CAJ | 학술논문

目的探讨类风湿关节炎(RA)患者外周血瘦素(LEP)和可溶性瘦素受体(sLEP-R)水平的变化及其与RA患者的骨质疏松间的相关性.方法采用酶联免疫吸附试验(ELISA)法测定64例RA患者和60名健康人外周血中LEP和sLEP-R水平,采用双能X线骨密度吸收仪测定骨密度,分析RA患者中LEP和sLEP-R水平的变化与RA患者骨密度、骨质疏松发生之间的相关性.结果 ①和健康对照组相比,RA组外周血LEP水平明显升高,sLEP-R水平明显降低(P<0.01).②RA患者各测定部位的骨密度均明显低于健康对照组(P<0.01),其骨质疏松发生率为35.9%,明显高于健康对照组中的15.0%(P<0.01).③RA患者外周血LEP水平与年龄呈正直线相关(P<0.01),与各测定部位骨密度呈负相关(P<0.05).RA患者外周血sLEP-R水平与年龄呈负相关(P<0.01),与各测定部位骨密度呈正相关(P<0.05).RA患者外周血LEP或sLEP-R水平与患者的临床及实验室指标间均无相关(P>0.05).④Logistic Regression多元回归法分析显示:外周血sLEP-R水平为RA患者中骨质疏松发生的独立的保护因素,OR=3.089,P=0.017,CI95%:0.017～7.108.结论 RA患者外周血LEP水平明显升高,sLEP-R水平明显降低,它们的变化与骨代谢状态的变化密切相关.外周sLEP-R水平为RA患者中骨质疏松发生的独立的保护因素.
목적 탐토류풍습관절염(RA)환자외주혈수소(LEP)화가용성수소수체(sLEP-R)수평적변화급기여RA환자적골질소송간적상관성.방법 채용매련면역흡부시험(ELISA)법측정64례RA환자화60명건강인외주혈중LEP화sLEP-R수평,채용쌍능X선골밀도흡수의측정골밀도,분석RA환자중LEP화sLEP-R수평적변화여RA환자골밀도、골질소송발생지간적상관성.결과 ①화건강대조조상비,RA조외주혈LEP수평명현승고,sLEP-R수평명현강저(P<0.01).②RA환자각측정부위적골밀도균명현저우건강대조조(P<0.01),기골질소송발생솔위35.9%,명현고우건강대조조중적15.0%(P<0.01).③RA환자외주혈LEP수평여년령정정직선상관(P<0.01),여각측정부위골밀도정부상관(P<0.05).RA환자외주혈sLEP-R수평여년령정부상관(P<0.01),여각측정부위골밀도정정상관(P<0.05).RA환자외주혈LEP혹sLEP-R수평여환자적림상급실험실지표간균무상관(P>0.05).④Logistic Regression다원회귀법분석현시:외주혈sLEP-R수평위RA환자중골질소송발생적독립적보호인소,OR=3.089,P=0.017,CI95%:0.017～7.108.결론 RA환자외주혈LEP수평명현승고,sLEP-R수평명현강저,타문적변화여골대사상태적변화밀절상관.외주sLEP-R수평위RA환자중골질소송발생적독립적보호인소.
Objective To determine the level of ieptin (LEP) and soluable leptin receptor (sLEP-R) in the peripheral blood of rheumatoid arthritis (RA). The change of LEP/sLEP-R in patients with RA and the relationship between LEP/sLEP-R with osteoporosis is also investigated. Methods Sixty-four patients with RA and 60 normal controls were involved. Levels of LEP and sLEP-R were measured by ELISA. Bone mineral density (BMD) of non-dominant forearm, lumbar vertebrae(L_(1～4)) and hip were measured by dual energy X-ray absorptiometry. Results ① Compared with normal controls, the level of LEP in RA increased significantly,but the level of sLEP-R in RA decreased significantly (P<0.01). ② BMD of all detected regions in RA were significantly reduced than those in the normal controls (P<0.01). There was a higher incidence of osteoporosis in patients with RA (35.9%) than in normal controls (15.0%)(P<0.01). ③ There was a positive lineary correlation between age and the level of LEP in the peripheral blood of RA (P<0.01). There was negative lineary correlations between BMD and level of LEP in the peripheral blood of RA (P<0.05). There was a negative lineary correlation between age and level of sLEP-R in the peripheral blood of RA (P<0.01). There was positive lineary correlation between BMD and level of sLEP-R in the peripheral blood of RA (P<0.05). There was no correlations between clinical or laboratory parameters and level of LEP/sLEP-R in the peripheral blood of RA. ④ Analysis of Logistic Regression showed that the level of sLEP-R in the peripheral blood of RA was an independent protective factor for the occurrence of osteoporosis in RA (OR=3.089, P=0.017, 95%CI: 0.017-7.108). Conclusion The level of LEP in RA increases significantly, while the level of sLEP-R decreases significantly. There is a closely correlation between bone metabolism status and the level of LEP or sLEP-R in RA. The level of sLEP-R in the peripheral blood of RA is an independent protective factor for the occurrence of osteoporosis in RA.