寻常型银屑病合并代谢综合征患者血清脂肪因子Chemerin的临床研究

发布时间：2019-06-01 22:12

【摘要】：目的:通过研究寻常型银屑病合并代谢综合征(MS)患者血清脂肪因子Chemerin的水平变化及相关因素,探讨寻常型银屑病与MS的关系及其可能的发病机制。方法:本研究共纳入研究对象115例,其中PSMS组(银屑病合并代谢综合征组)30例,PS组(银屑病组)30例,MS组(代谢综合征组)30例,NC组(健康对照组)25例。用酶联免疫吸附测定(ELISA)实验检测所有研究对象的血清Chemerin水平进行各组间比较,同时对各组研究对象身高、体重、腰围(WC)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、空腹胰岛素(Fins)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)浓度进行检测,计算身体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR),对于所有银屑病患者,追加调查PASI评分(银屑病面积与严重程度指数)、病程、初次发病年龄、烟酒史、用药史、家族史,将部分指标与血清脂肪因子Chemerin进行相关性分析。所有结果应用SPSS16.0进行相关统计学分析。结果:1.PSMS组、PS组、MS组血清Chemerin水平均高于NC组,其中又以PSMS组最高,差异有统计学意义(P0.05)；2.血清hs-CRP、IL-6水平PSMS组、PS组、MS组均高于NC组,且以PSMS组最高,差异有统计学意义(P0.05)；3.PSMS组、PS组、MS组BMI、WC、SBP、Fins、HOMA-IR、TG、TC、LDL-C水平均明显高于NC组(P0.05)；PSMS组WC、Fins、HOMA-IR、LDL-C水平高于单纯MS组,差异有统计学意义(P0.05)；4.PSMS组中MS各组分分布以腹型肥胖最多,其余依次为高TG、高血压、低HDL-C、高血糖；MS组MS各组分分布以高血压最多,其次为腹型肥胖、高TG、高血糖、低HDL-C；5.PSMS组与PS组比较,烟酒史、用药史、家族史无明显差异,但其PASI评分较PS组明显升高；6.PSMS组血清Chemerin水平与BMI(r=0.369)、WC(r=0.428)、TG(r=0.482)、LDL-C(r=0.371)、hs-CRP(r=0.519)、IL-6(r=0.575)、PASI(r=0.372),具有线性正相关关系(P0.05),与SBP、DBP、HOMA-IR、TC、HDL-C无明显相关性(P0.05)；7.以血清Chemerin浓度作为因变量,以BMI、WC、TG、LDL-C、hs-CRP、IL-6及PASI作为自变量作多元逐步回归分析显示hs-CRP、IL-6、WC、TG进入回归方程,其中对Chemerin影响最大的是IL-6(β=0.352),其次是hs-CRP(β=0.302)。结论:1.Chemerin主要通过参与炎症参与并影响寻常型银屑病合并MS的发病及进展,并且其血清水平与患者肥胖、脂代谢紊乱、炎症及银屑病严重程度密切相关；2.寻常型银屑病患者及MS患者均处于一定程度的炎症状态,又以二者并发时炎症程度最高；3.寻常型银屑病患者中存在代谢紊乱情况；寻常型银屑病可加重MS患者腹型肥胖、胰岛素抵抗与脂代谢紊乱程度,MS也可以增加寻常型银屑病患者病情的严重程度。
[Abstract]:Objective: to study the changes and related factors of serum fat factor Chemerin in patients with psoriasis vulgaris complicated with metabolic syndrome (MS), and to explore the relationship between psoriasis vulgaris and MS and its possible pathogenesis. Methods: a total of 115 cases were included in this study, including 30 cases in PSMS group (psoriasis complicated with metabolic syndrome group), 30 cases in PS group (psoriatic group), 30 cases in MS group (metabolic syndrome group) and 25 cases in NC group (healthy control group). The serum Chemerin levels of all subjects were measured by enzyme-linked immunosorbent assay (ELISA). At the same time, the height, weight and waist circumference (WC), systolic blood pressure of (SBP), diastolic blood pressure (DBP), were compared. TG (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FPG), fasting insulin (Fins), high sensitive C reactive protein (hs-CRP), The concentration of IL-6 (IL-6) was measured, the body mass index (BMI),) insulin resistance index (HOMA-IR) was calculated, and the PASI score (psoriasis area and severity index) and course of disease were investigated in all patients with psoriasis. The age of first onset, the history of tobacco and alcohol, the history of drug use and the family history were analyzed to analyze the correlation between some indexes and serum fat factor Chemerin. All the results were analyzed by SPSS16.0. Results: the serum Chemerin levels in 1.PSMS group, PS group and MS group were higher than those in NC group, and PSMS group was the highest, the difference was statistically significant (P 0.05). The level of serum hs-CRP,IL-6 in PSMS group, PS group and MS group was higher than that in NC group, and PSMS group was the highest, the difference was statistically significant (P 0.05). The levels of BMI,WC,SBP,Fins,HOMA-IR,TG,TC,LDL-C in 3.PSMS group, PS group and MS group were significantly higher than those in NC group (P 0.05). The level of WC,Fins,HOMA-IR,LDL-C in PSMS group was significantly higher than that in MS group (P 0.05). The distribution of MS in 4.PSMS group was the most in abdominal obesity, followed by high TG, hypertension and low HDL-C, hyperglycemia. The distribution of MS components in MS group was hypertension, followed by abdominal obesity, high TG, and hyperglycemia. Compared with PS group, there was no significant difference in tobacco and alcohol history, drug use history and family history between low HDL-C;5.PSMS group and PS group, but the PASI score was significantly higher than that in PS group. Serum Chemerin levels were correlated with BMI (r 鈮，

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