血清瘦素水平与强直性脊柱炎男性患者韧带骨赘形成之间的关联性研究

Relationship between serum leptin levels and the presence of syndesmophytes in male patients with ankylosing spondylitis

目的探讨强直性脊柱炎(AS)男性患者血清瘦素水平与韧带骨赘形成之间的关联性。方法 30例AS男性患者和30例非AS男性健康志愿者纳入研究。采用Bath强直性脊柱炎疾病活动指数(BASDAI)评价AS的疾病活动性,采用Bath强直性脊柱炎功能指数(BASFI)评估AS组患者的功能损害程度。通过腰椎正侧位X线片明确韧带骨赘形成。采用改良Stoke强直性脊柱炎脊柱评分(mSASSS)评估脊柱的结构性损害。采集所有研究对象的血液标本,测定其红细胞降沉率(ESR)、C-反应蛋白(CRP)及血清瘦素水平。结果 AS患者的ESR、CRP显著高于对照组,组间差异有显著性(P<0.001),但血清瘦素水平组间差异无显著性(P>0.05)。AS组中14例患者(46.7%)存在韧带骨赘形成,相比无韧带骨赘组患者,韧带骨赘形成组的年龄更高,病程更长,BMI更大,BASFI及mSASSS也更高(P<0.05)。然而,在CRP,ESR以及BASDAI,组间差异无显著性(P>0.05)。韧带骨赘形成组与无韧带骨赘组的血清瘦素水平分别为(5 678.2±958.2)pg/mL和(3 217.1±584.4)pg/m,差异有显著性(P=0.000),韧带骨赘形成组显著高于韧带骨赘组。在韧带骨赘形成组中,血清瘦素水平与AS韧带骨赘形成患者的mSASSS、BASFI及病程呈显著正相关,但与BASDAI、ESR水平或CRP无相关关系;无韧带骨赘组的血清瘦素水平与mSASSS、BASDAI、BASFI、CRP、ESR水平或病程均无相关关系。结论在AS男性患者中,韧带骨赘形成者的血清瘦素水平显著高于无骨赘形成者,瘦素可能参与AS男性患者的新骨形成机制。

【Objective】To clarify the relationship between serum leptin levels and the presence of syndesmophytes in male patients with ankylosing spondylitis（AS）. 【Methods】Thirty male patients with AS and 30 male healthy controls participated in this study. Disease activity of AS patients was assessed clinically according to the Bath AS Disease Activity Index（BASDAI）, while AS functional impairment was assessed using the Bath AS Functional Index（BASFI）. New bone formation was assessed as the presence of definite syndesmophytes as observed by radiography of the lumbar spine in two planes（anteroposterior and lateral）. The modified Stoke Ankylosing Spondylitis Spine Score（mSASSS） was used to assess structural damage. Serum samples were collected from all subjects to evaluate serum leptin, ESR, and CRP. 【Results】Serum leptin levels were not significant difference in AS patients as compared to healthy controls（P〉0.05）. ESR and CRP are significantly higher in the AS patients compared with the controls（P〈0.001）. Among all AS patients, syndesmophytes were seen in 14 patients（46.7%）. The results found that the patients with syndesmophytes were older, had longer disease duration, higher BMI, BASFI and mSASSS than those without（P〈0.05）. However, CRP, ESR, and BASDAI values were comparable between these groups（P〈0.05）.Serum leptin levels were significantly higher in AS patients with syndesmophytes compared with those without（5678.2±958.2 vs 3217.1±584.4 pg/mL, P =0.000）. For the patients with syndesmophytes, serum leptin levels were correlated positively with mSASSS, BASFI, and duration of the disease but not with BASDAI, ESR or CRP. However,for the patients without syndesmophytes, serum leptin levels were not correlated with mSASSS, BASFI, duration of the disease, BASDAI, ESR or CRP. 【Conclusions】Serum leptin levels are elevated in male AS patients with syndesmophytes as compared to those without, suggesting a potential role of leptin in new bone formation in AS.