胰岛素样生长因子结合蛋白-6在类风湿关节炎患者外周血中的表达及意义

Expression and Clinical Value of Insulin-Like Growth Factor Binding Protein-6 in Patients with Rheumatoid Arthritis

目的探讨胰岛素样生长因子结合蛋白-6(IGFBP-6)在类风湿关节炎(RA)发病机制中的作用和临床意义。方法采用酶联免疫吸附法检测43例RA患者和25例健康对照者外周血中IGFBP-6水平,并收集RA组的临床及实验室指标,包括肿胀关节数、压痛关节数、C反应蛋白、红细胞沉降率、类风湿因子、抗环瓜氨酸肽抗体、血常规指标等。计算28个关节的疾病活动度评分(DAS28),根据DAS28将RA组分为高疾病活动组(DAS28>5.1)、中疾病活动组(DAS283.2~5.1)和低疾病活动组(DAS28<3.2),并进行分析。结果RA组外周血中IGFBP-6水平显著低于健康对照组(P<0.001)。低、中及高疾病活动组IGFBP-6水平均显著低于健康对照组(P<0.001),且低疾病活动组的IGFBP-6水平显著高于高疾病活动组(P<0.05)。RA组IGFBP-6水平与血红蛋白呈正相关(P<0.05),与血小板、红细胞沉降率、DAS28呈负相关(P<0.05),与抗环瓜氨酸肽抗体和类风湿因子的相关性无统计学意义。结论IGFBP-6可能在RA的发生发展过程中发挥保护作用,且RA患者外周血中IGFBP-6表达水平在一定程度上可反映疾病活动度。

Objective To examine the role and clinical value of insulin-like growth factor binding protein-6(IGFBP-6)in the pathogenesis of rheumatoid arthritis(RA).Methods The levels of IGFBP-6 in the serum of 43 patients with RA and 25 healthy controls(HC)were determined using ELISA.Data collected from the RA group included swollen and tender joint counts,erythrocyte sedimentation rate(ESR),levels of C-reactive protein(CRP),rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody,and routine blood indicators.Based on a disease activity score of 28 joints(DAS28),the patients in the RA group were divided into high(DAS28>5.1),medium(DAS283.2 to 5.1),and low disease activity(DAS28<3.2)groups.Results Compared with the HC group,the level of IGFBP-6 decreased in the RA group(P<0.001)and each disease activity group(P<0.001).The level of IGFBP-6 in the low disease activity group was higher than that in the high disease activity group(P<0.05).In addition,the level of IGFBP-6 in the RA group positively correlated with hemoglobin,while it negatively correlated with platelets,ESR,and DAS28(P<0.05).No relationship was found between the level of IGFBP-6 and CRP,RF,and anti-CCP antibody.Conclusion IGFBP-6 may play a protective role in the development of RA,which is associated with disease activity.