92例哮喘患者血清瘦素与诱导痰嗜酸性粒细胞的关系

目的 研究哮喘患者血清瘦素与气道和血液中嗜酸性粒细胞的相关性。 方法 对124例受试者进行横断面研究,包括92例哮喘患者(46名超重患者,46名非超重患者)和32例健康对照,分别作为哮喘组(包括超重哮喘组和非超重哮喘组)、正常对照组。所有受试者均测定血清瘦素水平,其中57例哮喘患者测定诱导痰嗜酸性粒细胞百分比和中性粒细胞百分比。3组间比较采用非参数检验、相关分析及有序多项式Logistic回归分析。 结果 与正常对照组相比, 哮喘组的血清瘦素水平差异无统计学意义,超重哮喘组瘦素水平高于非超重哮喘组,17.7(11.1,27.4)vs 10.2(7.8,14.9)ng/mL, z=3.577, P<0.001。哮喘患者血清瘦素水平与诱导痰嗜酸性粒细胞百分比呈低度正相关(r=0.285, P=0.031),与诱导痰中性粒细胞百分比及血嗜酸性粒细胞百分比无关。调整血嗜酸性粒细胞、血清IgE、过敏性鼻炎和吸入性糖皮质激素治疗后,多元有序Logistic回归分析显示,血清瘦素水平与诱导痰嗜酸性粒细胞百分比有统计学意义的关联(OR=1.091, 95%CI:1.004~1.186, P=0.039)。非超重哮喘组血清瘦素水平与诱导痰嗜酸性粒细胞百分比呈中度正相关(r=0.496, P=0.005),而超重哮喘组血清瘦素水平与诱导痰嗜酸性粒细胞百分比无相关性(r=0.094, P=0.640)。 结论 超重哮喘患者血清瘦素水平明显高于非超重哮喘患者。哮喘患者血清瘦素水平与气道嗜酸性粒细胞增高呈正相关。

Association of serum leptin with induced sputum eosinophils in 92 asthmatic patients

Objective To determine whether serum leptin is related to airway and blood eosinophils in patients with asthma. Methods A cross-sectional study was conducted in 124 subjects, 92 of whom suffered from asthma including 46 overweight and 46 non-overweight and 32 of whom were healthy controls. Serum leptin levels were measured in all subjects, and induced sputum eosinophil and neutrophil percentages were determined in 57 asthmatic subjects. The differences among the three groups were evaluated by non-parametric test, correlation analysis and ordinal Logistic regression. Results Compared with healthy contrls, the serum leptin levels in asthmatic patients had no statistical difference. Overweight asthmatic subjects had significantly higher leptin levels than non-overweight asthmatic subjects, 17.7(11.1, 27.4)vs 10.2(7.8, 14.9)ng/mL, z=3.577, P<0.001. In subjects with asthma, leptin levels were positively correlated to the percentage of induced sputum eosinophils(r=0.285, P=0.031), but were not related to the percentage of induced sputum neutrophils and blood eosinophils. After adjustment for blood eosinophil level, serum IgE level, allergic rhinitis and usage of inhaled corticosteroids, multivariate ordinal Logistic regression analysis showed that serum leptin levels remained independently and positively related to the percentage of induced sputum eosinophils(OR=1.091, 95%CI:1.004-1.186, P=0.039). The correlation between serum leptin level and induced sputum eosinophils was statistically significant in non-overweight asthmatic subjects(r=0.496, P=0.005), while it was not statistically significant in overweight asthmatic subjects(r=0.094, P=0.640). Conclusion Compared with non-overweight asthmatic patients, serum leptin levels are significantly elevated in overweight asthmatic patients. Serum leptin is positively correlated to increased airway eosinophils in asthmatic patients.