目的:观察过氧化物还原酶(Prdxs)蛋白家族主要分子Prdx1、Prdx2、Prdx4和Prdx6在女性绝经后骨质疏松症(PMOP)中的表达水平,并分析其临床诊断价值。方法:选择湖北省中医院及武汉市中医院确诊的PMOP患者72例作为研究组,另选择同期骨密度正常的绝经后女性51例作为对照组。免疫酶联吸附实验(ELISA)测定血浆Prdx1、Prdx2、Prdx4和Prdx6的蛋白水平；逆转录定量聚合酶链反应(RT-qPCR)测定外周血单个核细胞(PBMC)中Prdx1、Prdx2、Prdx4和Prdx6的mRNA水平。分析Prdxs家族与患者临床参数的相关性。受试者工作特征曲线(ROC)评价Prdxs家族对女性PMOP的诊断价值。结果:研究组的血浆Prdx1、Prdx4和Prdx6水平显著低于对照组(P<0.05)。研究组PBMC中Prdx1和Prdx6的mRNA相对表达水平显著低于对照组(P<0.05)。研究组血浆及PBMC中多种Prdxs的蛋白水平或mRNA水平与血脂或炎症指标相关(P<0.05)。血浆Prdx6诊断PMOP的曲线下面积(AUC)为0.794(95%CI =0.714~0.874),PBMC中Prdx6的mRNA相对表达水平诊断PMOP的AUC为0.725(95%CI =0.635~0.814)。结论:Prdxs蛋白家族的表达降低(特别是Prdx1和Prdx6分子)与PMOP的发病密切相关,降低的Prdxs蛋白家族可能是通过脂代谢异常途径和系统性炎症水平增高途径来促进骨质疏松的发生。检测血浆和PBMC中的Prdx6分子水平对PMOP具有着良好的诊断价值。
Objective: To observe the expression levels of the main molecules of peroxiredoxins (Prdxs) protein family (Prdx1, Prdx2, Prdx4 and Prdx6) in women with postmenopausal osteoporosis (PMOP), and to analyze their clinical diagnostic values. Methods: Patients in Hubei Provincial Hospital of Traditional Chinese Medicine and Wuhan Hospital of Traditional Chinese Medicine diagnosed with PMOP from May 2016 to March 2018 were included as the study group (72 cases), postmenopausal women with normal bone mineral density (BMD) in the same period were also collected as the control group (51 cases). Levels of Prdx1, Prdx2, Prdx4 and Prdx6 in plasma were determined by ELISA. mRNA levels of Prdx1, Prdx2, Prdx4 and Prdx6 in peripheral blood mononuclear cells (PBMC) were determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The correlations between Prdxs and clinical parameters were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic values of Prdxs for PMOP. Results: Prdx1, Prdx4 and Prdx6 levels in the study group were significantly lower than those in the control group (P<0.05). The mRNA expression levels of Prdx1 and Prdx6 of PBMC in the study group were significantly lower than those in the control group (P<0.05). Several Prdxs protein levels (plasma) or mRNA levels (PBMC) in the study group were significantly correlated with lipid levels or inflammatory markers levels (P<0.05). The area under the curve (AUC) of plasma Prdx6 for diagnosing PMOP was 0.794 (95% CI =0.714-0.874). And the AUC of mRNA relative expression of Prdx6 in PBMC for diagnosing PMOP was 0.725 (95% CI =0.635-0.814). Conclusions:The decreased expression of Prdxs protein family (especially Prdx1 and Prdx6) is closely related to the incidence of PMOP, and the decreased Prdxs protein family may promote the occurrence of osteoporosis through the abnormal lipid metabolism pathway and the increased systemic inflammation pathway. The detections of Prdx6 levels in plasma and PBMC are of good diagnostic values for PMOP.