系统性红斑狼疮患者血清瘦素和可溶性瘦素受体的检测及意义

Detection of serum leptin and soluble leptin receptor levels and its significance in patients with systemic lupus erythematosus

目的探讨血清瘦素(leptin,Lp)和可溶性瘦素受体(soluble leptin receptor,s LR)与系统性红斑狼疮(systemic lupus erythematosus,SLE)发病及病情的关系。方法采用ELISA方法检测大连医科大学附属第一医院风湿科收治的87例SLE患者和85例健康对照者血清Lp和s LR浓度,并将SLE患者分为活动期组和稳定期组、合并狼疮肾炎组和无狼疮肾炎组、合并关节症状组和无关节症状组分别进行统计分析。分析SLE患者血清Lp和s LR水平与病程、体重指数(BMI)、血沉、血红蛋白、血小板、抗核抗体、抗双链DNA抗体、免疫球蛋白(Ig G、Ig A、Ig M)、补体(C3、C4)、SLEDAI评分等临床指标的相关性。结果 SLE组血清Lp水平(7.06±3.19)ng/m L高于健康对照组(5.36±2.66)ng/m L(P<0.05);血清s LR水平与健康对照组差异无显著性意义(P>0.05)。血清Lp和s LR水平在SLE活动期组和稳定期组,狼疮肾炎组和无狼疮肾炎组,有关节症状和无关节症状组均无明显差异(P>0.05)。SLE患者血清Lp水平与BMI呈正相关(r=0.375,P=0.022),与s LR呈负相关(r=-0.219,P=0.041)。SLE患者血清s LR水平与血沉、Ig G、Ig A、Ig M均呈正相关(r=0.387,P=0.001;r=0.336,P=0.009;r=0.331,P=0.010;r=0.366,P=0.004),与其它临床指标无相关性。结论 SLE患者血清Lp水平显著升高,Lp的水平变化可能与SLE的发病密切相关,但血清Lp和s LR浓度尚不能作为SLE病情评价及监测的指标。

Objective To investigate the serum levels of leptin and soluble leptin receptor in patients with systemic lupus erythematosus（ SLE） and to analyze their correlation with SLE disease activity and clinical parameters. Methods Serum leptin and soluble leptin receptor levels of 87 patients with SLE and 85 matched healthy controls were measured by ELISA assays. The liner correlation analysis was used to evaluate the relationship between levels of leptin and soluble leptin receptor with their clinical parameters. Results Compared to normal controls,serum level of leptin was significant higher in SLE patients [（ 7. 06 ± 3. 19） ng / m L vs.（ 5. 36 ± 2. 66） ng / m L,P〈0. 05]. No significant difference was found in soluble leptin receptor levels between SLE patients and controls. Furthermore there were no differences in the levels of leptin and soluble leptin receptor between active and inactive SLE patients,patients with and without lupus nephritis（ LN） and patient with and without arthritis,respectively. A positive association was observed between leptin levels in SLE patients and body mass index（ BMI）（ r = 0. 375,P = 0. 022）; a negative correlation was observed between leptin and soluble leptin receptor levels in SLE patients（ r =- 0. 219,P = 0. 041）. The serum soluble leptin receptor levels were positively correlated with ESR,Ig G,Ig A and Ig M（ r = 0. 387,P = 0. 001; r = 0. 336,P = 0. 009; r = 0. 331,P = 0. 010; r = 0. 366,P =0. 004,respectively）. Conclusion Abnormal levels of leptin might be involved in the pathogenesis of SLE. However,levels of serum leptin and soluble leptin receptor could not be used as a clinical index to evaluate the severity of SLE.