外周血脂联素在类风湿关节炎疾病骨与关节损伤中的临床意义

Clinical significance of serum adiponectin on bone and joint damage in patients with rheumatoid arthritis

目的探讨类风湿关节炎(RA)患者外周血脂联素(AD)水平的变化及其与RA患者骨与关节损伤之间的相关性。方法观察38例RA患者和34例健康对照组的年龄和身体质量指数(BMI),所有RA患者摄双手X线检查并进行Sharp评分。详细记录RA患者的各项临床及实验室指标,包括病程、关节肿胀数、关节压痛数、C-反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP)、自评分、28个关节的疾病活动度评分(DAS28评分);采用酶联免疫吸附试验(ELISA)检测38例RA患者和34例正常人外周血AD水平并进行对比分析。结果 RA患者血清中AD水平高于对照组[(17.5±7.5)μg/mL vs.(13.6±5.5)μg/mL,P=0.015];AD水平与年龄呈正相关(r=0.327,P=0.045);与病程、BMI、关节肿胀数、关节压痛数、血沉、CRP、RF、抗CCP、自评分、DAS28评分均无相关性(P>0.05);血清AD水平与双手X片关节骨侵蚀评分、双手X片关节间隙狭窄评分和双手X片Sharp评分均无相关性。结论 RA患者血清中AD水平较正常人明显增高,提示血清AD水平可以做为RA患者的生物标志物,RA患者血清AD水平与疾病活动度无关,与骨和关节的损伤也无相关性。

Objective To examine lhe plasma of adiponeclin （ AD） levels in palienls wilh rheumaloid arlhrilis （ RA） and invesligale lhe relalionship belween AD and bone and joinl damage. Methods Thirly eighl palienls wilh RA and 34 heallhy individuals were recruiled inlo lhis research. Radiographs of lwo hands in all lhe palienls wilh RA were evalualed according lo lhe Sharp＇s melhod. Delailed clinical and laboralory indicalors of RA palienls were recorded, including course of disease, joinl swelling, joinl lenderness, C-reaclive prolein （ CRP）, ESR, rheumaloid faclor （ RF）, anli-cyclic cilrullinaled peplide anlibody （ anli-CCP）, self-score and 28 joinl diseases aclivily score （ DAS28 score）. The levels of serum AD in 38 palienls wilh RA and 34 heallhy individuals were delecled wilh enzyme-linked immunosorbenl assay （ ELISA）, and lhe dala of lhe lwo groups were compared. Results The level of serum AD in RA palienls was significanlly higher lhan lhal in heallhyindividuals[（17.5±7.5）滋 g/mL vs. （13.6±5.5）滋 g/mL, P=0.015].TheserumADlevelwasposilivelyrelaledwilhage （ r=0.327, P=0.045）, and lhey were uncorrelaled wilh lhe course of disease, BMI, number of swollen joinls, joinl lenderness, ESR, CRP, RF, anli-CCP and DAS28 scores （ P〉0.05）. The serum AD level has no correlalion wilh bolh hands X-ray joinl bone erosion score, bolh hands X-ray joinl space narrowing score and bolh hands X-slice Sharp score. Conclusion Serum AD levels in RA palienls are significanlly higher lhan lhose in lhe normal people, il indicaled lhal serum AD levels may be served as a biomarker in RA palienls. Serum AD levels in palienls wilh RA has nolhing lo do wilh disease aclivily, and has no correlalion wilh bone and joinl damage.