脂联素、内脂素、抵抗素在系统性红斑狼疮患者血清中的变化及临床意义

发布时间：2019-01-23 13:05

【摘要】：目的探讨系统性红斑狼疮(SLE)患者血清脂联素、内脂素、抵抗素表达水平,及其在SLE、狼疮肾炎和SLE合并骨坏死中的作用及临床意义。方法选取2015年9月至2016年2月就诊于山东大学附属省立医院风湿免疫科SLE患者58例(SLE组),其中SLE合并骨坏死患者12例(SLE合并骨坏死组)、SLE未合并骨坏死患者46例(SLE未合并骨坏死组);狼疮肾炎患者23例(狼疮肾炎组)、SLE无肾损伤患者35例(SLE无肾损伤组)。同期选取该院查体中心健康人43例(健康对照组)。采用酶联免疫吸附法检测SLE组和健康对照组血清脂联素、内脂素、抵抗素表达水平,分析其与狼疮肾炎、SLE合并骨坏死的关系,及其与临床及实验室指标抗双链DNA抗体、抗核小体抗体、补体3、补体4、血沉、C反应蛋白、SLE疾病活动度评分(SLEDAI)、血清白蛋白、血清肌酐及24 h尿蛋白的相关性。结果 SLE组血清脂联素、内脂素、抵抗素水平较健康对照组明显升高(P0.001);狼疮肾炎组脂联素和抵抗素水平明显高于SLE无肾损伤组(P0.001,P=0.033);脂联素、内脂素、抵抗素在SLE合并骨坏死组和SLE未合并骨坏死组表达差异无统计学意义(P=0.117;P=0.058;P=0.674);内脂素表达水平与血沉呈相关性(rs=0.281,P=0.046);多元线性回归分析显示,体质量指数(BM I)和血沉均为影响内脂素表达水平的重要因素(P=0.010,0.020);BMI是影响抵抗素表达水平的重要因素(P=0.046)。结论血清脂联素、内脂素、抵抗素的高表达可能与SLE相关,且脂联素和抵抗素水平升高与SLE肾损害具有相关性,其确切作用机制尚需进一步研究。
[Abstract]:Objective to investigate the expression levels of adiponectin, endoadiponectin and resistin in (SLE) patients with systemic lupus erythematosus, and its clinical significance in patients with SLE, lupus nephritis and SLE complicated with osteonecrosis. Methods from September 2015 to February 2016, 58 SLE patients (SLE group) from the Department of Rheumatology and Immunology, affiliated to Shandong University, were selected, including 12 cases of SLE complicated with osteonecrosis (SLE combined with osteonecrosis). 46 cases of SLE without osteonecrosis (SLE group without osteonecrosis); There were 23 cases of lupus nephritis (35 cases of), SLE without renal injury in lupus nephritis group) (SLE group without renal injury group). At the same time, 43 healthy persons (healthy control group) were selected. The serum levels of adiponectin, endoadiponectin and resistin were detected by enzyme-linked immunosorbent assay (Elisa) in SLE group and healthy control group. The relationship between them and lupus nephritis, SLE complicated with osteonecrosis and anti-double-stranded DNA antibody were analyzed. Correlation of anti-nucleosome antibody, complement 3, complement 4, erythrocyte sedimentation rate, C-reactive protein, SLE disease activity score, (SLEDAI), serum albumin, serum creatinine and 24 h urinary protein. Results the serum levels of adiponectin, endogenous adiponectin and resistin in SLE group were significantly higher than those in healthy control group (P0.001), and the levels of adiponectin and resistin in lupus nephritis group were significantly higher than those in SLE without renal injury group (P0.001P0.033). There was no significant difference in the expression of adiponectin, endogenous adiponectin and resistin between SLE with osteonecrosis group and SLE group with no osteonecrosis group (P < 0. 117), the expression level of endogenous adiponectin was correlated with erythrocyte sedimentation rate (rs=0.281,P=0.046). Multiple linear regression analysis showed that both body mass index (BM I) and erythrocyte sedimentation rate (ESR) were important factors affecting the expression of resistin (P0.010 ~ 0.020); BMI). Conclusion the high expression of adiponectin, endogenous adiponectin and resistin may be related to SLE, and the elevated levels of adiponectin and resistin may be associated with renal damage in SLE. The exact mechanism of the expression of adiponectin, endoadiponectin and resistin needs further study.
【作者单位】：山东大学附属省立医院风湿免疫科;
【基金】：国家自然科学基金(81671605) 山东省重点研发计划(2015GSF118002)
【分类号】：R593.241

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