作者：ChandranV,et al

翻譯：北醫三院王欣宇

摘要

目的：我們的目的是確定可區分銀屑病關節炎（PsA）和骨關節炎（OA）的可溶性生物標誌物。

方法：檢測201例OA患者，77名PsA患者和76名對照的血清標本中軟骨代謝標誌物（軟骨寡聚基質蛋白[COMP]，透明質酸），代謝綜合徵指標（脂聯素，adipsin，抵抗素，肝細胞生長因子[HGF]，胰島素，瘦素）和炎症指標（C-反應蛋白[CRP]，白細胞介素-1β[IL-1β]，IL-6，IL-8，腫瘤壞死因子α[TNFα]，單核細胞趨化蛋白-1 [MCP-1]，神經生長因子[NGF]）的水平。使用Kruskal-Wallis檢驗比較各組的水平。使用Wilcoxon秩和檢驗進行成對比較。進行多變量邏輯迴歸分析以鑑定區分PsA與OA的標誌物。ROC曲線基於多變量模型。使用年齡，性別和生物標誌物係數計算預測概率，在一組獨立的73個PsA和75個OA樣本中進一步驗證最終模型。

結果：下述標誌物-COMP，透明質酸，抵抗素，HGF，胰島素，瘦蛋白，CRP，IL-6，IL-8，TNFα，MCP-1，NGF的表達水平在三組之間存在顯著差異（p <0.001）。在多變量分析中，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）與PsA相對於OA獨立相關。與僅有年齡和性別的模型（AUROC 0.87，p <0.001）相比，該模型的ROC曲線下面積（AUROC）爲0.99。使用驗證樣本獲得了類似的結果。

結論：聯合檢測四種生物標誌物可以區分PsA和OA。這些結果需要在前瞻性研究中進一步驗證。

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.