大腿骨頭壊死症の原因検索--脂質代謝及びHLAの検討を中心に

概要

論文の詳細を見る
An examination of lipid metabolism disorder and human leukocyte antigen (HLA) to identify some causes of idiopathic osteonecrosis of the femoral head (hereinafter referred to as ION) was conducted. Seventy-seven patients with ION (a mean age of 45.7 years) who have been receiving treatment were eligible for this study. Twenty-two outpatients (a mean age of 60.2 years) and 29 patients with coxarthrosis (a mean age of 47.4 years) served as control patients. The study variables relating to the disorder of lipid metabolism were measurements of total cholesterol (T-cho) and triglycerides (TG) . Additionally, apoproteins (Al, A2, B, C2, C3, E), LDL- cholesterol, HDL- cholesterol, Lp (a), and RLP-C were determined in 46 patients who consented to the study among those with ION. HLA was determined in 30 patients who consented to the study among those with ION. The Student's t-test and x<SUP>2</SUP> test were used for statistical analyes. A level of less than 0.05 was considered to indicate statistically significant. The ION group showed a mean T-cho of 200.0 mg dl, as compared with 200.3 mg/ dl for the coxarthrosis group and 199.6 mg/dl for the control group, suggesting that there were no significant differences among the three groups. The ION group showed a mean TG of 170.8 mg/dl, as compared with 124.0 mg/dl for the coxarthrosis group and 124.2 mg dl for the control group. These results also suggested that there were no significant differences among the three groups regarding T-cho, but the ION group alone was higher than the diagnostic criteria (150 mg/dl) . Furthermore, examinations of apoprotein and lipoprotein were performed in two ION subgroups, a group treated with Steroid therapy and a group receiving Nonsteroid therapy. There were no significant differences between the two subgroups. As for HLA, 6 antigens were expressed in A Locus, 15 antigens in B Locus, 5 antigens in C Locus, 10 antigens in DR Locus, and 3 antigens in DQ antigen. Of these antigens, B35 and DQ3 antigens were frequently and significantly observed. Additional examinations were conducted after the ION group was divided into 2 subgroups, a group involving patients with Bilateral ION and a group involving those with Unilateral ION. DR9 and DQ3 antigens were frequently and significantly observed in the Bilateral group. The results of this study suggest that some disorder of lipid metabolism is present in the ION group, but it is unlikely to be associated with the onset of osteonecrosis of the femoral head. The HLA measurements showed that significant differences are observed in the DR antigen. However, the DR antigen, a molecule expressed on the surface of antigen-presenting cells, forms an antigen presentation to T cells by binding to antigen peptides, resulting in immune response induction. This finding suggests that the theory of T cellrestrictive antigens is most likely one of the causes of the onset of ION.
学校法人昭和大学・昭和医学会の論文

大腿骨頭壊死症の原因検索--脂質代謝及びHLAの検討を中心に

スポンサーリンク

概要

著者

関連論文

スポンサーリンク