作者：ChandranV,et al

翻译：北医三院王欣宇

摘要

目的：我们的目的是确定可区分银屑病关节炎（PsA）和骨关节炎（OA）的可溶性生物标志物。

方法：检测201例OA患者，77名PsA患者和76名对照的血清标本中软骨代谢标志物（软骨寡聚基质蛋白[COMP]，透明质酸），代谢综合征指标（脂联素，adipsin，抵抗素，肝细胞生长因子[HGF]，胰岛素，瘦素）和炎症指标（C-反应蛋白[CRP]，白细胞介素-1β[IL-1β]，IL-6，IL-8，肿瘤坏死因子α[TNFα]，单核细胞趋化蛋白-1 [MCP-1]，神经生长因子[NGF]）的水平。使用Kruskal-Wallis检验比较各组的水平。使用Wilcoxon秩和检验进行成对比较。进行多变量逻辑回归分析以鉴定区分PsA与OA的标志物。ROC曲线基于多变量模型。使用年龄，性别和生物标志物系数计算预测概率，在一组独立的73个PsA和75个OA样本中进一步验证最终模型。

结果：下述标志物-COMP，透明质酸，抵抗素，HGF，胰岛素，瘦蛋白，CRP，IL-6，IL-8，TNFα，MCP-1，NGF的表达水平在三组之间存在显著差异（p <0.001）。在多变量分析中，COMP（OR 1.24,95％CI 1.06-1.46），抵抗素（OR 1.26,95％CI 1.07-1.48），MCP-1（OR 1.10,95％CI 0.07-1.48）和NGF（OR <0.001），95％CI <0.001至0.25）与PsA相对于OA独立相关。与仅有年龄和性别的模型（AUROC 0.87，p <0.001）相比，该模型的ROC曲线下面积（AUROC）为0.99。使用验证样本获得了类似的结果。

结论：联合检测四种生物标志物可以区分PsA和OA。这些结果需要在前瞻性研究中进一步验证。

OBJECTIVE: We aimed to identify soluble biomarkers that differentiatepsoriatic arthritis (PsA) from osteoarthritis (OA).

METHODS Markers of cartilagemetabolism (cartilage oligomeric matrix protein [COMP], hyaluronan), metabolicsyndrome (adiponectin, adipsin, resistin, hepatocyte growth factor [HGF],insulin, leptin) and inflammation (C-reactive protein [CRP], interleukin-1β[IL-1β], IL-6, IL-8, tumour necrosis factor alpha [TNFα], monocytechemoattractant protein-1 [MCP-1], nerve growth factor [NGF]) were compared inserum samples from 201 patients with OA, 77 patients with PsA and 76 controls.Levels across the groups were compared using the Kruskal-Wallis test. Pairwisecomparisons were made with Wilcoxon rank-sum test. Multivariate logisticregression analyses were performed to identify markers that differentiate PsAfrom OA. Receiver operating characteristic (ROC) curves were constructed basedon multivariate models. The final model was further validated in an independentset of 73 PsA and 75 OA samples using predicted probabilities calculated withcoefficients of age, sex and biomarkers.

RESULTS Levels of the following markers were significantly differentacross the three groups (p<0.001)-COMP, hyaluronan, resistin, HGF, insulin,leptin, CRP, IL-6, IL-8, TNFα, MCP-1, NGF. In multivariate analysis, COMP (OR1.24, 95% CI 1.06 to 1.46), resistin (OR 1.26, 95% CI 1.07 to 1.48), MCP-1 (OR1.10, 95% CI 0.07 to 1.48) and NGF (OR<0.001, 95% CI <0.001 to 0.25) werefound to be independently associated with PsA versus OA. The area under the ROCcurve (AUROC) for this model was 0.99 compared with model with only age and sex(AUROC 0.87, p<0.001). Similar results were obtained using the validationsample.

CONCLUSION A panel of four biomarkers may distinguish PsA from OA. Theseresults need further validation in prospective studies.

引自：Chandran V, Abji F, Perruccio AV, et al. Serum-based solublemarkers differentiate psoriatic arthritis from osteoarthritis..Ann Rheum Dis. 2019 Mar 25. pii: annrheumdis-2018-214737. doi:10.1136/annrheumdis-2018-214737.