Objective To investigate the relationship between bone mineral density ( BMD ) , bone metabolic biochemical markers and interleukin 17 ( IL-17 ) , matrix metalloproteinase-9 ( MMP-9 ) in patients with rheumatoid arthritis complicated by osteoporosis.Methods Nighty patients with rheumatoid arthritis who were admitted into our hospital from January 2013 to January 2015 were enrolled in the study.According to BMD determined by dual-energy X-ray absorptiometry, these patients were divided into normal BMD group, low BMD group and osteoporosis group.The serum levels of bone metabolic biochemical markers, including osteocalcin ( BGP ) , parathyroid hormone ( PTH ) , bone alkaline phosphatase (BALP), typeⅠcollagen cross-linked carboxy-terminal peptide (CTX-Ⅰ) were detected by radioimmunoassay,moreover, the serum levels of IL-17 and MMP-9 were detected by ELISA.Results Among 90 patients with rheumatoid arthritis, the incidences of osteoporosis and osteopenia were 18.89% (17/90),47.78% (43/90), respectively.The BMD in lumbar spine, femoral neck and Ward ’ s triangle in normal BMD group, low BMD group and osteoporosis group was gradually decreased in order,there was a significant difference among the three groups ( P <0.05), BMI,serum BGP,PTH levels were gradually decreased in the three groups, however ESR, serum CRP, CTX-Ⅰ, BALP, IL-17, MMP-9 levels were gradually increased,there were significant differences among the three groups ( P <0.05).The Sperman correlation analysis showed that the BMD in lumbar spine, femoral neck and Ward’ s triangle in patients with rheumatoid arthritis was positively correlated to BMI,serum BGP,PTH levels,however,which was gegatively related with ESR,CRP,CTX-Ⅰ,BALP,IL-17, MMP-9 levels ( P <0.05).Conclusion BMD is correlated to the serum levels of BGP, PTH, CTX-Ⅰ, BALP, IL-17, MMP-9 in patients with rheumatoid arthritis complicated by osteoporosis,moreover, the increase of IL-17 and MMP-9 levels may play an important role in the pathogenesis of osteoporosis in patients with rheumatoid arthritis.%目的：观察类风湿性关节炎并发骨质疏松患者骨密度（ BMD）、骨代谢指标与血清白介素17（ IL-17）、基质金属蛋白酶9（MMP-9）水平的关系。方法选取类风湿性关节炎患者90例，采用双能X线吸收法测定患者腰椎L1～L4、股骨颈、Ward’ s三角区BMD，根据BMD将患者分为骨量正常组、骨量减少组和骨质疏松组。采用放射免疫法测定3组血清骨钙素（ BGP）、甲状旁腺激素（ PTH）、骨碱性磷酸酶（ BALP）、Ⅰ型胶原胶联蛋白羧基末端肽（ CTX-Ⅰ）水平。酶联免疫吸附试验（ ELISA）测定3组IL-17、MMP-9水平。结果90例患者骨质疏松和骨量减少发生率分别为18贩．89％（17／90）、47．78％（43／90）。骨量正常组、骨量减少组、骨质疏松组患者腰椎L1～L4、股骨颈、Ward’ s三角区BMD逐渐降低，差异均有统计学意义（ P ＜0．05）；体重指数（BMI）、血清BGP、PTH水平逐渐降低，血沉（ESR）、血清C-反应蛋白（CRP）、CTX-Ⅰ、BALP、IL-17、MMP-9水平逐渐升高，差异均有统计学意义（ P ＜0．05）。患者腰椎L1～L4、股骨颈、Ward’s三角区BMD与BMI、血清BGP、PTH水平呈正相关（ P ＜0．05），与ESR、CRP、CTX -Ⅰ、BALP、IL-17、MMP-9水平呈负相关（P ＜0．05）。结论类风湿性关节炎患者BMD与血清BGP、PTH、CTX-Ⅰ、BALP、IL 1-7、MMP-9水平有关，血清IL-17、MMP-9水平升高可能是类风湿性关节炎并发骨质疏松的重要因素。
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