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

doi:10.6040/j.issn.1671-7554.0.2016.1634

摘要/Abstract

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(P<0.001);狼疮肾炎组脂联素和抵抗素水平明显高于SLE无肾损伤组(P<0.001, 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(r_s=0.281, P=0.046);多元线性回归分析显示,体质量指数(BMI)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。

关键词: 系统性红斑狼疮, 狼疮肾炎, 骨坏死, 内脂素, 抵抗素, 脂联素

Abstract: Objective To investigate the expressions of adiponectin, visfatin and resistin in systemic lupus erythematosus(SLE), and to explore their role in SLE, lupus nephritis, and SLE complicated with bone necrosis. Methods A total of 58 SLE patients including 12 SLE complicated with bone necrosis and 46 SLE without bone necrosis, 23 lupus nephritis(LN)cases, 35 SLE cases without LN, were recruited. Another 43 healthy volunteers were selected as healthy controls. The serum levels of adiponectin, visfatin and resistin were detected with ELISA to analyze their relationship with renal injury and bone necrosis. The correlation between clinical and laboratory parameters was analyzed. Results Serum levels of adiponectin, visfatin and resistin were higher in SLE patients than in healthy controls(P<0.001). Adiponectin and resistin levels were significantly higher in LN cases than in SLE without LN cases(P<0.001, P=0.033). There were no differences in adiponectin, visfatin and resistin between the SLE patients with and without bone necrosis 山东大学学报 (医学版)55卷4期 -麻贞贞,等.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 \=-(P=0.117, 0.058, 0.674, respectively). Visfatin was clearly associated with erythrocyte sedimentation rate(ESR)(r_s=0.281, P=0.046). Body mass index(BMI)and ESR were the significant factors of visfatin(P=0.010, P=0.020), and BMI was the significant factor influencing resistin(P=0.046). Conclusion The high expressions of serum adiponectin, visfatin and resistin may be associated with SLE, and increased adiponectin and resistin levels correlate with renal damage, but the underlying mechanisms need further studies.

Key words: Systemic lupus erythematosus, Lupus nephritis, Visfatin, Resistin, Bone necrosis, Adiponectin

中图分类号:

R593.24

麻贞贞,孙红胜,杨清锐. 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[J]. 山东大学学报（医学版）, 2017, 55(4): 86-90.

MA Zhenzhen, SUN Hongsheng, YANG Qingrui. Changes and clinical significance of serum adipokines in systemic lupus erythematosus[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 86-90.

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