饮食对肥胖大鼠骨关节炎的辅助治疗干预作用研究

鲁琛 范清秋 胡张捷 刘艺

[摘要] 目的 探讨饮食护理对肥胖大鼠骨关节炎（OA）大鼠行为学、脂代谢、关节形态及软骨中内脂素的作用。 方法 90只雄性SD大鼠随机分为六组，除正常组及OA模型组外，其余各组给予高脂高糖饲料，以内侧半月板切除和前交叉韧带切断的Hulth法建立骨性关节炎模型，将饮食护理组给予脱脂饲料，同时关节腔注射玻璃酸钠进行治疗;无护理组仅进行玻璃酸钠治疗。肥胖模型组及肥胖OA模型组在OA模型成功建立的基础上仍给予高脂高糖饲料，连续12周。饮食干预12周后，对各组大鼠称重并量取体长，计算身体质量指数（BMI）;检测大鼠自主活动、抓力、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）水平;观察大鼠膝关节软骨组织形态学变化，检测Visfatin血清含量水平及软骨组织Visfatin的蛋白表达。 结果 饮食护理组大鼠的体重、BMI、血清TC、TG、LDL-C、Visfatin含量水平及膝关节软骨组织Visfatin蛋白表达显著低于肥胖OA模型组;血清HDL-C含量水平、活动次数、抓力显著高于肥胖OA模型組。饮食护理组光镜下幼稚软骨细胞形态正常，损伤脱失明显改善。 结论 饮食干预对肥胖OA大鼠骨性关节炎具有保护作用，该作用可能与降低软骨组织visfatin蛋白表达水平，改善OA大鼠脂代谢有关。

[关键词] 骨关节炎;饮食;肥胖;内脂素

[中图分类号] R723.1          [文献标识码] A          [文章编号] 1673-9701（2021）30-0049-06

[Abstract] Objective To explore the effect of diet nursing on the behavior， lipid metabolism， joint morphology， and visfatin in the cartilage of obese rats with osteoarthritis （OA）. Methods Ninety male SD rats were randomly divided into six groups. Excepted for the normal group and the OA model group， the other groups were given a high-fat and high-sugar diet. The osteoarthritis model was established by the Hulth method of medial meniscus resection and anterior cruciate ligament cut. The diet nursing group was given defatted feed and sodium hyaluronate in the joint cavity. The non-nursing group only received sodium hyaluronate treatment. The obesity model group and the obesity OA model group were still given high-fat and high-sugar diets for 12 consecutive weeks on the basis of the successful establishment of the OA model. After 12 weeks of diet intervention， the rats in each group were weighed， and the body length was measured to calculate the body mass index （BMI）. The rats′ autonomous activities， holding power， total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein （HDL-C） and low-density lipoprotein （LDL-C） levels were detected. The morphological changes of rat knee cartilage tissue were observed. The serum level of Visfatin and the protein expression of Visfatin in cartilage tissue were detected. Results The body weight， BMI， serum levels of TC， TG， LDL-C， Visfatin and the Visfatin protein in knee cartilage tissue of rats in the diet nursing group were significantly lower than those in the obese OA model group. The serum HDL-C， number of activities，and grasping strength of the diet nursing group was significantly higher than that of the obese OA model group. In the diet nursing group， the shape of the naive chondrocytes under the light microscope was normal， and the loss of damage was significantly improved. Conclusion Diet intervention has a protective effect on osteoarthritis in obese OA rats. This effect may be related to reducing the expression of visfatin protein in cartilage tissue and improving lipid metabolism in OA rats.

[Key words] Osteoarthritis; Diet; Obesity; Visfatin

骨性关节炎（Osteoarthritis，OA）又称老年性退行性关节炎，是致残率最高的慢性骨关节病[1]。随着人口老龄化及肥胖症患者的增多，OA发病率逐年升高，严重危害人类健康[2]。……