系统性红斑狼疮及类风湿关节炎抗C1q抗体和血脂水平与疾病活动度的关系

Association of anti-C1q antibody and blood lipid levels with disease activity in systemic lupus erythematosus and rheumatoid arthritis

目的检测和分析系统性红斑狼疮(SLE)和类风湿关节炎(RA)患者血清中抗C1q抗体和血脂水平,探讨抗C1q抗体对判断SLE和RA活动性的意义,同时观察SLE和RA患者的血脂水平变化。方法收集2016年6月—2017年3月在天津医科大学总医院住院和门诊的70例SLE患者(包括SLE活动期36例、SLE缓解期34例)、62例RA患者(包括RA活动期32例、RA缓解期30例)及2016年9月—2017年3月在该院体检中心体检的30名健康志愿者血清进行检测分析,采用酶联免疫吸附试验(ELISA)检测血清中抗C1q抗体,酶比色法检测血清中血脂指标〔包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕,比较各组上述指标差异,分析抗C1q抗体与观察指标的相关性。结果SLE患者的血清抗C1q抗体和TG水平均明显高于对照组;SLE活动期患者血清抗C1q抗体水平明显高于缓解期患者(kU/L:13.47±9.58比6.37±4.12,P<0.01),血清HDL-C水平明显低于对照组和缓解期患者(mmol/L:1.02±0.31比1.31±0.42、1.29±0.51,均P<0.05)。RA活动期患者血清TG水平明显高于对照组和缓解组(mmol/L:1.55±1.12比1.17±0.21、1.02±0.37,均P<0.05),血清HDL-C水平明显低于对照组和缓解组(mmol/L:0.91±0.24比1.31±0.42、1.27±0.46,均P<0.05)。SLE血清抗C1q抗体与C3、C4和HDL-C均呈负相关(r值分别为-0.640、-0.479、-0.361,P值分别为0.006、0.008、0.009),与血细胞沉降率(ESR)、C-反应蛋白(CRP)、抗双链DNA(dsDNA)抗体及TG均呈正相关(r值分别为0.257、0.272、0.424、0.237,P值分别为0.031、0.037、0.008、0.044)。RA血清抗C1q抗体水平与C3、C4呈负相关(r值分别为-0.394、-0.267,P值分别为0.009、0.043),与血脂指标无相关性。结论检测血清抗C1q抗体有助于判断SLE活动性,SLE和RA患者均存在明显血脂异常。

Objective To detect and analyze the levels of anti-C1q antibody and blood lipids in serum from patients with systemic lupus erythematosus(SLE)and rheumatoid arthritis(RA),to explore the significance of anti-C1q antibody in judging the activity of SLE and RA,and to observe the level of blood lipids in SLE and RA patients.Methods Serum from 70 SLE patients(including 36 cases in active stage and 34 cases in remission stage)and 62 RA patients(including 32 cases in active stage and 30 cases in remission stage)who were inpatients and outpatients in Tianjin Medical University General Hospital from June 2016 to March 2017,and from 30 healthy volunteers in physical examination center of the hospital from September 2016 to March 2017 were tested and analyzed.The level of anti-C1q antibody was detected by enzyme linked immunosorbent assay(ELISA).The levels of blood lipids[including total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)]were measured by enzyme colorimetry.The above indices in each group were compared,and the correlation between anti-C1q antibody and observed indexes was analyzed.Results The levels of anti-C1q antibody and TG in SLE patients were higher than those in control group.The level of anti-C1q antibody in SLE active patients was higher than that in remission group(kU/L:13.47±9.58 vs.6.37±4.12,P<0.01).The HDL-C level of SLE patients in active group was lower than that in control group and remission group(mmol/L:1.02±0.31 vs.1.31±0.42,1.29±0.51,all P<0.05).The level of TG in RA active patients was higher than that in control group and remission group(mmol/L:1.55±1.12 vs.1.17±0.21,1.02±0.37,both P<0.05).The level of HDL-C was lower than that of control group and remission group(mmol/L:0.91±0.24 vs.1.31±0.42,1.27±0.46,both P<0.05).Anti-C1q serum antibodies in SLE patients were negatively correlated with the levels of C3,C4 and HDL-C(r=-0.640,-0.479,-0.361,P=0.006,0.008,0.009).In addition,it was positively correlated with ESR,CRP,anti-dsDNA antibody and TG(r=0.257,0.272,0.424,0.237,P=0.031,0.037,0.008,0.044).Serum anti-C1q antibody level in RA group was negatively correlated with C3 and C4(r=-0.394,-0.267,P=0.009,0.043),but not correlated with the levels of blood lipids.Conclusions The detection of serum anti-C1q antibody is helpful to judge the activity of SLE.Significant dyslipidemia in patients with SLE and RA could be observed.