Objective To analyze the correlation between the polymorphism on interleukin 6 (IL-6) gene promoter region-174 locus and adolescent idiopathic scoliosis (AIS), including the susceptibility, the bracing effectiveness, and the possible mechanism. Methods The 182 AIS patients and 210 healthy controls who met the inclusion criteria between January 2013 and January 2016 were collected as research objects. The genotype of IL-6 gene promoter region-174 locus, the serum IL-6, the bone mineral density (BMD) of femoral neck and vertebrae (L1–4), and the bone metabolism parameters, including bone alkaline phosphatase (BALP), bone gla protein (BGP), tartrate resistant acid phosphatase 5b (TRACP-5b), urine Ca, and urine Ca/Cr, were detected. All research objects were divided into the AIS group and the control group according to whether they had AIS, the GG, CG, CC groups according to their genotype, and progression-free group and progression group according to the therapeutic effectiveness of 1-year bracing treatment. Statistical analysis for the indexes were conducted respectively. Results There were significant differences in AIS history, BMD of femoral neck and lumbar vertebrae between the AIS group and control group (P<0.05). According to the therapeutic effecitveness of 1-year bracing treatment, 182 AIS patients were divided into progression-free group in 110 cases and progression group in 72 cases. The results of single factor analysis showed that there were significant differences in the genotype and allele distribution of IL-6 gene promoter region-174 locus, BMD of femoral neck and lumbar vertebrae, IL-6, TRACP-5b, urine Ca, and urine Ca/Cr between the progression-free group and progression group (P<0.05). The results of multivariable analysis showed that the BMD of lumbar vertebrae, TRACP-5b, and urine Ca were the influencing factors of bracing efficacy (P<0.05). According to the results of genotype detection, all research objects were divided into GG group in 264 cases, CG group in 104 cases, and CC group in 24 cases. The IL-6, TRACP-5b, urine Ca, and urine Ca/Cr of GG type carriers were higher and BMD of femoral neck and lumbar vertebrae were lower when compared with the CG and CC type carriers (P<0.05). The BMD of lumbar vertebrae of CG type carriers was lower than that of CC type carriers (P<0.05). Conclusion The polymorphism of IL-6 genepromoter region-174 locus wasn’t correlated with the AIS susceptibility, but it was correlated (not independently correlated) with the scoliosis progression under bracing treatment, and the risk for G-carried patients was higher. The mechanism may be that the polymorphism affected the IL-6 expression level and eventually affected the BMD of AIS patients through the bone metabolism.
Objective To explore the risk factors associated with interleukin 6 (IL-6) level in serum after total knee arthroplasty (TKA). Methods A retrospective study was made on the clinical data of 273 patients underwent primary unilateral TKA between July 2015 and April 2017. There were 50 males and 223 females with an average age of 66.3 years (range, 36-89 years), and the body mass index (BMI) was (25.5±3.7) kg/m2. Of them, 256 patients suffered with osteoarthritis, and the other 17 patients with rheumatoid arthritis. Univariate analysis was made to find the related factors between IL-6 level in serum at 1 day after operation and preoperative data including gender, age, BMI, diagnosis, comorbidities, preoperative American Society of Anesthesiologists (ASA) grade, preoperative varus or valgus deformity, range of motion of the knee, preoperative level of C-reactive protein (CRP) and IL-6 in serum, operation time, intraoperative blood loss, usage of drainage tube and catheter, and dosage of tranexamic acid and dexamethasone used on day of operation. Furthermore, the multiple linear regression analysis was performed to identify the risk factors. Results The operation time was (79.7±15.6) minutes, and the intraoperative blood loss was (107.8±25.3) mL. Drainage tubes were used in 111 patients and catheters were used in 41 patients after operation. The dosage of tranexamic acid and dexamethasone used on day of operation were (3.2±0.8) g and (15.1±6.6) mg, respectively. The levels of IL-6 in serum were (4.48±3.05), (42.65±37.09), and (28.21±26.44) pg/mL before operation and at 1 and 3 days after operation, respectively. Univariate analysis showed that the level of IL-6 in serum at 1 day after operation was significantly higher in variables as follows: age, diagnosis, history of lung infection, range of motion, preoperative levels of CRP and IL-6 in serum, intravenous dosage of tranexamic acid and dexamethasone on day of operation (P<0.05). Multiple linear regression analysis showed that range of motion less than 90°, intravenous dosage of tranexamic acid on day of operation less than 3 g, and dosage of dexamethasone on day of operation less than 10 mg were significant risk factors (P<0.05). Conclusion Range of motion less than 90°, intravenous dosage of tranexamic acid on day of operation less than 3 g, and dosage of dexamethasone on day of operation less than 10 mg were independent risk factors that resulted in increased level of IL-6 in serum at 1 day after TKA.