血浆瘦素在原发性痛风性关节炎及高尿酸血症患者的表达及临床意义

Expression and significance of plasma leptin in patients with primary gouty arthritis and hyperuricemia

目的:检测血浆瘦素(leptin,LEP)在原发性痛风性关节炎患者(gouty arthritis,GA)、高尿酸血症者(hyperuricemia,HA)及健康体检者(normal control,NC)的表达水平,从而探讨LEP在GA和HA发病机制中可能的作用。方法:采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测GA组(84例)、HA组(38例)和NC组(43例)血浆LEP含量,比较其差异性,分析血浆LEP与GA及HA组临床及实验室指标的相关性。结果:LEP在三组表达差异有统计学意义(F=17.78,P<0.05),进一步两两分析(LSD法)发现LEP在GA组的表达显著高于HA组[(436.55±246.65)pg/mL vs(306.25±173.16)pg/mL,P<0.05]和NC组[(436.55±246.65)pg/mL vs(199.68±185.54)pg/mL,P<0.05],HA组显著高于NC组[(306.25±173.16)pg/mL vs(199.68±185.54)pg/mL,P<0.05]。相关分析发现痛风患者LEP水平与体重指数(BMI)、极低密度脂蛋白(VLDL)、肌酐(Cr)均呈显著正相关(r=0.31,r=0.28,r=0.25;P均<0.05),而与血尿酸(UA)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血糖(GLU)、中性粒细胞绝对值(GR)、淋巴细胞绝对值(LY)、血沉(SR)、C反应蛋白(CRP)均无明显相关性(P均>0.05)。高尿酸血症者LEP水平与GLU呈显著正相关(r=0.42,P<0.05),与UA、TG、HDL、LDL、VLDL均无明显相关性(P均>0.05)。结论:LEP的高表达可能参与了原发性痛风性关节炎及高尿酸血症的发生发展。LEP可能主要在痛风的脂代谢障碍及肾功能损害中发挥作用,可能参与高尿酸血症的糖代谢过程。

Objective：To investigate the expression levels of plasma leptin （LEP） in patients with primary gouty arthritis （GA） and hyperurieemia （HA） respectively, as well as to explore the pathogenesis of GA and HA. Methods： ELISA was used to determine the levels of plasma leptin in 84 GA, 38 HA, and 43 normal control （NC） patients. Correlation analysis was used to evaluate the relation- ship between the levels of LEP and the data which were collected from clinical and laboratory samples. Results ： Plasma concentrations of leptin were significantly different in the three groups （ F=17.78 ,P 〈 0.05 ）. The expression levels of plasma leptin were significant- ly higher in GA than that in HA （436.55 ±246.65 pg/ml vs 306.25 ± 173.16 pg/ml,P 〈0.05） and NC （436.55 ±246.65 pg/ml vs 199.68±185.54 pg/ml,P 〈 0.05 ） , and the expression levels of plasma leptin in HA increased significantly when compared to the NC （306.25±173.16 pg/ml vs 199.68±185.54 pg/ml,P 〈 0.05 ） BMI,VLDL and Cr （r =0.31,r =0.28, and r=0.25;P 〈0.05） In GA patients, the levels of leptin were positively correlated with but there was no correlation between UA, TG, HDL, LDL, GLU,GR, LY, SR, CRP and the expression levels of leptin （P 〉 0. 05）. The levels of leptin were positively correlated with GLU （ r = 0. 42 ;P 〈 0.05 ） , but there was no relationship between UA, TG, HDL, LDL, VLDL （ P 〉 0.05 ）. and the expression levels of leptin in HA. Conclusion： The increased expression of the leptin is involved in the metabolic disturbance of lipid and the functional le- sion of the kidney in primary gouty arthritis. It has a relationship with glycometabolism in hyperuricemia, and may play a key role in the pathogenesis of primary gouty arthritis and hyperuricemia.