女性系统性红斑狼疮患者血清瘦素水平的检测及意义

Serum leptin level and its influencing factors in women with SLE

目的探讨瘦素在女性SLE患者中的表达情况及其影响因素。方法用放射免疫分析(RIA)法分别检测104例女性SLE患者及30例正常对照血清瘦素的水平,并按治疗时强的松剂量分未使用强的松组,小剂量组(5～20mg/d),中高剂量组(25～80mg/d)三组,按SLEDAI分非活动组(0～9分)和活动组(≥10分),按病程分≤1年和>1年两组,分别比较瘦素水平。结果104例女性SLE患者血清瘦素浓度为16.81±15.34μg/L,高于正常对照8.07±6.19μg/L(P<0.001)。未使用强的松组,小剂量组,中高剂量使用强的松组瘦素水平为分别为14.75±10.98μg/L,14.49±12.39μg/L,21.04±21.03μg/L,均明显高于正常对照组8.07±6.19μg/L(P<0.05,P<0.05,P<0.001),中高剂量使用强的松组瘦素水平明显高于未使用强的松组(P<0.05)。活动组瘦素水平为19.19±22.49μg/L,明显高于非活动组水平15.81±13.34μg/L(P<0.05)。病程≤1年组瘦素含量为19.77±18.55μg/L,高于病程>1年组13.53±10.05μg/L(P<0.05)。结论女性SLE患者血清瘦素水平升高,瘦素水平可作为SLE活动性的指标之一,糖皮质激素尤其是中高剂量糖皮质激素是影响血清瘦素水平的重要因素。瘦素可能参与了SLE的发生发展。

Objective To investigate the expression and influencing factors of serum leptin in women with SLE. Methods Serum leptin from 104 women with SLE and 30 healthy controls were determined by RIA. The patients were divided into three groups according to the doses of prednisone： before treatment, low doses（5-20mg/d） and middle or high doses（25- 80mg/d）. According to the SLEDAI, they were also divided into inactive group （0-9scores） and active group （≥10 scores）, and again divided into two groups according to the course of SLE： ≤ 1 year group and 〉1 year group. The differences of serum leptin among each group were analysed. Results Serum leptin in 104 women with SLE was higher than that in the controls（16.81±15.34μg/L versus 8.07±6.19μg/L（P〈0.001）. The serum leptin in the groups before treatment, with low doses（5-20mg/d）, with middle or high doses（25-80mg/d） were all higher than that of the controls（14.75±10.98μg/L,14.49±12.39μg/L,21.04±21.03μg/L versus 8.07±6.19μg/L（P〈0.05,P〈0.05,P〈0.001）, respectively. The serum leptin concentration in the group with middle or high doses was also higher than that in before treatment group （P〈 0.05）. There were no significant differences between other groups（P〉0.05）. The leptin concentration in the active group was higher than that of inactive group （19.19±22.49μg/L versus 15.81±13.34μg/L,P〈0.05）. The serum leptin in the group of SLE course with≤ 1 year was higher than that in the 〉1 year group （19.77±18.55μg/L versus 13.53±10.05μg/L, P〈0.05）. Conclusions The serum leptin in women with SLE were higher than that in healthy women. It can be used as one of the active indexes of SLE. The application of glucocorticoids especially with middle or high doses is the important factor to the serum leptin level of SLE, and serum leptin maybe participate in the course of SLE.