强直性脊柱炎患者肥胖与炎性指标、疾病严重程度指标和心血管疾患危险因素指标相关性分析

Correlation between obesity and inflammatory indicators,disease severity indicators and cardiovascular disease risk factors in patients with ankylosing spondylitis

目的:探讨强直性脊柱炎患者肥胖与炎性指标、疾病严重程度指标和心血管疾患危险因素指标之间的相关性。方法:强直性脊柱炎患者125例,根据体重指数(BMI)分为BMI 1组(体重过低,BMI<18.5 kg/m^(2))共36例,BMI 2组(体重正常,BMI 18.5~23.9 kg/m^(2))共63例,BMI 3组(超重,BMI≥24 kg/m^(2))共26例;比较不同BMI组强直性脊柱炎患者炎性因子(血沉、CRP、TNF-α、IL-2)、病情相关指标[晨僵时间、枕墙距、指地距、强直性脊柱炎疾病活动指数(BASDAI)、强直性脊柱炎疾病功能指数(BASFI)、胸廓扩张度、腰椎活动度等]及心血管疾患危险因素指标(包括收缩压和舒张压、空腹血糖、总胆固醇、甘油三酯)等差异,采用Pearson法分析BMI与炎症、疾病严重程度和心血管疾患危险因素指标的相关性。结果:BMI 1组、BMI 2组和BMI 3组患者间的心血管疾患危险因素指标、炎性因子、晨僵时间、枕墙距、指地距有逐渐增高趋势(均P<0.01),而血沉、BASFI、BASDAI、胸廓扩张度、腰椎活动度有逐渐下降趋势(均P<0.01)。BMI与强直性脊柱炎患者的胸廓扩张度、腰椎活动度(Schober试验)呈负直线相关(r=-0.608、-0.617,均P<0.05),与晨僵持续时间呈正直线相关(r=0.712,P<0.05)。结论:不同BMI水平强直性脊柱炎患者在心血管疾患危险因素相关指标、炎性反应指标、疾病严重程度指标上存在一定的差异,仅肥胖与强直性脊柱炎病情严重程度存在内在联系,故减肥可能为降低疾病活动性和改善患者功能的一个有效途径。

Objective:To investigate the relationship between obesity and inflammatory indicators,disease severity indicators and cardiovascular disease risk factors in patients with ankylosing spondylitis.Methods:125 patients with ankylosing spondylitis were divided into BMI 1 group(underweight,BMI<18.5 kg/m^(2),36 cases),BMI 2 group(normal weight,BMI 18.5~23.9 kg/m^(2),63 cases),and BMI 3 group(overweight,BMI≥24 kg/m^(2),26 cases)according to BMI.The inflammatory factors(ESR,CRP,TNF-α,IL-2),disease-related indicators(morning stiffness,occipital wall distance,finger ground distance,BASDAI,BASFI,thoracic expansion,lumbar spine mobility)and cardiovascular disease risk factors(systolic and diastolic blood pressure,fasting blood glucose,total cholesterol,triglycerides)were compared among three groups.Pearson method was used to analyze the correlation between BMI and inflammatory indicators,disease severity indicators and cardiovascular disease risk factors.Results:The cardiovascular disease risk factors,inflammatory factors,morning stiffness,occipital wall distance,and finger ground distance among patients in BMI 1,BMI 2 and BMI 3 groups gradually increased(all P<0.01),while ESR,BASFI,BASDAI,thoracic expansion and lumbar spine mobility showed a gradual decrease(all P<0.01).BMI had a negative linear correlation with the thoracic expansion and lumbar spine mobility(Schober test)in patients with ankylosing spondylitis(r=-0.608,-0.617,both P<0.05),and a positive linear correlation with the duration of morning stiffness(r=0.712,P<0.05).Conclusion:Ankylosing spondylitis patients with different BMI levels have certain differences in cardiovascular risk factors related indicators,inflammatory indicators,and disease severity indicators.Only obesity is intrinsically related to the severity of ankylosing spondylitis,so weight loss is an possible effective way to reduce disease activity and improve patient function.