血清β-半乳糖凝集素-3在非创伤股骨头坏死中的意义△

Significance of serum β-galectin-3 in non-traumatic necrosis of the femoral head

摘要:

[目的]本研究旨在探讨血清 β-半乳糖凝集素-3（lectin galactoside-binding soluble 3, LGALS3）水平在非创伤性股骨头坏死 （non-traumatic osteonecrosis of the femoral head, NONFH） 诊断中的临床价值。[方法] 2023 年 4 月—2023 年 9 月纳入 NONFH 患者 84 例为坏死组，选取同期检者健康人 78 例为对照组。采用酶联免疫吸附法检测两组血清中 LGALS3 的水平，并收集相关临床资料，包括性别、年龄、体重指数（body mass index, BMI）、吸烟史、NONFH 病因、受累侧数、疼痛视觉模拟评分（visual analogue scale, VAS）、Harris 评分、坏死程度及 ARCO 分期。对两组 LGALS3 浓度及其与各临床参数的关系进行比较分析。[结果]坏死组血清中 LGALS3 浓度显著高于正常人组 [(9.8±7.7) ng/ml vs (4.2±4.1) ng/ml, P＜0.001]。在 NONFH 患者中，双侧受累组的 LGALS3 浓度显著高于单侧受累组 [(14.7±8.1) ng/ml vs (5.3±3.3) ng/ml, P＜0.001]，股骨头塌陷者显著高于未塌陷者 [(13.5±7.3) ng/ml vs (3.1±1.2) ng/ml, P＜0.001]。根据 ARCO 分期，从 I 期至 IV 期 LGALS3 浓度呈逐渐升高趋势，且各亚组间差异有统计学意义 [(2.1±1.0) ng/ml vs (4.1±1.3) ng/ml vs (11.0±5.8) ng/ml vs (16.8±8.2) ng/ml, P＜0.001]。NONFH 患者的 LGALS3 浓度与 VAS 评分呈显著正相关 （r=0.843, P＜0.001）, 与 Harris 评分呈显著负相关 （r=-0.710, P＜0.001），与 ARCO 分期呈显著正相关 （r= 0.822, P＜0.001）。ROC 分析表明，LGALS3 浓度预测是否 NONFH 的曲线下面积（area under curve, AUC）为 0.769。[结论] 血清中的 LGALS3 水平可反映 NONFH 病情的严重程度，并可能作为该病早期诊断的潜在生物标志物。

Abstract:

[Objective] To investigate the clinical value of serum β-galactoside-binding soluble 3 (LGALS3) in the diagnosis of nontraumatic osteonecrosis of the femoral head (NONFH). [Methods] From April 2023 to September 2023, 84 NONFH patients were enrolled as necrosis group, while other 78 healthy subjects were selected as control group. The serum LGALS3 concentration in the two groups were detected by enzyme-linked immunosorbent assay, and related clinical data were collected, including gender, age, body mass index (BMI), smoking history, NONFH etiology, number of affected sides, visual analogue scale (VAS) for pain, Harris score, and ARCO staging. The LGALS3 concentration and its relationship with clinical parameters in the groups divided by different facots were compared and analyzed. [Results] The serum LGALS3 concentration in the necrotic group was significantly higher than that in healthy group [(9.8±7.7) ng/ml vs (4.2± 4.1) ng/ml, P＜0.001]. In patients with NONFH, LGALS3 concentration was significantly higher in the bilateral affected than in the unilateral involved [(14.7±8.1) ng/ml vs (5.3±3.3) ng/ml, P＜0.001], the femoral head collapsed was significantly higher than the non-collapsed [(13.5± 7.3) ng/ml vs (3.1±1.2) ng/ml, P＜0.001]. Based on ARCO staging, the concentration of LGALS3 gradually increased from stage I to stage IV, with statistically significant differences among the subgroups [(2.1±1.0) ng/ml vs (4.1±1.3) ng/ml vs (11.0±5.8) ng/ml vs (16.8±8.2) ng/ml, P＜ 0.001]. LGALS3 concentration in NONFH patients was significantly positively correlated with VAS score (r=0.843, P＜0.001), whereas was significantly negatively correlated with Harris score (r=-0.710, P＜0.001), and positively correlated with ARCO stage (r=0.822, P＜0.001). ROC analysis showed that the area under curve (AUC) of LGALS3 concentration predicting NONFH was of 0.769. [Conclusion] Serum LGALS3 can reflect the severity of NONFH, and may be a potential biomarker for early diagnosis of the disease.