 healthy controls.Of the 150 gouty arthritis patients,40 were diagnosed as acute gout(joint rash and pain),and the other 110 as chronic gout.At the time of serum sampling,various clinical and laboratory parameters were assessed.The correlations of DKK-1 or TRAP5b and clinical/laboratory parameters were analyzed.Results:(1) The serum levels of DKK-1 were eleva-ted in the patients with gouty arthritis (2 574.8±997.9) ng/L] and with hyperuricemia (2 009.4±756.9) ng/L] compared with the healthy controls (981.8±770.7) ng/L],F=49.59,P<0.001.(2) The serum levels of TRAP5b in the three groups were(3.2±1.4)U/L,(2.5±1.4)U/L and(0.2±0.2)U/L,respectively.F=103.039,P<0.001.(3) A significant difference of DKK-1 was observed between the patients with gouty arthritis and with hyperuricemia(t=3.998,P<0.001).Similarly,a significant difference of TRAP5b was observed between the patients with gouty arthritis and with hyperuricemia(t=3.391,P=0.004).(4) In the patients with gouty arthritis,there was a positive correlation between DKK-1 and TRAP5b(r=0.47,P<0.001),while the levels of DKK-1 were not related with age,disease duration,body mass index or serum uric acid(r=-0.153,-0.123,0.158,0.00,P=0.126,0.509,0.381,0.926).(5) In the patients with gouty arthritis,the serum levels of TRAP5b were elevated in the patients with tophi compared with the patients without tophi(8.4±6.4)U/L vs.(4.0±1.6)U/L,t=-2.938,P=0.007].The level of TRAP5b was associated with the disease duration(r=0.455,P=0.01),while there was no correlation between TRAP5b and age,body mass index or serum uric acid(r=0.135,0.278,0.144,P=0.595,0.117,0.132).Conclusion: In the patients with gouty arthritis,the levels of DKK-1 were remarkably elevated,and there was a positive correlation between DKK-1 and TRAP5b.Our results demonstrate that DKK-1 is involved in bone destruction in gouty arthritis.