系统性红斑狼疮患者血清抵抗素的表达及临床应用价值

Expression and clinical application value of serum resistin in patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者血清抵抗素(resistin)的表达水平及临床应用价值。方法收集2023年1月至8月南京中医药大学鼓楼临床医学院就诊的45例SLE患者,按照SLE活动度评分表(SLEDAI)对患者进行活动性评分和分组,其中SLEDAI值<9分为非活动组(n=32例),SLEDAI值≥9分为活动组(n=13例)。另收集34例体检健康者作为健康人对照者。收集并检测SLE患者及健康人对照者的临床资料和实验室相关指标(尿蛋白、血清补体C3);采用ELISA法测定各组血清抵抗素水平;应用ROC曲线评估抵抗素对SLE的临床筛查价值;应用Pearson相关法分析血清抵抗素水平与各项实验室指标的相关性。结果SLE患者血清抵抗素水平显著高于健康人对照者[(7.64±0.64)ng/mL vs(2.56±0.43)ng/mL],差异具有统计学意义(t=6.195,P<0.01);SLE疾病活动性患者血清抵抗素水平明显高于SLE疾病非活动性患者[(10.10±1.45 ng/mL)vs(6.64±0.60 ng/mL)],差异有统计学意义(t=2.632,P<0.05);血清抵抗素筛查SLE的ROC曲线面积(AUC ROC)为0.897,当cut-off值为5.893 ng/mL时,其敏感性为86.67%,特异性为82.35%。SLE患者血清抵抗素水平与尿蛋白呈正相关(r=0.692,P<0.01),而与血清补体C3呈负相关(r=-0.354,P<0.05)。结论SLE患者血清抵抗素的表达水平显著增高,且与SLE疾病活动度及尿蛋白呈正相关。抵抗素或可成为SLE诊断和疗效判断的新型生物学标志物。

Objective To investigate the expression level and clinical application value of serum resistin in patients with systemic lupus erythematosus(SLE).Methods Forty-five SLE patients visited Nanjing Drum Tower Hospital,Clinical College of Nanjing University of Chinese Medicine from January to August 2023 were enrolled in the study.The patients were scored and grouped according to the SLE disease activity index(SLEDAI),with SLEDAI<9 score in the inactive group(n=32)and SLEDAI≥9 score in the active group(n=13).Thirty-four healthy individuals who underwent physical examination in our hospital were recruited as healthy controls.The clinical data and laboratory related indicators such as urine protein and serum complement C3 levels were collected from SLE patients and healthy controls.Serum resistin levels were detected by enzyme-linked immunosorbent assay(ELISA).The clinical screening value of serum resistin for SLE was evaluated with the receiver operating characteristic(ROC)curve.The correlations of serum resistin levels with different laboratory indicators were determined by Pearson correlation analysis.Results The serum resistin levels in SLE patients([7.64±0.64]ng/mL)were significantly higher than that in healthy controls([2.56±0.43]ng/mL),and the difference was statistically significant(t=6.195,P<0.01).The serum resistin levels in active SLE patients([10.10±1.45]ng/mL)were significantly higher than that in inactive SLE patients([6.64±0.60]ng/mL),and the difference was statistically significant(t=2.632,P<0.05).The area under the ROC curve(AUC ROC)of serum resistin for screening SLE was 0.897.When the cut-off value was 5.893 ng/mL,the sensitivity was 86.67%and the specificity was 82.35%.The serum resistin level in SLE patients was positively correlated with urine protein(r=0.692,P<0.01),while negatively correlated with serum complement C3(r=-0.354,P<0.05).Conclusion The expression levels of serum resistin in SLE patients are significantly increased and positively correlated with SLE disease activity and urine protein.Serum resistin may become a novel biomarker for the diagnosis and therapeutic effect assessment of SLE.