脂肪因子与大动脉炎血管炎症相关性的临床分析

Association between serum adipokine profile and vascular inflammation in patients with Takayasu arteritis

目的 探讨脂肪因子在大动脉炎血管炎症和管壁慢性损伤中的作用.方法 比较59例大动脉炎患者外周血脂肪因子水平、临床资料与40例女性健康对照的差异,计量资料采用Mann-WhitneyU检验,计数资料采用x2检验进行比较;并对各脂肪因子之间以及脂肪因子与炎症指标间进行Spearman秩相关检验.结果 大动脉炎患者血清瘦素水平[（25±16） ng/ml与（7±5） ng/ml,U=300.00,P＜0.01]和血清抵抗素水平[（11.5±8.3） ng/ml与（2.2±1.3） ng/ml,U=120.00,P＜0.01]显著高于健康对照,内脂素和总脂联素在2组间差异无统计学意义.大动脉炎初发患者血清瘦素水平与纤维蛋白原（r=-0.42,P=0.03）、ESR（r=-0.35,P=0.03）、CRP（r=-0.36,P=0.03）呈负相关,但与IL-6、MMP-3、MMP-9呈正相关趋势.治疗后瘦素与MMP-3呈正相关（r=0.86,P=0.01）.大动脉炎患者血清抵抗素水平升高独立于ESR和CRP.结论 瘦素与大动脉炎血管壁损伤、抵抗素与血管炎症的相关性较强,有望成为疾病病情评估的指标.

Objective To investigate the circulating levels of leptin,resistin,visfatin,total adiponectin and their relationships with disease activity and vascular inflammation in patients with Takayasu arteritis （TA）.Methods Fifty-nine consecutive patients with TA and forty age-matched healthy women were enrolled.Serum adipokine levels were measured with enzyme immunoassay kits and inflammation indicators were simultane ously examined including erythrocyte sedimentation rate （ESR）,C-reactive protein （CRP）,fibrinogen,interleukin （IL）-6 and matrix metalloprotease （MMP）-3/MMP-9.The Mann-Whitney U test,x2 test and Spearman correlation coefficient were used for statistical analysis.Results The serum leptin[（25±16） ng/ml vs （7±5）ng/ml,U=300.00,P〈0.01] and resistin[（11.5±8.3） ng/ml vs （2.2±1.3） ng/ml,U=120.00,P〈0.01] concentrations in patients with TA were significantly higher than those in healthy control women.There were no obvious differences between the above two groups in regard to serum total adiponectin and visfatin levels.In the untreated TA subgroup,leptin showed mildly negative association with fibrinogen （r=-0.42,P=0.03）,ESR （r=-0.35,P=0.03） and CRP（r=-0.36,P=0.03）,but it tended to be positively related to IL-6 and MMP-3/MMP-9.In the treated subgroup,leptin was positively associated with MMP-3 （r=0.86,P=0.01） to a significant extent.Furthermore,serum resistin level was found to rise independently on ESR and CRP.Conclusion Leptin and resistin may contribute to vascular inflammation and injury.They may be used as biomarkers for monitoring disease activity of TA.