OBJECTIVE Different adipokines have been reported to play a role in the development, progression, and severity of knee osteoarthritis, but this association may be mediated by obesity. The aim of this study was to evaluate separately the associations of leptin and adiponectin with clinical severity and inflammatory markers in nonobese and obese women with knee osteoarthritis. DESIGN Cross-sectional study with systematic inclusion of 115 women with symptomatic primary knee osteoarthritis. Age, physical exercise, symptoms duration, and body mass index were collected. Radiographic severity was evaluated according to Kellgren-Lawrence scale. Pain and disability were assessed by WOMAC-total, -pain, -function subscales. Two adipokines (leptin and adiponectin) and 3 inflammatory markers (TNF-α, hsCRP, and IL-6) were measured by ELISA in synovial fluid and serum. RESULTS Synovial fluid adiponectin was associated with WOMAC pain, function, and total and with synovial fluid IL-6 in nonobese female knee osteoarthritis after controlling by confounders (partial correlation coefficient [PCC] = 0.395, 0.387, 0.427, and 0.649, respectively). Synovial fluid and serum leptin were significantly associated with IL-6 (PCC = 0.354) after controlling by confounders but associations with clinical severity and the rest of inflammatory markers were mitigated after control. CONCLUSIONS Adiponectin in synovial fluid was associated with clinical severity and local inflammatory markers in knee osteoarthritis women, while leptin relation was attenuated when controlled by confounders.

中文翻译：

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滑膜脂联素与膝关节骨性关节炎女性的临床严重程度比滑膜瘦素更相关。

目的已报道不同的脂肪因子在膝骨关节炎的发生、进展和严重程度中发挥作用，但这种关联可能由肥胖介导。本研究的目的是分别评估瘦素和脂联素与非肥胖和肥胖膝骨关节炎女性临床严重程度和炎症标志物的关联。设计 系统纳入 115 名有症状的原发性膝关节骨性关节炎女性的横断面研究。收集年龄、体育锻炼、症状持续时间和体重指数。根据 Kellgren-Lawrence 量表评估放射学严重程度。疼痛和残疾通过 WOMAC-total、-pain、-function 分量表进行评估。两种脂肪因子（瘦素和脂联素）和 3 种炎症标志物（TNF-α、hsCRP、和IL-6）通过ELISA在滑液和血清中测量。结果 在控制混杂因素后，滑液脂联素与非肥胖女性膝骨关节炎的 WOMAC 疼痛、功能和总滑液 IL-6 相关（偏相关系数 [PCC] = 0.395、0.387、0.427 和 0.649，分别）。在混杂因素控制后，滑液和血清瘦素与 IL-6 (PCC = 0.354) 显着相关，但与临床严重程度和其他炎症标志物的相关性在控制后得到缓解。结论 滑液中的脂联素与膝骨关节炎女性的临床严重程度和局部炎症标志物相关，而当受混杂因素控制时，瘦素相关性减弱。在混杂因素控制后（偏相关系数 [PCC] = 0.395、0.387、0.427 和 0.649）。在混杂因素控制后，滑液和血清瘦素与 IL-6 (PCC = 0.354) 显着相关，但与临床严重程度和其他炎症标志物的相关性在控制后得到缓解。结论 滑液中的脂联素与膝骨关节炎女性的临床严重程度和局部炎症标志物相关，而当受混杂因素控制时，瘦素相关性减弱。在混杂因素控制后（偏相关系数 [PCC] = 0.395、0.387、0.427 和 0.649）。在混杂因素控制后，滑液和血清瘦素与 IL-6 (PCC = 0.354) 显着相关，但与临床严重程度和其他炎症标志物的相关性在控制后得到缓解。结论 滑液中的脂联素与膝骨关节炎女性的临床严重程度和局部炎症标志物相关，而当受混杂因素控制时，瘦素相关性减弱。在混杂因素控制后，滑液和血清瘦素与 IL-6 (PCC = 0.354) 显着相关，但与临床严重程度和其他炎症标志物的相关性在控制后得到缓解。结论 滑液中的脂联素与膝骨关节炎女性的临床严重程度和局部炎症标志物相关，而当受混杂因素控制时，瘦素相关性减弱。在混杂因素控制后，滑液和血清瘦素与 IL-6 (PCC = 0.354) 显着相关，但与临床严重程度和其他炎症标志物的相关性在控制后得到缓解。结论 滑液中的脂联素与膝骨关节炎女性的临床严重程度和局部炎症标志物相关，而当受混杂因素控制时，瘦素相关性减弱。