慢性精神分裂症患者血浆白介素17与糖脂代谢的相关性研究

Relationship between IL-17 Level and Glycolipid Metabolism in Patients with Chronic Schizophrenia

背景精神分裂症的发病机制与炎症密切相关,而炎症水平与代谢水平密切相关。白介素(IL)-17是重要的炎症早期启动因子,其与精神分裂症患者糖脂代谢的关系值得研究。目的探究慢性精神分裂症患者血浆IL-17水平与糖脂代谢的关系。方法选取2018年4-6月安徽医科大学附属巢湖医院、合肥市第四人民医院、马鞍山市第四人民医院收治的符合研究标准的慢性精神分裂症患者为研究对象。依据患者血浆IL-17水平的四分位点,将其分为IL-17高水平组(≥P75)和IL-17低水平组(<P75)。比较IL-17高水平组和IL-17低水平组患者一般资料,包括社会人口学资料和临床资料〔部分住院电子病历资料、糖脂代谢指标、阳性和阴性症状量表(PANSS)及其分量表得分〕,分析血浆IL-17水平与糖脂代谢指标间的关系,并探究慢性精神分裂症患者血浆IL-17水平的影响因素。结果本研究共纳入327例慢性精神分裂症患者,其中IL-17高水平组患者82例〔IL-17为33.20(51.82)ng/L〕、IL-17低水平组患者245例〔IL-17为2.69(2.39)ng/L〕。两组患者性别、年龄、婚姻状况、受教育年限、总病程、糖尿病史比例、氯丙嗪当量、总胆固醇水平、三酰甘油水平、低密度脂蛋白(LDL)水平、空腹血糖水平、PANSS总分及其各分量表得分比较,差异无统计学意义(P>0.05);两组患者发病年龄、高密度脂蛋白(HDL)水平、胰岛素水平、胰高血糖素水平比较,差异有统计学意义(P<0.05)。Spearman秩相关分析显示,血浆IL-17水平与HDL(rs=0.179,P=0.001)、胰高血糖素水平(rs=0.155,P=0.005)呈正相关。二元Logistic回归分析结果显示,HDL〔OR=6.24,95%CI(2.31,16.86),P<0.001〕、胰岛素〔OR=1.05,95%CI(1.01,1.10),P=0.021〕是慢性精神分裂症患者血浆IL-17水平的影响因素。结论IL-17高水平的慢性精神分裂症患者胰岛素、胰高血糖素、HDL水平更高,且血浆IL-17水平与糖脂代谢存在关联。

Background The pathogenesis of schizophrenia is closely related to inflammation,whose stage has a strong link with metabolic level,so the relationship of IL-17,an important early inflammatory promoter,with glycolipid metabolism in schizophrenics is worth studying.Objective To explore the relationship between plasma IL-17 level and glycolipid metabolism in patients with chronic schizophrenia.Methods Patients with chronic schizophrenia who met the study criteria were selected from Chaohu Hospital of Anhui Medical University,Hefei Fourth People's Hospital and Maanshan Fourth People's Hospital from April to June 2018.According to the quartile of plasma IL-17 level,they were divided into high IL-17(≥P75),and low IL-17(<P75)groups.And intergroup differences in the general data,including socio-demographic data,and clinical data〔partial electronic medical records of hospitalization,glucose and lipid metabolism indices,Positive and Negative Syndrome Scale(PANSS)and its subscale scores〕were analyzed.The relationships of plasma IL-17 level and glucose and lipid metabolic indices were estimated.The influencing factors of plasma IL-17 level were explored.Results A total of 327 patients were enrolled,including 82 with high level of IL-17〔33.20(51.82)ng/L〕and 245 with low level of IL-17〔2.69(2.39)ng/L〕.High and low IL-17 groups had no significant differences in sex ratio,distribution of marital status,prevalence of previous or present diabetes,average fasting blood glucose and scale and subscale scores of PANSS,and median age,years of education,duration of chronic schizophrenia,chlorpromazine equivalent,total cholesterol,triglyceride,and low-density lipoprotein(P>0.05),but showed significant differences in average age of onset,high-density lipoprotein(HDL)level,insulin and glucagon levels(P<0.05).Spearman correlation analysis showed that plasma IL-17 level was positively correlated with HDL(rs=0.179,P=0.001)and glucagon levels(rs=0.155,P=0.005).Binary Logistic regression analysis showed that,HDL level〔OR=6.24,95%CI(2.31,16.86),P<0.001〕and insulin level〔OR=1.05,95%CI(1.01,1.10),P=0.021〕were the influencing factors of plasma IL-17 level.Conclusion In chronic schizophrenia patients,high plasma IL-17 level was associated with higher levels of insulin,glucagon and HDL,and IL-17 may be associated with glucose and lipid metabolism.