类风湿关节炎患者脂肪因子水平及其与DAS28的相关性

目的了解类风湿关节炎(rheumatoid arthritis,RA)患者脂肪因子水平,并探讨其与DAS28的相关性。方法选取2017年3—8月金华市中心医院治疗的RA患者126例为观察组,选取同期接受健康体检者100名为对照组,比较2组研究对象血清内脂素、脂联蛋白、抵抗素水平。根据患者疾病活动度将126例RA患者分为高度活动组47例,中低度活动组79例,采用酶联免疫吸附法(ELISA)测定所有研究对象血清标本中内脂素、脂联蛋白、抵抗素水平,采用Pearson相关性分析法分析患者血清内脂素、脂联蛋白、抵抗素水平与DAS28的相关性。结果观察组血清内脂素(6.68±1.25)ng/L、脂联蛋白(11.36±3.29)μg/m L、抵抗素(13.78±4.21)ng/m L,对照组血清内脂素(4.13±1.16)ng/L、脂联蛋白(6.57±1.38)μg/m L、抵抗素(6.85±2.34)ng/m L,观察组患者血清内脂素、脂联蛋白、抵抗素水平明显高于对照组(P<0.05);高度活动组内脂素(4.81±1.95)ng/L、脂联蛋白(22.64±8.96)μg/m L、抵抗素(15.72±7.97) ng/m L,中低度活动组内脂素(4.05±1.66) ng/L、脂联蛋白(19.35±9.62)μg/m L、抵抗素(13.28±5.96)ng/m L,高度活动组患者血清内脂素水平明显高于中低度活动组(P<0.05),2组患者血清脂联蛋白、抵抗素水平比较差异无统计学意义(P>0.05)。Pearson相关性分析显示,血清内脂素、脂联蛋白、抵抗素水平与患者DAS28评分均呈正相关(P<0.05)。结论 RA患者血清中脂肪因子水平显著升高,且在疾病活动度较高的患者中水平更高,与DAS28评分呈正相关,提示脂肪因子可能参与了RA的炎症免疫反应,可作为RA患者疾病活动程度的判断指标之一。

The levels and association of adipokines with DAS28 in patients with rheumatoid arthritis

Objective To investigate the levels of adipokines in patients with rheumatoid arthritis (RA) and to explore their association with DAS28. Methods One hundred and twenty-six patients with RA admitted to Jinhua central hospital from March 2017 to August 2017 were selected as observation group. One hundred people who received physical examination in our hospital during the same period were selected as control group. The levels of visfatin, adiponectin and resistin in two groups were compared. Then, according to the patient's disease activity, 126 patients with RA were divided into 47 patients with high activity group and into 79 patients with moderate-low activity group, the serum lipid, adiponectin and resistin levels were measured by enzyme linked immunosorbent assay(ELISA) the levels of visfatin, adiponectin and resistin were compared between the two groups. Finally, pearson correlation analysis was used to analyze the correlation between the levels of lipoprotein, adiponectin, resistin in patients and DAS28. Results Visfatin was (6.68±1.25) ng/L, adiponectin was (11.36±3.29) μg/mL and resistin is (13.78±4.21) ng/mL in the observation group, visfatin was (4.13±1.16) ng/L, adiponectin was (6.57±1.38) μg/mL and resistin was (6.85±2.34) ng/mL in the observation group, the levels of visfatin, adiponectin and resistin in the control group were significantly higher than those in the control group(P<0.05). Visfatin was (4.81±1.95) ng/L, adiponectin was (22.64±8.96) μg/mL and resistin was (15.72±7.97) ng/mL in the highly active group, visfatin was (4.05±1.66) ng/L, adiponectin was (19.35±9.62) μg/mL and resistin was (13.28±5.96) ng/mL in the moderate-low activity group, the levels of visfatin in the highly active group was significantly higher than that in the moderate-low activity group(P<0.05), there was no significant difference in adiponectin and resistin levels between the two groups(P>0.05). Pearson correlation analysis showed that the levels of serum visfatin, adiponectin, and resistin were positive correlated with the DAS28 score (P<0.05). Conclusion The levels of adipokines in RA patients are high, especially in patients with higher disease activity and positively correlated with DAS28 scores, suggesting that adipokines may be involved in the inflammatory immune response of RA and can be used as a measure of disease activity in patients.