不同亚型脂联素在类风湿关节炎患者血清中表达的研究

发布时间：2018-04-14 21:50

本文选题：类风湿关节炎 + 脂联素　；参考：《吉林大学》2015年硕士论文

【摘要】：目的：类风湿关节炎（rheumatoid arthritis，RA）是一种常见的全身性自身免疫病，主要表现为慢性、对称性的关节滑膜炎症。脂联素（adiponectin，APN）有三种亚型，即高分子量（high-molecular weight，HMW）脂联素、中分子量（medium-molecular weight，MMW）脂联素和低分子量（low-molecular weight，LMW）脂联素，这三种APN亚型不仅在数量上有差异，其生物学活性也存在很大差异。目前APN在RA发病中的作用仍有争议，且国内外关于APN亚型与RA间关系的研究数量极少。本文旨在探讨总APN以及各亚型APN在RA患者血清中的表达及其与RA的关系。方法：纳入近期诊断且未经治疗的RA患者180例（RA组），病程均在1年以内，同时选择160名年龄和性别相匹配的健康体检者作为对照组，采用酶联免疫吸附试验（enzyme-linked immunosorbent assay，，ELISA）方法测定RA组和健康对照组血清中总APN以及HMW、MMW、LMW型APN水平，同时测定红细胞沉降率（erythrocyte sedimentation rate，ESR）、C-反应蛋白（C-reactive protein，CRP）、抗环瓜氨酸肽（anti-cyclic citrullinated peptide antibody, CCP）抗体、类风湿因子（rheumatoid factor，RF）IgM、RF-IgG、RF-IgA、甘油三酯（triglyceride，TG）、总胆固醇（Total cholesterol，TC）、高密度脂蛋白胆固醇（high density lipoproteincholesterol，HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）、血压（blood pressure，BP）、血糖（glucose）、身体质量指数（body massindex，BMI)，并计算RA患者28个关节的疾病活动度评分（disease activity scorein28joints，DAS28）。结果：①与健康对照组相比，RA组患者血清总APN及HMW、MMW、LMW型APN水平显著降低（P＜0.01）。②RA组血清总APN及HMW、MMW、LMW型脂联素水平与血清TG水平呈正相关，而与DAS28呈负相关。逐步多元回归分析显示血清总APN及HMW、MMW、LMW型APN水平与血清TG水平呈正相关，血清LMW型APN水平与DAS28呈负相关。③将RA组患者分为近3个月应用NSAIDs(NSAIDs+)及近3个月未应用NSANDs (NSAIDs-)两组，结果显示两组患者血清总APN及HMW、MMW、LMW型APN水平无明显差异（P＞0.05）。④RF-IgG或RF-IgA或RF-IgM或抗CCP抗体阳性组与RF-IgG或RF-IgA或RF-IgM或抗CCP抗体阴性组RA患者血清总APN及HMW、MMW、LMW型APN水平无明显差异（P＞0.05）。结论：1、RA患者血清中总APN及HMW、MMW及LMW型APN水平均发生了变化。2、RA患者血清总APN及HMW、MMW、LMW型APN可能影响了血清TG的代谢。3、RA患者血清LMW型APN可能参与了RA疾病活动，血清LMW型APN可以作为评价RA疾病活动性的指标。
[Abstract]:Objective: rheumatoid arthritis (RA) is a common systemic autoimmune disease characterized by chronic, symmetrical synovitis.Adiponectin (APN) has three subtypes: high molecular weight high-molecular weight (HMW) adiponectin, medium molecular weight (MMW) adiponectin and low molecular weight low-weight molecular weight (LMWs) adiponectin. These three APN subtypes not only differ in quantity but also in biological activity.At present, the role of APN in the pathogenesis of RA is still controversial, and there are few studies on the relationship between APN subtypes and RA at home and abroad.The purpose of this study was to investigate the expression of total APN and subtypes of APN in serum of RA patients and their relationship with RA.Methods: 180 newly diagnosed and untreated RA patients were enrolled in this study. The course of disease was less than one year, and 160 healthy persons matched with age and sex were selected as control group.The levels of total APN and HMW-MMWMW-LMW APN in serum of RA group and healthy control group were determined by enzyme-linked immunosorbent assayam-ELISA.The erythrocyte sedimentation rate and erythrocyte sedimentation rate (erythrocyte sedimentation rate) of erythrocyte erythrocyte sedimentation rate- ESRP protein (C-reactive protein), anti-cyclic citrullinated peptide antibody (CCPP) antibody were measured by enzyme-linked immunosorbent assay (Elisa).Rheumatoid factor RF-IgGG, triglyceride triglyceride TGG, total cholesterol total cholesterol cholesterol total cholesterol cholesterol cholesterol high density cholesterol cholesterol cholesterol high density protein cholesterol cholesterol cholesterol low density lipoprotein lipoprotein lipoprotein LDL-C, blood pressure blood pressure blood pressure, blood glucose, body mass index (BMI) body mass index (BMI) BMIA, total cholesterol cholesterol total cholesterol cholesterol (HDL-C), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), low density lipoprotein cholesterol (LDL-C), blood pressure blood pressure (BP), blood glucose glucose, body mass index (BMI), body mass index (BMI), and 28 joint diseases in RA patients were calculated.Disease activity scorein28jointsDAS28.Results compared with the healthy control group, the levels of serum total APN and HMW-MMWMW-LMW type APN in patients with RA were significantly lower than those in the control group (P < P < 0.01).2RA). The levels of serum total APN and HMW-MMWMW-LMW adiponectin were positively correlated with serum TG levels, but negatively correlated with DAS28.Stepwise multivariate regression analysis showed that the serum levels of total APN and APN were positively correlated with the serum TG levels, and the serum LMW APN levels were negatively correlated with DAS28. 3. The patients in RA group were divided into two groups: NSAIDs(NSAIDs in the last 3 months and NSANDs NSAIDs-not in the last 3 months.The results showed that there was no significant difference in serum total APN and APN levels between the two groups (P > P > 0.05). There was no significant difference in serum total APN and HMW-MMWMW-LMW APN levels between RF-IgG or RF-IgA or RF-IgM or anti- antibody negative group and RF-IgG or RF-IgA or RF-IgM or anti- antibody negative group (P > 0.05).Conclusion the levels of total APN, HMWMMW and LMW type APN in serum of patients with RA may be affected by the changes of total APN and MMW type APN in patients with RA, and the level of LMW APN may be involved in the disease activity of RA.Serum LMW type APN can be used as an index to evaluate the disease activity of RA.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.22

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