脂联素及其受体在原发性痛风性关节炎患者外周血的表达及临床意义

Expremion of adiponectin and its receptors in patients with primary gouty arthritis

目的研究脂联素及其受体1，2在原发性痛风性关节炎（GA）患者外周血的变化及临床意义。方法采用酶联免疫吸附试验（ELISA）测定88例GA患者和80名健康对照者（Nc）血浆脂联素含量，实时荧光定量聚合酶链反应（RT．qPCR）检测33例GA患者和30名Nc外周血单个核细胞（PBMCs）中脂联素受体（ADR）1和ADR2的mRNA水平并进行比较，分析脂联素、ADR1、ADR2与GA患者临床及实验室指标的相关性。采用t检验、Spear／nan相关分析及多元回归分析进行统计学分析。结果GA组血浆脂联素含量低于Nc组[（6±7）μg／ml与（84-6）μg／ml，t=-3．71，P〈0．01]，而ADR1、ADR2mRNA表达量在GA组（ADR1：0．09±0．08，ADR2：0．0122±0．0164）则高于NC组（ADR1：0．05±0．03，ADR2：0．0054±0．0024）（t=2．71，2．35，P均〈0．05）。相关性分析发现GA患者脂联素与淋巴细胞绝对值（LY）、血尿酸均呈负相关（r=0．32，-0．36，P均〈O．05），与红细胞沉降率（ESR）和低密度脂蛋白（LDL）均呈正相关（r．0．31，0．39，P均〈0．05）；ADR1mRNA水平与甘油三酯呈负相关（r=-0．43，P〈0．05），与ESR、C反应蛋白则呈正相关（r=0．45，0．57，P均〈0．05），ADR2mRNA表达量与血糖和血尿酸均呈负相关（r=0．50，-0．59，P均〈0．05）。结论脂联素及其受体表达异常可能参与了GA的发生发展，可能与痛风的炎症、免疫及代谢过程密切相关。

Objective To investigate the role of adiponectin （ADP） and its receptors （ADR） in patients with primary gouty arthritis （GA）. Methods Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of plasma ADP in 88 GA and 80 healthy controls （NC）. Real time quantitative polymerase chain reaction （RT-qPCR） was employed to study the expression of ADR1 and ADR2 mRNA in peripheral blood mononuclear cells （PBMCs）. The biochemical indicator of TG, HDL, LDL, VLDL, apoA1, apoB100 and uric acid （UA） were detected at the same time. T test, Spearman＇s correlations and regression analysis were used for statistical analysis. Results The concentration of plasma ADP was significantly lower in GA than that in NC [（6±7）μg/ml, （8＋6） μg/ml, t=-3.71, P〈0.01], the expression of ADR1 and ADR2 mRNA in GA （ADRI： 0.09＋0.08, ADR2： 0.0122＋0.0164） was significantly increased when compared to the NC （ADRI： 0.05±0.03, ADR2： 0.0054±0.0024） （t=2.71, 2.35, P〈0.05）. In the GA patients, the level of ADP was negatively correlated with the lymphocytes count （LY） and UA （r=-0.32, -0.36, P〈0.05）, and it was positively correlated with ESR and LDL level （r=0.31, 0.39, P〈0.05）. The expression of ADR1 mRNA was negatively correlated with TG （r=-0.43, P〈0.05）, but positively correlated with ESR and CRP level （r= 0.45, 0.57, P〈0.05）. The expression of ADR2 mRNA was negatively correlated with glucose and UA（r= -0.50, -0.59, P〈0.05）. Conclusion Altered expression of ADP and its receptors may be involved in the pathogenesis of gouty inflammation.