类风湿关节炎患者血清维生素D水平与IL-10、IL-37、IL-6和IL-17的相关性分析

Correlation analysis of serum vitamin D level with IL-10,IL-37,IL-6 and IL-17 in patients with rheumatoid arthritis

目的检测不同病程类风湿关节炎(RA)患者血清中维生素D、血清抑炎细胞因子白细胞介素(IL)-10和IL-37与炎症细胞因子IL-6和IL-17水平,对维生素D与炎症相关因子相关性进行分析。方法将112例确诊为RA的患者设为观察组,根据疾病活动度评分(DAS28)分为缓解组、低度组、中度组和重度组,选取32例体检健康者作为对照组。使用化学发光法检测维生素D水平,酶联免疫吸附试验检测各组IL-10、IL-37、IL-6和IL-17水平。采集临床一般资料进行相关性分析。结果观察组血清中维生素D水平明显低于对照组,随着病情加重,维生素D水平逐渐下降,且各组间差异有统计学意义(P<0.05)。观察组4种细胞因子水平均明显高于对照组,差异有统计学意义(P<0.05);随病情加重,4种细胞因子呈上升趋势,各组间比较差异有统计学意义(P<0.05),但IL-10水平差异无统计学意义(P>0.05),缓解组IL-37、IL-6和IL-17水平均明显高于对照组,差异有统计学意义(P<0.05)。对照组血清维生素D水平与抑炎细胞因子IL-10和IL-37及炎性细胞因子IL-6和IL-17水平之间不相关(P>0.05),观察组各组维生素D水平与IL-10水平不相关(P>0.05),缓解组维生素D水平与IL-10、IL-37、IL-6和IL-17水平之间不相关(P>0.05);低度组、中度组和重度组维生素D水平与IL-37、IL-6和IL-17水平之间均呈负相关(r=-0.6165^-0.3472,P<0.05)。结论维生素D与不同病程RA患者血清中抑炎细胞因子IL-10和IL-37与炎症细胞因子IL-6和IL-17水平存在相关性,提示维生素D参与调节炎症相关细胞因子水平,影响RA的进程,检测其表达水平对RA的病情变化具有重要的临床意义。

Objective To detect the levels of vitamin D,serum anti-inflammatory cytokines interleukin(IL)-10 and IL-37 and inflammatory cytokines IL-6 and IL-17 in patients with rheumatoid arthritis(RA)in different course of disease,and to analyze the correlation between vitamin D and inflammation-related factors.Methods Totally 112 patients with RA were enrolled in the observation group.According to the disease activity score(DAS28),they were divided into the the remission group,the low degree group,the moderate group and the high degree group,32 healthy people were selected as the control group.The level of vitamin D was detected by chemiluminescence,and the levels of IL-10,IL-37,IL-6 and IL-17 in each group were detected by enzyme-linked immunosorbent assay.Clinical general data were collected for correlation analysis.Results Serum vitamin D level in the observation group were significantly lower than that in the control group.With the aggravation of the disease,the vitamin D level of each group gradually decreased,and the differences between the groups were statistically significant(P<0.05).The levels of four cytokines in the observation group were significantly higher than those in the control group,and the difference were statistically significant(P<0.05).The four cytokines showed an increasing trend with the aggravation of the disease,and the differences between the groups were statistically significant(P<0.05),but there was no statistically significant difference in IL-10 level(P>0.05).The levels of IL-37,IL-6 and IL-17 in the remission group were significantly higher than those in the control group,and the difference were statistically significant(P<0.05).There was no correlation between serum vitamin D level and IL-10,IL-37,IL-6 and IL-17 levels in the control group(P>0.05),no correlation between the level of vitamin D and the level of IL-10 in the observation group(P>0.05),and no correlation between vitamin D and IL-10,IL-37,IL-6 and IL-17 levels in the remission group(P>0.05).There were negative correlations between vitamin D and IL-37,IL-6 and IL-17 levels in the low degree group,the moderate group and the high degree group(r=-0.6165--0.3472,P<0.05).Conclusion There is a correlation between vitamin D and the levels of IL-10,IL-37,IL-6 and IL-17 in serum of RA patients with different course of disease,suggesting that vitamin D plays an important role in the regulation of inflammatory cytokines and affects the progression of RA.It is of great clinical significance to detect the expression level of vitamin D in RA.